Sticking To The Weights :: essays research papers

1†¦2†¦3†¦4†¦5. I had to get stronger before the next basketball season at La Puente High School. I was pushing myself hard when it came to lifting weights and running. I thought I could catch up with all the time I missed during the last six weeks of last year. I was out of the end of the season last year from a torn muscle in my hip. I knew I was weak and out of shape compared to the other players that were going to be on the team next season. I pushed myself very hard for the first couple of weeks. Because I worked myself so hard I began to slowly push it away from my to do list.   Ã‚  Ã‚  Ã‚  Ã‚  I started to set my sets and repetitions lower and lower till I just wasn’t doing it anymore. I had that whole summer that I was really looking forward to. I wanted to come back the next season and be in better shape then I’ve ever been. I also wanted to show my coach that I never quit not even in my off-season. That wasn’t the way it went though. I wasted time and a lot of it. I wasted time with weight lifting and also a jumping program that I got that guaranteed a 10-12 inch gain in my vertical jump. The last few weeks of the summer my friend invited me to lift with him. He had put together a weight program that we did the rest of the summer.   Ã‚  Ã‚  Ã‚  Ã‚  Just those last few weeks of the summer my friend and I were really seeing how we were getting stronger. That really inspired us to keep working hard. The first day of school, our coach saw the changes in the both of us. He new we had been working hard and he admired that. I started to think of how I would feel if I had been working as hard as I was then, the whole summer. I started to get mad at myself for not doing what I should have been instead of sitting around all summer playing video games. After that moment I promised myself that I wouldn’t stop lifting weights. That I would always work hard. So far I’m doing really well, I haven’t stopped since I started in the summer and I’m really glad that I didn’t. That was like six weeks ago and I’m still working hard.

Into the Wild and Walden

After reading Walden, by Henry D. Thoreau and watching the movie titled, Into The Wild, written by Sean Penn, I realized how similar and different both main characters were. Christopher McCandless, the main actor in the movie and, Henry D. Thoreau, the author and main character in Walden, share many things in common however, their views on the world and motives for going on their journeys are very different from one another. These two men share complex views on life and how one should live that life. They differ in regards to how they deal with and go about living their lives. Thoreau and McCandles live their lives doing what they feel makes them happy. McCandless quotes Thoreau and says, â€Å"If you want something in life, reach out and grab it† (sc. 167). Both of their journeys were beneficial for them and taught them a lot about themselves. Both of these men went out on a quest to find themselves and give insight into how they define and live with technology, finding spiritual freedom, the necessities of life, and living life to its fullest, but it is these similarities shared between the two that they also contrast each other greatly. Both McCandless and Thoreau deal with the advancement of technology in their journeys. McCandless is the Henry D. Thoreau of the 1990s. What sets him apart from Thoreau is his view on technology. Thoreau states, â€Å"The nation itself, with all its so- called internal improvements, which, by the way, are all external and superficial†¦Ã¢â‚¬  (119). This statement is the opposite of McCandless‘ view. McCandless uses the advancements in technology to get to his final destination of Alaska. McCandless travels by train, which would have made Thoreau absolutely sick. Thoreau clearly expressed his iscussed for the railroads in Walden. McCandless also relies of cars and trucks as he hitch hikes across the country. Now in Thoreau’s time there were not these elaborate highways and cars but Thoreau would not have been happy about this. If Thoreau had a problem with the railroads in the 1800s then there is no doubt he would have not agreed with the way McCandless chose to get to Alaska. They both had technology that they relied on. They both love to read and write. Ink and books were both made from the advancements in technology over centuries. They also both had tools while out in the ilderness that they heavily relied on. They both had knives that they used all they time for cutting and cleaning food. Thoreau had a wheelbarrow and a spade, where as McCandless had a gun, and a handbook on, what was edible in nature. McCandless and Thoreau both went in search to find spiritual freedom and escape society. Thoreau recorded his two year experiment to express what he has learned about himself and society. McCandless also recorded his escape from society on his two year journey. They both were out in the wilderness alone for two years as they connected to the earth spiritually. Unlike McCandless, Thoreau never mentioned problems within his family in Walden. McCandless had another reason to escape society other than to find himself, he was escaping the violence and troubles presented in is everyday life at home. A voiceover of Carine, McCandless sister, comes on and says â€Å"Worse yet was that it was Marcia to whom he was still legally married at the time. And it was Chris and I who were the bastard children† (sc. 53). This shows how McCandless had so much more to leave behind than Thoreau did. This scene also give us insight into McCandless’s state of mind nd how much his life at home effected him. Thoreau states, â€Å" I left the woods for as good of a reason as I went there†¦I had several more lives to live, and could not spare any more time for that on† (426). Thoreau’s statement tells us how he just went for the purpose to get away from society and live in nature and solitude. McCandless had emotional problems brought on him by the instability of his family. Both Thoreau and McCandless lived with the necessities of shelter and durable clothing. They both had shelters that were made by man. McCandless lived in a bus out in he Alaskan wilderness, and Thoreau lived in a cabin at Walden pond. Thoreau and McCandless had to deal with the airiness of their homes. Thoreau says, â€Å"This was an airy and unflustered cabin, fit to entertain a traveling god†¦Ã¢â‚¬  (110). Thoreau however did have a functioning cabin where as, McCandess lived in a bus that was converted into a house. Thoreau had a more room to move around as well as better protection from the weather. McCandless lived in more open and colder environment than Thoreau had to. Both men also relied on their clothing to be durable and able to withstand the elements. The harshness of their living conditions required them to have warm and durable clothing. They did not have enough room in their bags to bring every item of clothing they owned. It had to be functional year round as well as strong enough to hold over a duration of two years of hunting and gathering. Thoreau had did not have as much variety of clothing to chose from as McCandless did. McCandless was born in a generation that made clothes in mass quantities and clothes were more accessible to everyone plus McCandless had his parents to buy him clothes over the years. Thoreau and McCandless were both college graduates that lived their lives to the fullest. Thoreau graduated from Harvard and McCandless graduated from Emory University in Atlanta, Georgia. Both men were highly educated and were very knowledgeable in many aspects but prefer not to have a job. McCandless says to Mr. Franz , â€Å"I think careers are a twentieth century invention and I don’t want one. You don’t need to worry about me. I have a college education. I’m not destitute. I’m living like this by choice† (sc. 185). They both were philosophizers and knew about the uselessness of possessions. McCandless donated twenty-six thousand dollars to Oxfam, cut up his identification card, and credit cards. Thoreau however, did not give up his possessions, he just set them off to the side until his experiment was complete. McCandless lived the last two years of his life doing what he wanted and exploring nature. He died doing what he wanted to do, not what he had to do. Although Thoreau did not die during his experiment he lived his life the same way. Thoreau knew that for one to be happy, one must live their lives doing what they want. Both men lived their lives to the fullest and did what they wanted to do. McCandless and Thoreau have learned so much about themselves and about how the world works, whether its for the better or not, while out in the wild. As these two men have traveled and lived in their final destinations they have had to deal with technology, finding spiritual freedom, the necessities of life, and living life to its fullest, to make it there. Thoreau says, â€Å"If a man does not keep pace with his companions, perhaps it is because he hears a different drummer† (430). Thoreau is saying that it does not matter how you match up to others or if you follow other people, only he or she can make their ife worth living and worth telling about. Both McCandless and Thoreau have similarities but because they are different people they also have many contrasts between them. They both benefited from their journeys and have taught us all something. The have both gained knowledge of the world and of themselves while out in the wild. They teach us that if one wants to be happy, do that which makes one happy. Their journeys are something we can all do for ourselves. And if we do go on a journey like this we wont always have the same answer for questions but will be faced with the same questions of life.

Crohns Disease Essay - 1762 Words

Crohn’s disease is a chronic condition that affects a person’s digestive system with no known cause. When Crohn’s disease strikes, it can affect any part of your digestive system ranging from your mouth, all the way to your anus. Crohn’s disease is chronic and there is no known cure for this condition. So basically, once someone is diagnosed with this condition, they might as well get used to living out the remainder of their life being affected by Crohn’s disease. Crohn’s is not, shall we say, â€Å"constant†. The symptoms happen on and off in what are usually called â€Å"flare-ups†. While there is no known cause, some people suspect that certain kinds of mycobacterium may really be the cause of Crohn’s disease, but that is just†¦show more content†¦The name for these erosions is aphthous ulcers. These erosions, after a while, start to deepen and grow in diameter. Once they reach a certain size, they can be ref erred to as ulcers. These ulcers can cause scarring and they can also cause the bowel to become stiff and lose its elasticity. As Crohn’s worsens, the bowel becomes obstructed once the passageways narrow enough. This obstruction can cause a buildup of food that is still being digested, fluid and gas that comes from the stomach. This obstruction will then prevent all of those products from entering into the colon. This will cause severe abdominal cramps, nausea, vomiting, and even abdominal distention. If the ulcers located in the walls of the bowel become large or extreme enough, holes can form in the walls of the bowel. Once those holes are formed in the bowel, the bacteria normal to the bowel can then pass through those holes and spread to nearby organs and into the abdominal cavity causing what are called fistulas. These fistulas are like a channel/tunnel that is formed between the ulcer and the adjacent organ. Then when a fistula is created between the affected intestine and the bladder, it is called an enteric-vesicular fistula which can lead to UTI’s and feces being presented during urination. Next, when the fistula is formed between the intestine and skin, it is called an enteric-cutaneous fistula. What this fistula, pus and mucous exit the body through a painful opening found in the skin of theShow MoreRelatedNo Cure for Crohns Disease1607 Words   |  6 PagesThere is no known cure for Crohns disease (CD). However, several treatment options are available to relieve the symptoms associated with the disease, ranging from dietary modification to medication and surgery (Steinhart, 2012). Diet and Nutrition: Nutrition is an important factor for patients with Crohn’s disease, and plays a big role in the management of inflammatory bowel disease and its symptoms by maintaining general health during times of disease activity and remission (Filippi et al., 2006)Read MoreInflammatory Bowel Disease/ Crohns Disease Essay1899 Words   |  8 PagesInflammatory Bowel Disease/ Crohns Disease Inflammatory bowel disease (IBD) is a group of chronic disorders that cause inflammation or ulceration in the small and large intestines. Most often IBD is classified as ulcerative colitis or Crohns disease but may be referred to as colitis, enteritis, ileitis, and proctitis. Ulcerative colitis causes ulceration and inflammation of the inner lining of a couple of really bad places, while Crohns disease is an inflammation that extends into the deeperRead MoreEssay on Analysis of Crohns Disease1176 Words   |  5 PagesAnalysis of Crohns Disease An inflammatory bowel disease is characterized by intermittent and recurrent abdominal pain associated with ulceration in bowel function. Inflammatory bowel disease is a group of chronic disorders that cause inflammation or ulceration in the small and large intestines. Most often, inflammatory bowel disease is classified as ulceration colitis or Crohn’s disease but may be referred to as colitis, enteritis, ileitis, or proctitis (Crohns disease-website). Crohn’s diseaseRead MoreThe Impacts of Crohns Disease on Daily Life722 Words   |  3 PagesAlthough people may believe that disease comes from germs and viruses around them, but with Crohn’s disease that is not the case. Crohn’s is an inflammatory bowel disease that affects the gastrointestinal (GI) tract. This disease can form, inflame, anywhere from your stomach to small intestine. Patients who struggle with Crohn’s usually would need a lifetime of care just to contain the disease; there is still not a cure, but it impacts their daily schedule. Crohn’s is a disease doctors are still to findRead MoreCrohns Disease Essay1159 Words   |  5 PagesCrohn’s Disease was named after an American gastroenterologist, Dr. Burrill Bernard Crohn, in 1932. He and his colleagues discovered an abnormal pathogen, Mycobacterium paratuberculosis while studying a related disease, ulcerative colitis, which belongs to a larger group if illnesses called Infla mmatory Bowel Disease (IBD). The discovery was made while studying the effects of ulcerative colitis in cattle and noticing the similar characteristics in humans. The infections had an abnormal responseRead MoreResearch Paper on Crohns Disease1064 Words   |  5 PagesResearch paper Crohns disease is an inflammatory bowel disease (IBD). It causes inflammation of the lining of your digestive tract, which can lead to abdominal pain, severe diarrhea and even malnutrition. Inflammation caused by Crohns disease can involve different areas of the digestive tract in different people. The inflammation caused by Crohns disease often spreads deep into the layers of affected bowel tissue. Like ulcerative colitis, another common IBD, Crohns disease can be both painfulRead MoreTaking a Look at Crohns Disease1552 Words   |  6 Pages Crohn’s Diseases is a idiopathic inflammatory bowel disease, of the gastro intestinal tract from the mouth to the anus. Crohns has an effect on people in many different forms and fashion from physiological to psychological. Depression is a major factor that comes into play with this (IBD). Patients live on the edge from day to day when dealing with spontaneous episodes of diarrhea and chronic abdominal pains. Clients may show a lack of interest in the social aspect of life due to illness, and mayRead MoreCrohnS Disease . .. .. .. .. .. .. .. .. . By: Elizabeth1594 Words   |  7 Pages Crohn s Disease By: Elizabeth Nazginov 8G1 Due: April 5th 2017 Crohn s disease is one of two conditions referred to by the term Inflammatory Bowel Disease (IBD). The other condition that is referred to as an IBD is called Ulcerative Colitis. Both Crohn’s and Ulcerative Colitis are conditions that cause recurring or persistent inflammation in one or more sections of the intestine. The literal definition ofRead MoreEssay on Overview of Crohns Disease1298 Words   |  6 PagesDescription Crohn’s disease is chronic inflammatory disease of the intestines however affects the entire digestive system, from the mouth to the anus otherwise known as the Gastrointestinal Tract (GI Tract) [1]. Individuals affected by the disease are often young adults and adolescents aged 15 – 35 [7]. Crohn’s Disease is one of the two types of Inflammatory Bowel Disorders (IBD), the other being ulcerative colitis [3] and is usually located in the lower part of the small intestines and the upperRead MoreCrohns Disease is Inflammation in the Digestive System Essay709 Words   |  3 PagesCrohn’s disease is a life-long condition effecting victims of any age. It is considered a form of an inflammatory bowel disease that causes inflammation in the digestive system. The cause of the disease is unknown. The inflammation is due to the immune system attacking the healthy cells throughout the body’s gastrointestinal tract. The exact causes of Crohn’s disease remain unknown, but most believe that factors that contribute to the disease may include genetics, immune system, environment, etc

How Media Organizations Produce Audiences And Markets

This segment will review variety of literature exploring on how and why media organizations produce audiences and markets. The different types of audience theories there are will explore this, and how the audience reacts within these theories. There are many various audience theories out there, however six will be explored. â€Å"The word audience is so much part of our everyday talk that its complexity is often taken for granted.† (Ross Nightingale 2003) Today, media is surrounding us, whether it is television, films, magazines, games, radio, music, the news, and even billboards and posters, and we don’t even acknowledge it, unless it hits us in the face. Along with this media, comes different audience, and different reactions. The†¦show more content†¦Hall also suggested that the way an audience reacts, is dependant on their cultural backgrounds and how they were brought up, for example, if the mass media’s intended message is fruit is great, it all depends if an individual has been brought up to dislike fruit, etc. the audience is also given more credit, and it’s understood that they mat react in different ways. Reception theory is the social interaction aspect, and the Two-Step Flow theory is also similar. â€Å"Formulated first in the The People’s Choice, the hypothesis suggests that ‘ideas often flow from radio and print to the opinion leaders and from them to the less active sections of the population.’† (Lazarfield and Katz, 1970) Paul Felix Lazerfiled originally came up with this theory, and then later, Elihu Katz began working with him. The two of them looked at during the presidential elections, how the votes make up the audience’s minds and wrote a book exploring the different factors of it. They speculated how the mass media connects with people, however this communication is routed through opinion leaders. These people are very media-literate and they link their understanding to others. The mass media uses comedians as the opinion leaders, as they take real life news, and analyse it in a comical way, and the mass media probably entrust the comedians more, as they come across less bias and less of an agender, and the public find the news sometimes so bias, it was almost comical. Two-Step Flow theory is

Comparing The Declaration Of Independence, And U.s....

Comparison Paper In comparing Thomas Jefferson’s Letter to the Danbury Baptists, The Declaration of Independence, and U.S. Constitution, it is evident that the basis of all three documents is the idea that all human beings possess God-given fundamental rights and that government is created to protect those rights. The Declaration of Independence, written by Thomas Jefferson in 1776, is the first of the three documents penned. This is important because it defined the rights of liberty and equality of all American citizens as outlined in John Locke’s natural law thesis (Martin, page 113). In addition to providing an itemized account of the grievances colonist’s held against King George III of England, it served to justify the colonist’s quest for independence and separation from British rule. The Declaration of Independence conveyed to the crown that all men are created equal, that they are endowed by their Creator with certain unalienable rights, which among these are life , liberty and the pursuit of happiness. The Founders’ of the New World understood that their pursuit of liberties and autonomy specified in the Declaration of Independence could not come to fruition without instituting decrees. In 1787, the U.S. Constitution, was written to replace the Articles of Confederation with a better defined series of stringent laws that would legally uphold the freedoms and privileges established in the Declaration of Independence. The First Amendment of the Bill of Rights inShow MoreRelatedComparing The Declaration Of Independence877 Words   |  4 PagesComparison Paper In comparing the Thomas Jefferson’s Letter to the Danbury Baptists, The Declaration of Independence, and U.S. Constitution, it is evident that the basis of all three documents is the idea that all human beings possess God given fundamental rights and that government is created to protect those rights. The Declaration of Independence, written by Thomas Jefferson in 1776, is the first of the three documents penned. This is of great importance because it defined the rights of libertyRead MoreThe Bill Of Rights And The Amendment Of The Constitution962 Words   |  4 PagesIn 1976, The Declaration of Independence was signed by Thomas Jefferson and included the Bill of rights that provided us with Freedom (Schweikart, 2004). The bill of rights was established so each citizen is equally treated and allowed to share their idea and not be disgraced for it (Bodenhamer, 1993). The first ten amendments to the constitution of the United States established basic American civil liberties ( Schweikart, 2004). The Bill of rights and the amendments of the constitution were writtenRead MoreThe Declaration Of Independence Of The United States Of America Essay1481 Words   |  6 Pagesequality up to this very day. The Declaration of Independence states that every citizen is granted the right to life, liberty and pursuit of happiness. Furthermore, it marks the groundbreaking turning point in American history where the United States gained its independence from the British Government. Since then, the Declaration of Independence argues on the people’s behalf for civil protection, and to a certain extent, negates government power. Embedded in the Declaration, it states â€Å"whenever any formRead MoreThe Declaration Of Independence And The United States Of America Essay1411 Words   |  6 Pagesglobalization and equality up to this very day. The Declaration of Independence states that every citizen is granted the right to life, liberty and pursuit of happiness. Furthermore, it marks the turning point in American history where the United States gained its independence from the British Government. The Declaration of Independence argues for the protection of people’s, and to a certain extent, negates government power. Embedded in the Declaration, it states â€Å"whenever any form of government becomesRead MoreHealth Care Of The United States1557 Words   |  7 Pages In accordance to the U.S. Census Bureau, in 2012 there were about 47.9 million people in the United States that did not have health insurance. That is about 15.4% of the U.S. population. United States is one of the countries that do not have universal health care. Health care is administered by health practitioners in nursing, medicine, and other health professions. It is the treatment, diagnosis and prevention of illnesses, diseases and injuries in h uman beings. Physicians for a National HealthRead MoreMagna Vs. Bill Of Rights Essay1190 Words   |  5 PagesEngland, the U.S was not a country ruled by a king neither did barons write the Bill of Rights. The Bill of Rights were the amendments to the original U.S Constitution which was written by James Madison. So, it is hard to discuss one and not the other. The U.S. Constitution outlined the branches of the government as well as the rights of citizens, and laws by which every citizen including those in positions of power abided by. It was pulled from documents such as The Declaration of Independence and TheRead MoreEconomic Equality Between The Social Classes Of The Great United States Of America1658 Words   |  7 PagesDaniel Mallock on American Thinker believes that the social contract illustrates the obligations that citizens are dependent on some sort of agreement between them and the government or sovereign. In specific terms, the current U.S. social contract is continge nt on The Constitution. This all-abiding document describes the written and unwritten ways in which each citizen, albeit it, some more than others, lives their daily life. The rules, laws, rights, actions, and consequences are the foundation of dailyRead MoreDemocracy Vs American Democracy973 Words   |  4 Pagessuch as the doctrine of democracy and the freedom of expression. In a complete democratic society, everyone is born equal. People not only have power in democracy but also have a responsibility to the society. In addition, democracy relates with Constitutions and election. There are a lot of democracy societies except the United States. As a democratic country, the United States and Canada have similar political and rules, but still have differences. Thomas Paine, who was an English-born AmericanRead MoreEssay on America Needs Gun Education, Not Gun Control Laws1735 Words   |  7 Pagesmore gun control legislation. This education should begin at the beginning, by defining the where gun rights came from and the need for these rights. The Constitution of the United States serves to define the rights and freedoms of the people and serves as the supreme law of the land. The most important freedom or right defined in the constitution is the right of American’s to keep and bear arms. This right was so important to the authors, that is was the second of the basic freedoms and privilegesRead MoreA Kantian Perspective On The International System1489 Words   |  6 Pagesanalysing the three main articles and their major concepts (respectively republics, non-aggression and universal hospitality) and comparing them with today’s world. First, the Kantian perspective on the international system, expressed in his work Perpetual Peace (Kant 1795), can be summarized in three main articles. The first one, stating that ‘the civil constitution of every state should be republican’ (Kant 1795, 13), shows that a Kantian world would be characterised by the predominance of a republican

Critical Reasoning Cycle Samples for Students †MyAssignmenthelp.com

Question: Discuss about the Critical Reasoning Cycle. Answer: Clinical reasoning cycle helps a nurse to critically analyze a patients situation and accordingly relate her knowledge ofnursing to it. This is then followed by the introduction of evidence based interventions in the care plan for the patient, which includes goals, actions and evaluation of outcomes (Forsberg, 2016). Often handling opioid tolerant patients becomes difficult for those nurses who have not been exposed prior to such a situation as treatment of opioid tolerant patient after surgery is different form opioiod nave patients. Hence, it is important for a nurse to develop prior knowledge of handling such patients and apply the correct ethical considerations when caring for the patient. The present assignment will highlight how a nurse totally ignored the condition of opioid tolerance patient and how she reflected the errors she made and leant form her mistake. This assignment will also contain the ethics required to handle such patients and provide effective treatment. A 60 year old lady was admitted in the ward after she had a fall in her garden when she was having an evening walk in assistance with her grandson of 14 years old. She was admitted to the ward with a fractured knee and was instructed for a knee arthroplasty. She was obese and was also suffering from immense pain due to her osteoarthritis. She was aged; the doctor had instructed her not to go for knee arthroplasty and therefore she had to undergo extensive pain in her knees. The medications that were provided to her could not give her relied form the pain and the doctor had to continually change her medication to long affecting opioid to give her relief on her request. She remains depressed and often cries because of her inability to move. He son had now requested the doctor to undertake knee arthroplasty to which his mother had also provided consent. She is a lover of fast food and requests her son to bring such food every day, her son could not deny thinking his mother may feel bad. She also does not take any exercise and have recently started taking walks in lawns half heartedly on advice of her son. She is on opioid treatment. Clinical reasoning cycle helps the healthcare professionals by proving them to use it as a tool which helps them to collect cues, process the information and thereby come to an understanding of the patient problem or the situation. This would be then followed by making a proper plan followed by the implementation of interventions as well as evaluation of outcomes (Liou, Liu, Tsai, Tsai, Lin, Chang, 2016). The nurse would then reflect upon the experiences so that she can apply the learning to net similar cases in her practice tenure in her professional life. The first step in a critical reasoning cycle is considering the patient situation. This mainly involves description as well as the list of facts, contexts, objects and people (Koivisto, Multisilta, Katajisto, 2016). The patient is aged and is offerings form obesity as well as osteoarthritis. She is a lover of fast foods and do not want to take any exercise regime. She is also suffering from restricted mobility and has developed a sense of depression because of her loss of independence. She cannot perform her activities by herself which keep her depressed. The next step involves the collection of cues and information of the patients. This step mainly involves reviewing current information, gathering new information and also recalling the knowledge (Hunter, 2016). She has faced a fall and had fractured her knees. The doctor has prescribed her to undergo for knee arthroplasty as there has been no other option to it. Her cause of development of obesity is mainly because of her inappropriate lifestyles, like having calorigenic fast food and lack or p[roper exercises. Her development of depression is mainly because of her lost of independence. Moreover her body weight is also affecting her conditions of osteoarthritis. Her knee arthroplasty will help her to overcome the pain to some extent and would be one of the contributor to her develop her quality of life. The next step is processing of the information which includes the nurses to interpret, discriminate, relate, infer and match the situation with past references. This would be followed by prediction phase (Dalton Gee, 2015). Here it is seen that the patient is not at all concerned about her own body weight and cannot realize the negative aspects related with her taking of fast food. She does not possess any health literacy and therefore she is unable to understand the pathopshysilogy of her gaining weight. Moreover she is also not having any idea about how her lack of enthusiasm to perform exercises is affecting her health. All these had resulted in heavy weight which is creating an additional pressure in her knees and worsening the condition of osteoarthritis. However her osteoarthritis is mainly due to the wear and tear of the cartilages that had taken place over the years and her love for remaining independence state that she was an ardent worker in the past in her young age (Kao Tsai, 2014). Therefore she is not being able to cope up with the change in the lifestyles. The next stage is synthesis of the facts and the inferences to identify the problem and thereby make a proper diagnosis. From the previous steps, it is seen that there obesity of the patient is creating an extra stress on her osteoarthritis condition. It is very important to make her correct her body weight as this might still create issues even when she undergoes knee arthroplasty as her knees might face extra pressure due to her body weight (Loew, Kenny, Durand-Bush, Poitras, Wells, 2014). Moreover she should be allowed to undertake therapies with counselor like interpersonal therapy as well as cognitive behavioral therapy. All these are important for her to develop a better quality life. The next stages are the establishment of goal and then taking appropriate action for them. The first goal would be to provide her with preoperative education with her knee arthroplasty surgery so that she can be well prepared with the situation and cope up with the situation so that she feels less stressed after the operation. For this the action that should be taken is to make her proper appointments of classes of preoperative education. The second goal would be to fix up a meeting with a dietician who would be providing her with her health education and give her a proper diet which would be helpful for her to stick to a low calorie diet. A proper exercise regime would be set for her who she would need to take to maintain her weight and also to develop her mobility (Tanaka, Ozawa, Kito, 2016). The third goal and action to be taken is to make her free from her depression and for that the patient should be prescribed to meet with a counselor and also undertake cognitive behavioral th erapy and also interpersonal therapy. Proper medication administration should be continued as per the medication so that her health condition is gradually made stable. The next step is the evaluation of outcomes. In each of the action, the nurse should take the responsibility of proper assessment at interval of 12 hours in order to check that each and every goals and actions that she had implemented are bringing in best results in the patient (Williams, 2015). f any of the actions are not bringing positive results, then the nurse should modify the action at once so that her length of day in the hospital is not increased and she can experience better health as much faster as possible. The eight step of the clinical reasoning cycle would be the reflection phase where the nurse or the healthcare professional needs to reflect on her own practice in order to learn from her mistakes and to handle the cases in amore better way form the nest time onwards. I came to know a very crucial fact form the handling of the patient which I was not at all aware before. The patient was opioid tolerant and I never took this fact into consideration while planning my critical reasoning cycle. I was severely criticized by mynursing mentor for the error I made while providing her with the opioid post treatment. I had never handled any cases of opioid tolerant patient before and therefore I never knew of the consequences which might occur if I provide similar opioid medication to an opioid tolerant patient post surgery in comparison to that of opioid nave persons. As I had provided a normal course of opioid medication provided to all patients, I had provided the dame medication to the pat ient. However, the patient started to shout aloud in pain and on assessment of the pain management scale, it was seen that her score was 9/10. Seeing this, the mentor arrived immediately and asked me to follow the procedure required to take for opioid tolerant patient. She taught me that as the patient had been staying on long acting opioid for long time due to her pain of osteoarthritis, the medications are not acting for her and as a result her sensation of pain is very high. Ketamine in low sub anesthetic doses are helpful in acting primarily as the non competitive antagonist of NMDA receptors (Vaid, Green, Shinkaruk, 2016). Therefore I have leant that post operative administration of ketamine in opioid tolerant patients can lead to improved pain scores as well as decreased opioid concentration. The patient is now addicted to opioid and for this, the medication would be highly beneficial. This should be administered in the form of low dose in IV or SC infusion (Pasero, Quinlan-C olwell, Rae, Broglio, 2016). Moreover I had actually provided under-medication and therefore the patients pain score was quite high. The medication which can bring positive effect is the transdermal fentanyl patches. Moreover after surgery, I have also learnt that transition form an intravenous or epidural to an oral opioid regime needs special attention from healthcare professionals in opioid tolerant patients. They need to have opioids for a prolonged period of time via intravenous or epidural route when compared with opioid-naive patients. Transition period to oral medication of opiod will need time and monitoring of sedation should be maintained as well. The first 24 to 48 hours need the patient to be associated with intravenous opioids via PCA after which oral medication doses can be started. The first ethics that the nurses should keep in mind during the management is opioid tolerant patients is providing the patient with the scope of autonomy and dignity. A patient should be given the chance of expressing their own concern, fear, anxiety as well as the stress they are experiencing. It is the responsibility of the nurse to address the patients concerns and take appropriate interventions accordingly (de Koning, Penninx, Elders, Heijboer, Smit, ... Lips, 2015) . This will help the patent to report better satisfaction after the treatment and this will also ensure the nurse to develop the linking, disliking, important facts and incidences about the patient which can help her in the long run. Another ethics that the nurse should follow is the provision of the safest intervention in order to ensure that the patient is free from any sort of threats (Krokmyrdal, 2015). The nurse should be responsible enough to take proper assessment of the patient history about the intake of o pioids and be prepared prior to any surgical advancements. This would ensure the best care to the patient where the patient would not have to go through severe pain in any stage of the treatment. This ethics is based on the principle of beneficence where it becomes the duty of the nurse to provide the best practice to that of the patients. The third ethics that the nurse should also ensure is that she herself is free from any sort of bias and emotion. The nurses should strictly adhere to the guidelines of ethics which will help her to provide the best, unemotional, practical way of treatment and care which would be free from biasness and emotions (Bockhold, 2016). This should be irrespective of the caste creed, religion as well as culture of the patient. These factors should never influence the decisions and the pattern of care for the patient. This is based on the principle of justice. From the above assignment, it was found that how clinical reasoning cycle helped the nurse to handle the patient situation effectively. It helped the nurse to establish the link that is present between the different co morbid disorders and how each of them have been affecting her present conditions leading to a poor quality life. Not only her physical condition, but her mental condition was also analyzed with establishment of proper care plan. However, the refection phase helped to identify the mistake that had been conducted by the nurse. She had completely no idea those opioid resistant patient require different sides of medication as the normal pain medication does not bring them proper results. With the help of the mentor, she was able to learn the procedure. The important ethics, of maintaining the patients autonomy, providing the best and safest intervention by beneficence and providing an unbiased care with the principle of justice are the three ethics which should be maintain ed by the nurse for treatment of the opioid nave patients. This would help her to protect herself form ethical and legal obligations. Bibliography Bockhold, C. R. (2016). he ethics of opioids for chronic noncancer pain. Nursing2017 , 63-67. Dalton, L., Gee, T. .-J. (2015). Using clinical reasoning and simulation-based education to'flip'the Enrolled Nurse curriculum. Australian Journal of Advanced Nursing, , 29. de Koning, E. J., Penninx, B. W., Elders, P. J., Heijboer, A. C., Smit, J. H., ... Lips, P. (2015). Vitamin D supplementation to prevent depression and poor physical function in older adults:. BMC geriatrics , 151. Forsberg, E. Z. (2016). Assessing progression of clinical reasoning through virtual patients: An exploratory study. . Nurse education in practice , 97-103. Hunter, S. . (2016). Clinical reasoning ofnursing students on clinical placement: Clinical educators' perceptions. Nurse education in practice, , 73-79. Kao, M. H., Tsai, Y. F. (2014). Illness experiences in middle?aged adults with early?stage knee osteoarthritis: findings from a qualitative study. Journal of advanced nursing , 1564-1572. Koivisto, J. M., Multisilta, J. N., Katajisto, J. . (2016). Learning by playing: A cross-sectional descriptive study of nursing students' experiences of learning clinical reasoning. Nurse education today , 73-89. Krokmyrdal, K. A. (2015). Nurses' competence in pain management in patients with opioid addiction: A cross-sectional survey study. Nurse education today , 789-794. Liou, S. R., Liu, H. C., Tsai, H. M., Tsai, Y. H., Lin, Y. C., Chang, C. H. (2016). The development and psychometric testing of a theory?based instrument to evaluate nurses perception of clinical reasoning competence. Journal of advanced nursing , 707-717. Loew, L., Kenny, G. P., Durand-Bush, N., Poitras, S., Wells, G. A. (2014). The Implementation of an Effective Aerobic Walking Program Based on Ottawa Panel Guidelines for Older Individuals with Mild to Moderate Osteoarthritis:. A Participant Exercise Preference Pilot Randomized Clinical Trial Protocol Design , 2014. Pasero, C., Quinlan-Colwell, A., Rae, D., Broglio, K. . (2016). American Society for Pain Management Nursing position statement: Prescribing and administering opioid doses based solely on pain intensity. Pain Management Nursing , 170-180. Tanaka, R., Ozawa, J., Kito, N. . (2016). Effects of exercise therapy on walking ability in individuals with knee osteoarthritis: a systematic review and meta-analysis of randomised controlled trials. Clinical rehabilitation , 36-52. Vaid, P., Green, T., Shinkaruk, K. .-S. (2016). Low-Dose Ketamine Infusions for Highly Opioid-Tolerant Adults Following Spinal Surgery: A Retrospective Before-and-after Study. Pain Management Nursing , 150-158. Williams, L. S. (2015). Understanding medical surgical nursing. FA Davi. 56.

T.S. EliotS The Love Song Of J. Alfred Prufrock Essays - Chapbooks

T.S. Eliot'S ?The Love Song Of J. Alfred Prufrock? Philosophers recognize the harmony and duality of the universe with symbols like Ying and Yang. The title character in T.S. Eliots poem, The Love Song of J. Alfred Prufrock, has not. The poem is an internal monologue where Prufrock reveals himself as lonely and timid. Prufrock is a man in conflict with his duality, the society he has to live in, and the long lost dreams of his youth. Hot and cold, fire and water; duality is part of nature. Prufrock is not in harmony with his two sides. On the surface Prufrock is like a field mouse, frozen by fear who asks, Do I dare? And Do I dare? Inside is a tiger that knows there is time to murder and create. Prufrock is a tiger in the body of a field mouse. Prufrocks field mouse is what society sees. Instead of cats and owls, ridicule and rejection are his natural enemies. Prufrock fears he is not able to meet societys standard. He fears society will have him pinned and wriggling on the wall. J. Alfred Prufrock is afraid, not only of what they will say, but how society will look at him. Prufrocks inner tiger wants to ride seaward on the waves and experience the passion of his youth. He is aroused by the perfume from a dress, but is held back by fear. Now, he only dreams of one night cheap hotels, because he knows those times are past. He has seen his life pass by, teaspoon by teaspoon, and knows death is waiting; laughing at a life half lived. Some use the sun to measure days; Prufrock uses a coffee spoon. No longer the man he was, and unable to deal with the man he has become, Prufrock can not coexist with himself or society. The poem, an internal monologue, reveals the timidity and loneliness of J. Alfred Prufrock. Poetry