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Concept Analysis Pain In The Oncology Patient Nursing Essay

Are you having any pain. These are most likely the first words from a registered nurse to an oncology patient. Pain is a concept that creates many challenges for medical professionals. In a review of patients with cancer, pain was reported in 33% of patients after treatment to cure cancer, 59% of patients given anti-cancer treatment with the aim of either curative or palliative treatment, 64% of patients having advanced, metastatic or terminal cancer and 53% of patients with all stages of the disease (Chapman, 2012a). Pain management is a common reason an oncology patient is admitted as an inpatient to a hospital. Nurses are at the forefront of assessing and managing pain to achieve adequate therapy. However, in order to reach this outcome, nurses need to understand the types and causes of pain, assessment tools, non-pharmacological treatment and action of pain medications (Casey, 2011). Nursing staff and other medical professionals need to act as patient advocates when dealing with pain so that symptoms can be managed. Nevertheless, within the healthcare system, the prevalence of pain is increasing and pain is a complex issue that is not always well understood or managed by healthcare professionals and patients (Shaw, 2006). Issues with Pain Nurses are constantly faced with managing pain and need to develop skills to identify when pain is not adequately controlled in order to make recommendations to alleviate a patient’s pain. Unfortunately, there are many times when both nurses and physicians are not well educated in pain management and are not successful in decreasing an individual’s pain level. Regardless of the variety of treatment options, cancer pain is not always effectively managed due to several barriers that include poor assessment, insufficient knowledge about pain and treatment and specific concerns about dependence, tolerance, addiction and drug-related side effects (Chapman, 2012b). In addition, many medical professionals hold inappropriate beliefs and attitudes toward pain management, which can affect providing pain relief for patients (Naylor, 2003). Some practitioners are fearful of prescribing or administering pain medications at a high level that might be required due to a patient’s tolerance. This creates many challenges in providing adequate pain control for patients that are able to verbalize their pain, as well as those patients who are not able to verbally express their pain levels. Significance in Nursing Pain is a significant concept in oncology nursing. Physicians and nurses working with this population need to be experts in pain management. It is critical for medical professionals to understand the different types of pain that oncology patients can experience. There are several pain management treatments available and not every medication will work effectively for a patient. It is important for nurses to recognize differences so that patients can be effectively managed. When pain is not adequately controlled, patients can become withdrawn and unable to focus on important aspects of their quality of life including activities of daily living and sexual and social relationships (Chapman, 2012a). In addition, mood, sleep patterns, cognition and existential beliefs can be affected (Chapman, 2012a). There are several types of pain that an oncology patient can experience. The most common types of pain are chronic pain, acute pain and breakthrough pain. Chronic pain is a constant pain. Acute pain can last anywhere from a few days to a few months and typically resolves when the underlying condition is treated (Chapman, 2012). Breakthrough pain happens briefly with moderate-to-severe flare-ups that occur even when a patient is taking long acting pain medication to address their chronic pain (Kedziera, 1998). Understanding these types of pain is pivotal to determine medications to be prescribed and implement non-pharmacological therapies. When medical staff understands the causes and types of cancer pain, they can individualize pain management strategies in order to improve the quality of patient care as well as provide sufficient pain relief (Chapman, 2012a). Oncology patient’s pain can be caused by several factors. Pain can be caused by tumors, surgery, chemotherapy and radiation which can affect different parts of the human body (Chapman, 2012a). When staff is knowledgeable about disease processes and treatments, medical professionals can prescribe medications to address specific pain. Nurses must assess an individual’s pain management regimen at home so that dosing can be adjusted when admitted to the hospital. Nurses must be diligent in comparing prescribed medications to home medications. There have been instances when physicians will fail to order a long acting pain medication that a patient might take at home that can result in inadequate relief. Pain Assessment Assessing an individual’s pain is a key component in achieving pain management. Nurses need to evaluate a patent’s pain when considering pain therapy and the nurse needs to focus on the following factors: (1) consistency in pain control, (2) taking action in response to an individual’s pain assessment, (3) maximize effectiveness of medications while reducing side effects and (4) avoid “gaps” in pain control (Casey, 2011). Physicians do not spend as much face-time with patients as nurses, therefore, nurses have the responsibility to understand a patient’s pain and verbalize to the physician to achieve adequate pain control. An accurate and detailed assessment can provide guidance in creating an individualized treatment plan (Naylor, 2003). Each person’s pain is going to be different and it is important to utilize assessment tools to implement the most effective pain management plan. When determining ways to manage pain based on the assessment, nurses need to not only focus on the physical aspects but also include pharmacological and non-pharmacological treatments to reach optimal comfort (Naylor, 2003). Education and training on different types of pain assessment tools and scales that are utilized in practice is essential to effectively manage pain levels of each patient. Without the ability to adequately assess a patient’s pain, there will be profound negative effects on comfort levels and the ability to meet health goals. Nurses have a pivotal role in addressing pain in oncology patients. It is essential for nurses to realize that managing pain goes beyond administering medication and that utilizing a holistic nursing care approach can allow a nurse to better understand a patient’s individual pain. Pain responses can be affected by psychological, social and cultural influences, such as anxiety, anger and fear that may enhance an individual’s perception of pain (Naylor, 2003). In addition, cultural beliefs, upbringing and social situations may be the reason for certain expressions of pain (Naylor, 2003). Nurses need to be vigilant in recognizing factors that affect a patient’s pain and the meaning that an individual attaches to pain (Chapman, 2012a). A nurse’s role goes beyond completing tasks on a checklist but having the ability to connect with their patients to identify root causes of pain. It has been found that in order to reach a goal of effective symptom management, the multidisciplinary team must create a positive therapeutic relationship with the patient (Chapman, 2012a). Many times a patient is looking for the opportunity to express themselves and nurses have the ability to provide an environment that allows patients to open-up and verbalize their feelings. Changes to Nursing Practice The concept analysis has brought heightened awareness to the idea of pain. When assessing pain, there are many factors to be considered as addressed in the concept analysis. The analysis opened a door to look beyond what medical practitioners physically assess but also the importance of listening and understand the patient. The nurse must reflect on experiences he/she has with patients to improve their ability to effectively manage pain. Nurses need to realize that in order to implement appropriate nursing activities to meet a patients pain needs requires an ongoing learning process to truly understand the concept of pain (Cheng, 2003). Nurses have the ability to manage pain by getting to know their patients to be able to implement change. Nurses need to work on their listening skills so that patients feel that they can openly express their feeling and concerns. This allows the nurse to help guide the patient to becoming involved in his/her care. It is clear that when pain is not adequately controlled it can have negative consequences on not only the patient but the entire family unit. Anticipated Outcomes Through the use of reflecting, provides the opportunity to anticipate outcomes and create successes in managing pain. One tool to achieve effective pain management and evaluate strategies is by conducting pain assessments (Naylor, 2003). Through these assessments, a nurse can identify physical effects of pain and understand both location and intensity. To know if a nurse is successful, the nurse will see a change in level of reported pain or physical attributes that a patient might exhibit. By changing current practice methods, nurses will be able to create an environment where patients will verbally express feelings which will be a sign of progress in better meeting patient needs. In addition, through these encounters nurses will be able to identify their patient’s use of coping mechanisms to address pain. Nurses can also see success when utilizing a holistic nursing approach by looking beyond everyday tasks and viewing the patient as a human being. As nurses identify factors that affect pain management, they will be able to better meet patient needs. Nurses will have the education and skills to recognize and alleviate pain before it occurs by utilizing pain management interventions, methods and medications. Concept Analysis The analysis has relevance to understanding the concept of pain, while also isolating it from other concepts. The concept analysis regarding pain was intended to increase awareness and understanding pain by clarifying the defining attributes of pain, identifying antecedents that affect the perception of pain and the possible consequences of pain (Cheng, 2003). It is clear that pain is a concept that is not always well understood and requires analysis that others can become more conscious and responsive to addressing patient’s pain needs. The model case discussed pain using a scenario regarding an oncology patient. The model case included all the defining attributes: (a) unpleasant and distressful experiences originating from physical sensation and having both positive and negative meanings for an individual; (b) an individual human experience; (c) a state of feeling in both sensation and emotion (verbal), and behavioral components; (d) physical and psychological responses to the stimulus; (e) function of pain, including protective and warning signs; (f) pain responses and learned and influenced by personality, environment, emotions, social and cultural (Cheng, 2003). This example supported the concept of pain and clearly stated the characteristics of the case to addressing all the points regarding the concept of pain. Due to each patients individuality, personal experiences and views, there are several types of scenarios that could have been utilized as a model case. The model case creates awareness for nurses of all the factors to consider when understanding a patient’s pain. Nurses have to be able to use the skills to visually assess and listen to patients while understanding a patient’s history and the events that have taken place to bring the patient to the point of the pain that they are reporting. Understanding a patient’s culture and individual beliefs can provide insight regarding a patient’s response and expression of pain. Nurses need to be aware of potential patterns in certain cultural groups, however, nurses should not over generalize or stereotype that everyone within a culture will behave in the same manner (Davidhizar, 1997). This emphasizes the complexities when assessing and understanding a patient’s pain, and nurses need to go beyond the basic assessment tools and understand the individual to achieve effective pain control. The use of a borderline case and contrary case were used to distinguish the concept of pain from the model case (Cheng, 2003). The cases are important in differentiating the concept of pain from other closely related concepts, as seen in the additional cases. The borderline case did not meet all the elements of the model case and the contrary case addressed the concept of fear related to pain (Cheng, 2003). These cases enhance the model case and allow the reader to see alternate examples of situations that may arise in a clinical setting. Conclusion Pain is a universal part of the human experience and will continue to be an integral part of providing nursing care (Shaw, 2006). Pain is a complex concept that does not have one specific answer to meet all patient needs. Pain management requires assessment skills, knowledge and a holistic approach to nursing care to be successful at eliminating or effectively controlling pain in oncology patients. Nurses have both technical and moral tasks in the management of pain because they are the ones conducting assessments, administering pain medications and evaluating effectiveness, as well as, determining which pain relief measures and interventions are provided to patients (Shaw, 2006). Nurses need to continue to expand their knowledge base and be aware of their own values and beliefs in order to be successful in managing the dynamics and complexities of pain.
Duke University Suicide as a Sociological Phenomenon Essay.

Introduction. Write a brief introduction for your essay where you simply outline what the essay argues (remember that while the introduction is the first thing that shows in an essay, it is better to write it after the main text and conclusion are completed).Elaboration of argument. This is the main body of your essay—you can divided into sub-sections with headings if you find that useful. Here you need to do a couple of things. a. First, you should explain—very briefly—why suicide should be considered as asocial problem or sociological phenomenon (of course, here you should followDurkheim’s own reasoning).b. Secondly, using quotes and/or examples from Durkheim’s Rules of theSociological Method and his Suicide,explain to the reader (in this case, the instructor) how Durkheim’s study of suicide is an application of Durkheim’smethodological rules. To show the connection between the two works, think of the following questions:How does Durkhiem’s discussion of sucide in the Introduction to his book compare to (or resembles) his discussion of what is a social fact?How does Durkehim use data and other evidence to “discard preconceptions”? Look, for example, at how Durkheim examines the relationship between suicide rates and what he calls “cosmic factors” (basically, the seasons of the year). How is he using the data here? Is it to prove or to challenge an idea?Lastly, at what level does he establish a connection between his typology of suicides and actual suicice rates? What are the “variables” he uses to explain the connection?3. Conclusion. After explaining why suicide should be considered a sociological phenomenon and showing how Durkheim addresses it via his own methodological rules, by way of conclusion, you will briefly evaluate whether Durkheim’s theory is relevant today. Can we use his concepts of anomic, egoistic, fatalistic or altruistic suicide to understand today’s suicide trends? In what ways is his theory still useful? In what ways is it too limited for our contemporary moment? Of couse, my own questions here hint at what I consider the best approach: rather than a blanket rejection or uncritical embrace of Durkheim’s theory, it is probably better to argue that Durkheim’s theory of suicide has some contemporary relevance but that it also has some limitations. The important thing to know is: where is the relevance and where are the limits?5 pages 1 reference page MLA Style format This is the link for the film and the rest of the essay guidelines are listed below
Duke University Suicide as a Sociological Phenomenon Essay

Family-Community Partnerships Creation Report

Creating Family-Community Partnerships Authoritative teachers need to address undesirable behaviors of children and involve parents in resolving behavioral issues. In the case of Lucy’s inappropriate behavior in the classroom, it is necessary to involve her relatives in the development of the plan according to which the family can cooperate with the teacher to contribute to the girl’s development. The plan should include the following aspects: the involvement of the English-speaking relatives or educators to improve the communication between the teacher and parents; scheduling the teacher’s regular visits to the family’s home; scheduling the observation and reports related to Lucy’s behavior in the classroom. The family engagement techniques that are the basis of the plan include sharing the control with the family; inviting the family members to discuss the behavior of their child at home; visiting families at home; supporting linguistically diverse children; providing the parents with notes on the child’s successes (Kostelnik, Soderman, Whiren,

The Zero Crossing Detector Engineering Essay

professional essay writers The X 10 transmitter sends data timed with the zero crossing of the power line, thus each unit needs to have a built-in zero crossing detectors. Mainly, the X10 manufactures are using PIC16F8XXX family to detect zero crossing by applying the external interrupt on the RB0 pin, which links to the power line through 5M resistance (to limit the current into the PICmicro) as it is shown in the figure 00. The PICmicro has a protection diodes which are designed to clamp any voltage higher than VDD or lower than VSS. Thus, when a negative half cycle of the AC voltage is applied, the RB0 pin clamps the voltage to VSS – 0.5V, this can be interpreted as a logic-0. At the same time, as the AC voltage rises to or over VDD, the logical value will become logic-1. RB-0 is configured for external interrupts, whereas the input buffer is a Schmitt trigger. Therefore, the input threshold (0.2 VDD = 1V) on the falling edge and (0.8 VDD = 4V) on a rising edge. So there is an interrupt occurs on every zero crossing. The following equation is used to calculate the RB0 pin state which will change in relative to the zero crossing V = Vpk*sin(2*ƒ•*f*t), where Vpk = 320Vand f = 50 Hz On the rising edge, RB0 can go high about 64 µ s after the zero-crossing. However, on the falling edge, it can go low about 16 μs before the zero-crossing. 120 kHz Carrier Generator X-10 transmitters use 1msec bursts of a 120 kHz to send information over 50 Hz power lines. Different techniques could be used in order to generate 120 kHz, however, in x10 units are mainly use one of the PICmicro MCU’s CCP modules as it is shown in the figure100. The CCP (Capture/Compare/PWM) module of PIC 16F67xA is used in PWM mode to produce a 120 kHz square-wave with a half duty cycle of (50% of the duty cycle). In order to generate the carrier frequency of 120 kHz, the system oscillator capacity was chosen to be 7.680 MHz, Where the frequency of the PWM is the inverse of the period (1/period) And since one instruction is taking four oscillation periods we come up with the term of 4Tosc Main oscillator is 7.680MHz, Tosc = 1/7.680MHz PWM period = 1/120 kHz = 8.333µs PWM period = [(PR2) 1] * 4 * Tosc * (TMR2 prescale value) = [(0) 1] * 4 * 1/7.680MHz * (16) = 8.333µs After initialization, the CCP (Capture/Compare/PWM) is always enabled, and the register TRISC bit is used to gate On and Off the PWM output. By sitting the TRISC bit = 1, then the pin is an input and the 120 kHz signal is blocked and not accessible to the pin, other than When the TRISC bit = 0, the pin becomes an output and the 120 kHz signal is free and coupled to the AC power line. Before the 120 kHz coupled to the powerline, it will pass through 200Ω resistance, a transistor amplifier and high pass filter as depicted in the Figure 5. Since the impedance of a capacitor is Zc = 1/(2*ƒ•*f*C), If f = 120kHz Zc = 1/(2*ƒ•*120k*0.1*10-6) If f = 50kHz Zc = 1/(2*ƒ•*50k*0.1*10-6) The capacitor of the high pass filter is equal to 0.1 μF which presents low impedance to the 120 kHz carrier frequency, but with 50 Hz power line frequency it will present high impedance. Therefore high pass filter will safely couple the 120 kHz signal to the 50 Hz power line. Finally, the 12 kHz signal should well match with the synchronize of zero crossing with maximum delay about 300 μs from the zero-crossing to the beginning of the X-10 envelope in order to be compatible with other x10 receiver. Since the maximum delay of the zero-crossing detector = 64 μs 300 μs – 64 μs = 236 μs Thus the firmware must begin the transmission of the 120 kHz envelope with maximum time of 236 μs after detection of the zero-crossing to. 120 kHz Carrier Detector In order to receive a x10 signal, it is essential to detect the presence of the 120 kHz signal on the 50Hz AC power line. This application requires a specific hardware structure which? contains three blocks placed between the PIC and the power line and subsequence the 120 kHz carrier will bass through all of them to reached RC pin of the PIC. The first block from the power line side is the decoupling capacitor which contains e a 0.1µ capacitor in parallel with 1MΩ resistance. The next one is the high bass filter and the final one is the envelop detector which is connected to the PC pin of the PIC as it shown in figureXX. Since the impedance of a decoupling capacitor is Zc = 1/ (2*ƒ•*f*C), If f = 120 kHz Zc = 1/ (2*ƒ•*120k*0.1*10-6) =1/ 0.075 = 13.26 Ω Zc of 120 kHz = 13.26 Ω If f = 50 kHz Zc = 1/ (2*ƒ•*50*0.1*10-6) = 1/31×10^-6 = 32.25 k Ω Zc of 50 Hz = 32.25 k Ω The capacitor of the decoupling filter is equal to 0.1 μ farad which is presenting low impedance (13.26 Ω) to the 120 kHz carrier frequency, but with 50 Hz power line frequency it will present high impedance (32.25 k Ω). Therefore the decoupling filter will safely couple the 120 kHz signal detector to the 50 Hz power line and allow only 120 kHz to bass through it. The next block is another high pass filter, design an RC filter that will pass only 120 kHz carrier and attenuate the entire 50Hz. The second high pass filter scheme is shown below Where the high pass filter characteristics is shown in the next scheme ωp is the passband edge of the high pass filter ωp = 1 / CR where C = 150 pF and R = 33 k Ω ωp = 2 ƒ• fp fp = 1 / 2*ƒ•*C*R fp = 1/(2*3.14*33*10^3*150*10^-9). fp = 32 kHz. Where, fp is the frequency of the passband edge that will assures all the 50 Hz signal is completely attenuated, at the same time as the 120 kHz signal is passed through the filter to the amplifier stages. The signals are inter the amplifier stage with a value between ten millivolts to a few hundred millivolts. The module must amplify the carrier to certain limit and converted to a logic level signal that the PIC can detect. The amplification, however, must be carefully selected in order to prevent the signal will pass through the first stage which is the tuned amplifier stage where the 120 kHz signal is amplified by using a series of 4069UB inverters to configure as high gain amplifiers. The tuned amplifiers operate with peak response at 120 kHz at the first two stages while the next two stages are untuned amplifier but provide additional amplification. The amplified 120 kHz signal is passed to the envelope detector block which is containing a diode, capacitor, and resistor. The output of the envelope detector is buffered through an inverter and finally the inverse of the amplified 120 kHz is presented to an input pin (RC3) of the PIC16F8xxx. When the zero crossing is interrupt the RC3 will checked to see whether or not the carrier is present within the 1 ms transmission envelope. A stream of 1 volt is representing the presence of the carrier while 0 is the absence of the carrier. Transformerless Power Supply X10 modules used PIC16F877A or any other PIC requires a 5V supply to feed the board circuit. Since X-10 units are intended to be plugged into a wall outlet, a transformerless power supply is used to provide the require voltage. There are two significant characteristics of transformerless supplies that should be kept in mind: lack of isolation from the 240 volt AC and limited current capacity. Figure00 illustrates the transformerless power supply diagram used in this application. As it shown in figure00, a 220v VDR (voltage dependent resistor) being and connected between Line and Neutra to protect the circuit from spikes on the AC power line. 1MΩ resister connects in parallel with two capacitors to provide a discharge path for the voltage left on the capacitors when the module is unplugged from the wall. The voltage across 1000Mfarad was rectified by using two diodes and finally a 5.1V Zener diode to produce a 5V supply for the circuit. Load Switch There are two options to control a mains rated load, either to use a Triac or a relay. Electrical designers used relays in many different applications because they are suitable for very high power loads and very low power loads also when the main rated load need to be isolated and finally when the load require a relatively slow toggling rates. A Triac is the best option for switching non isolated medium power loads and they have a rapid switching capability and subsequence they are very suitable for dimming and lamp control. x10 manufacturer used a Triac as a load switch of the x10 units because its medium power switching capacity and most of the home appliances are consumes a medium power. In addition, Triacs are an inexpensive three-terminal device designed to switch a medium current load and has been used extensively in home appliances such as lamp dimmers and motor speed controllers. The main two terminals M1 and M2 are wired in series with the load figure00. A Triac is, three-terminal device that acts as a high-speed, bidirectional AC switch, two terminals, MT1 and MT2, are wired in series with the load. A small trigger current between MT1 and the gate allow conduction to occur between MT2 and MT1.when the latching occur between M1 and M2, the load current continues to flow even after the gate current is disconnected, as long as the load current exceeds the latching value. Therefore, when the 50Hz AC voltage falls below the latching voltage near each zero-crossing, the Triac will automatically switch off. There are two ways to maintain the load current beyond each single half cycle of the 50Hz AC supply, either the gate current have to be maintained continuously or the triac have to be retriggered each half-cycle of 50Hz. the advantage of the pulse trigger is that only lower average current is required. Typically, the trigger pulse duration must be long enough for the load current in order to reach the latching current. A L4008L6 Triac was selected for X10 module because it has a sensitive gate that the logic level output of the PIC MCU I/O pin will directly control it. Although, the PIC MCU can provide only positive voltages to the gate, the sensitive gate Triac can control the alternative AC current in both directions through the device. A lamp dimmer can be created by including a delay between the time that the trigger current is provided to the Triac from the PIC MCU and the time of each zero-crossing. In other words, TRIACs can be used to control the brightness of a light by switching the 50Hz AC power on part-way through each half cycle (Figure 2 and Figure 3). Therefore x10 maker allows the PIC MCU to directly drive the gate of a TRIAC through a current limiting resistor. By controlling the power-line cycle, the PIC MCU can control the average voltage across the lamp, and therefore the brightness . . .(unclear)???

Human Life & Police Brutality Modern Societies Major Global Issues Essay

Human Life & Police Brutality Modern Societies Major Global Issues Essay.

topic: police brutalityOverviewThe Problem/Solution Essay is an important example of analytical writing and will be useful not only in college but also in your professional career. Companies appreciate employees who are problem solvers and who can come up with creative solutions to different kinds of workplace problems. You have a great deal of freedom in choosing your topic for this paper. Make sure to find a controversial issue. Then find a solution and persuade your reader to your point of view. The AssignmentCompose a 3 – 4 page Problem/Solution Essay that relates to one problem in society. You will use 3 – 4 sources. Use secondary sources to support your argument and make your problem compelling to your reader. You must have an arguable thesis that has some degree of controversy. You must also include counter arguments at some point in your essay. Composing AdviceI will collect your prewriting and an informal topic proposal from you to start out the process. I want to make sure your topic is workable before you get too far. Then you will hand in an outline including the problem you are focusing on and your proposed solution. You will also list the main arguments you will make to support your solution as well as counterarguments that will show your reader you have taken other positions into consideration.
Human Life & Police Brutality Modern Societies Major Global Issues Essay

PCN 540 GCU Qualitative vs Quantitative Research Methodologies Article Review Essay

PCN 540 GCU Qualitative vs Quantitative Research Methodologies Article Review Essay.

Select and read one of the following articles The Role of Faculty Mentors in the Research Training of Counseling Psychology Doctoral Students The Career Development of Mexican American Adolescent Women: A Test of Social Cognitive Career TheoryWrite a 500-750-word analysis of your selected article. Include the following in your analysis: What are the key differences between qualitative and quantitative research? What are the strengths and weaknesses of qualitative research designs? What are the essential components that should be considered when applying qualitative methods to counseling outcomes?Prepare this assignment according to the guidelines found in the APA Style Guide.This assignment uses a rubric. Please review the rubric
prior to beginning the assignment to become familiar with the expectations for
successful completion.
PCN 540 GCU Qualitative vs Quantitative Research Methodologies Article Review Essay

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