The Most Influential Designers of the Century

Paul Poiret (1879 – 1944) is best known for liberating women from corsets. Lacking certain technical dressmaking skills Poiret made draping the focal point of his designs. He was interested in simple shapes that freed the body and being inspired by Fauvism, Japanese culture and the Ballet Russes mostly used exotic colours. He was the king of Oriental Era in 1910's and a natural businessman. He expanded limits of what fashion meant at the time and brought some serious innovations to the industry. Kimono coat, â€Å"hobble† skirt, â€Å"lampshade† tunics, â€Å"harem† pantaloons are all signature outfits of Paul Poiret.Along with other designers like Mariano Fortuny, Paul Poiret helped to establish what we now call a Classical style and of course, he is one of those designers who define Exoticism. While researching this revolutionary designer I came up with idea of three types of women he designed for: 1) Goddess-like woman in rich colored, empire waisted, b eautifully draped dress; 2) Exotic, seductive, slave-like woman in turban and harem pantaloons/hobble skirt. 3) Rich, extravagant Eastern/Japanese woman in fur, velvet, etc. lush fabrics.Gabrielle Coco Chanel (1883 – 1971) is rightfully called a queen of 20's. She was (and still is) one of the most influential designers of all time. The style that Chanel promoted is considered classic today, not to mention timeless wardrobe essentials as little black dress or Chanel suit. Channel started off by shortening hemlines so that women who now had to work in factories (post WWI) would feel more comfortable. Using unconventional fabrics (at the time) like jersey and tweed she adapted menswear to women needs and actually transformed what a modern woman means.Her woman was independent and strong. She lowered the waistline to upper hips level thus creating an androgynous/boyish silhouette – La Garconne. Combining elegance and practicality she used simple materials to create access ories: for the first time in history daring to mix pearls with glass beads and inventing â€Å"poor chic†. On the contrary to Poiret, Coco Chanel was an experienced seamstress and paid great attention to details. Later in her career, she stopped using sewing machines and started making every garment by hand.She was also known for her signature embroidery which was carried out by Russian house Kitmir exclusively for her. For me, Chanel stands for timeless elegance. She is inspirational image of independence and innovation. Nowadays, Karl Lagerfeld is a head of design in house of Chanel. Here are my three favorite looks this season (from pret-a-porter A/W 2012): Madeleine Vionnet (1876 – 1975) was the first designer to adapt her â€Å"haute couture† designs to high street and by doing so she transformed commercial fashion industry. Vionnet combined modern business practices with innovation in dressmaking.She is also praised for taking garment construction to the h ighest level – adopting and perfecting the bias-cut (many people say she invented the bias cut but in her biography Vionnet clearly states that is not true), making dresses with one seam and showing off outstanding cutting skills in each garment. Vionnet promoted style which I would describe as Grecian aesthetics minimized and polished to form clean, sleek, ageless idea of beauty. In 1925 British Vogue, articulating Vionnet's appeal, declared her ‘perhaps the greatest geometrician among all French couturiers'.Her ideas survived and are continued with great success in the house of Vionnet. http://vionnet. com Here are some of my favorite looks this season: Elsa Schiaparelli (1890–1973), Italian designer and the greatest rival of Chanel was a very influential figure in 30's fashion. Fascinated by Surrealism, she formed one of the most iconic partnerships between Art and Fashion while working with world-renowned artist Salvador Dali. (I must mention though, that she collaborated with many other artists of the time).Unfortunately, she didn't adapt to changes after WWII and her business had to close in 1954. Today, her garments are kept in museums and she is praised as a genius, messiah of ultramodern couture. Few of her creations are particularly famous: Tear (1), Lobster (2) and Skeleton (3) dresses and Shoe hat (4). Claire McCardell (1905-1958) is regarded as the inventor of the â€Å"American Look†. With the rationing of silk and wool during WWII, she employed corduroy, seersucker, denim and cotton fabrics to create sensational designs. She said, that â€Å"All of us, any of us, deserves the right to a good fashion†.Her Monastic and Popover dresses were massive hits, not to mention cloth ballet slippers which survived until today. She was the originator of mix-and-match separates, spaghetti straps, pedal-pushers, bareback summer dresses, strapless swimsuits, and feminine denim fashion. Immediately after WWII, Christian Dior (19 5 – 1957) jumped into a fashion arena. He launched his â€Å"New Look† in 1947 and it was an immediate success. After years of rationing Dior cut himself loose and designed dresses with full skirts (making of these required up to 50 yards of fabric), â€Å"waspie† waists and slender shoulder line.He brought back femininity and hope for a better life. Although many people in Europe were shocked with such drastic changes, Americans gladly accepted the new breeze and much of Dior's income in the first years came from export to USA. Unfortunately, genius died 10 years later leaving young master Yves Saint Laurent as an artistic director of his house. Today Dior house is one of the strongest leaders in fashion industry and one of my personal favorites as well. Here are my three favorite looks from A/W 2012 haute couture collection:Yves Saint Laurent (1936 – 2008) was hailed as the man who (at the age of 22) saved the house of Dior, a King of French fashion and a first couturier to present ready-to-wear collections. I think that the most important time began when he opened his own house in 1962. He was a genius and cared about empowering women, also (much like Schiaparelli) he aimed to shock. Therefore a trouser suit – Le Smoking – was born. It was a trend setting evening trouser suit and it became Yves Saint Laurent's trademark, also a must-have in modern women's wardrobe.We have to be grateful to him for blazers, see-through blouses and a business wardrobe for women. He was one of the main figures in 60's and 70's taking the best out of pop culture and translating it to fashion (Andy Warhol inspired dresses). He was also a great lover of art so he designed a collection of dresses inspired by his favorite painter Piet Mondrian. â€Å"Mondrian Look† (especially one particular dress) is as famous as New Look or Elsa Schiaparelli's Tear dress. Yves Saint Laurent house continues to make androgynous women designs under le adership of newly appointed creative director Hedi Slimane.Here are my favorite looks from Spring/Summer 2013 ready-to-wear collection: Hubert de Givenchy (1927 – today) is best known for his elegant, refined style, and for his popularity with celebrities like Audrey Hepburn (Audrey Hepburn became a symbol of house of Givenchy, she popularized him in movies like â€Å"Sabrina†, â€Å"Breakfast at Tiffany's†, â€Å"My fair lady†, etc. ) , Jackie Kennedy, Grace Kelly and many others. Givenchy introduced a new concept of mix and match separates (unthinkable in 1950's). His signature garments were: little black dress and â€Å"Bettina† blouse.Creating elegance for 40 years straight, Givenchy house continues to astonish the world today with a new leader Riccardo Tisci. Here are my favorite looks from A/W 2012: Givenchy's idol was Cristobal Balenciaga (1895 – 1972) a great Spanish couturier and colorist. He was strictly modern, very technical and a master of illusion. He invented the threequarter-length sleeve and the standaway collar. He taught fashion design classes, inspiring other designers such as Oscar de la Renta, Andre Courreges, Emanuel Ungaro, Mila Schon and Hubert de Givenchy.He was so innovative, that he designed waistless dresses and tunics in 50's proving to be fashion forward by almost a decade. However, in 1968 he decided to close his business. Balenciaga house was bought by Gucci group and today is run by Nicolas Ghesquiere, one of the most talented designers of today(as praised by Vogue). Here are my favorite looks of the season: Mary Quant (1934 – today) is a British designer and fashion icon which has become synonymous with the â€Å"swinging sixties† in London. She is credited with the invention of a mini skirt, skinny rib sweater and false lashes.She reinvented the use of PVC material and created the popular â€Å"Wet Look†. She popularized hot pants and eventually received OBE and Hall of Fame awards from British Council for her outstanding contribution to fashion industry. Through 70's and 80's she concentrated on cosmetics industry and interior design and her clothing lines became of secondary importance. Today she has about 200 Mary Quant Colour shops in Japan where her cosmetic products remain popular. Vivienne Westwood (1941 – today) is the mother of 70's punk era.Together with Malcolm McLaren she established a brand that specialized in clothing with bondage pants, kilts, chains, leather jackets and T-shirts with provocative imagery. Popularized by McLaren's managed band â€Å"Sex Pistols† the look became a new wave of fashion . It was quickly accepted amongst teenagers and young adults and I think it captured the overall atmosphere of self-expression in 70's. Vivienne did not stop here though, she went on to receive prestigious OBE and DBE awards and opened quite a few labels under her name: Golden Label, Anglomania, Red Label and Man.Her house successfully work today and here are my favourite looks from A/W 2012 collection: Rei Kawabuko (1942 – today) is a Japanese avant-garde designer which managed to enter the international fashion scene with an uproar. In 1983 (together with another designer Japanese designer Yohji Yamamoto) she presented a new concept in fashion – deconstructed silhouette, colourless, distressed fabrics and garments full of clothes. The look was immediately dubbed â€Å"the Hiroshima chic†, â€Å"boro look†, â€Å"beggar look† and similar.Her distinctive point of view shocked and amused the West and that earned her a place in Parisian Chambre Syndicale du Pret-a-Porter. Today she is a head of her own company Comme des Garcons, and one of the most popular brands in the world. Here are my favourite looks from this season: Yohji Yamamoto (1943 – today) became popular at the same time as Rei Kawabuko. Presenting the unprecedented style concept to Western fas hion world with his 1983 cutwork collection he was instantly acknowledged and recognized.His asymmetrical designs always take a viewer by surprise, his commercially successful designs are sold worldwide and together with Rei Kawabuko Yohji Yamamoto is held responsible for putting Tokyo on the map fashion wise. Wonderful thing is, that despite similarities in Kawabuko's and Yamamoto's designs (and their life together in 80s – 90s) they both have different aesthetics and distinctive directions. Kawabuko occurs to me to be more conceptual and Yamamoto is way more elegant designer. Here are my favourite looks:John Galliano (1960 – today) is one of the most controversial designers today but nevertheless, genius. In short, he graduated from Central Saint Martins College of Art and Design Galliano was awarded the â€Å"British Designer of the Year† in the year 1987, 1994 and 1995. Due to frequent financial troubles he accepted the job offer at Givenchy and in two years time he was transferred to Dior as a creative director of the house. He also has his own house under his name. Achieving that amount of success in a short period of time, he is proven to be genius and of course he has plenty of respectable awards to prove it.His creations are magical, his style is very dramatic and his presentations are always theatrical . Despite his recent â€Å"crimes† (in 2011 he was dismissed from Dior when found guilty of racial insults in public) Galliano name still stands for unspeakable elegance and innovation, his garments are highly collectible. It is unclear to me what happened to genius after he was dismissed from Dior. House of Galliano is working without his original captain under leadership of Bill Gaytten. However his idea of beauty prevails and I think he is the next Chanel. Here are my favourite looks from this season:Alexander McQueen (1969 – 2010) was a magnificent designer who left a huge imprint through his short lifetime. He wo n a great number of awards for his distinctive dramatic point of view, including Commander of the Order of the British Empire, International Designer of the Year 2003 by Council of fashion designers of America and others of similar caliber. Ever since he entered fashion industry he was considered a genius. Fashion editors were left in awe after each new collection, not to mention the infamous VOSS. He is well known for his collaborations with celebrities such as Lady Gaga, Bjork, Kanye West and Katy Perry.I would say his style is eccentric, avant-garde but extremely elegant at the same time. Alexander McQueen was original in every way and extremely technical as well. After unfortunate and untimely death of genius in 2010 Sarah Burton took the helm of Alexander McQueen's house and added her own feminine touch to the name. She has also designed a wedding dress for the Royal Wedding of Kate Middleton and Prince Williams. Alexander McQueen's house successfully runs today and here are fe w wonderful creations from this year Autumn/Winter collection:

Cause of Prejudice Essay

There are many types of prejudice in modern society. The definition of prejudice according to Webster’s Dictionary is â€Å"an adverse opinion or leaning formed without just grounds or before sufficient knowledge.† The causes of some prejudice can be linked to a person’s childhood. The effects of being prejudice can be harmful to the person who is prejudice and to the people or group that person is prejudice of. The causes of racial prejudice stem mainly from childhood. One way childhood can cause a person to be more prejudice is where that person lived as a child. For example, if a child lives in southern United States, that person is more likely to be more prejudice against African-Americans because their culture in the South has been more prejudice towards that group because it has had a prejudice toward that group in general for many years due to slavery. This is not to say that all people in the South are prejudice but it does lean more prejudice against that group. Whereas, in the northern states, there is less prejudice in general towards African-Americans. Another way childhood can affect whether or not a person has a prejudice is their family and how they were raised. If a child see’s their family or parents using racial slurs or putting down a race for any reason, that child could grow up to be the same way and think it is acceptable to have a prejudice. The effect of that could be going in public or at school using derogatory comments towards a race and thinking that it is alright and hurting someone’s feelings. Living in a household with more open views to other races allows for a child to be more open, show less prejudice to others, and be more accepting and tolerant. A child could also pick up prejudice opinions through their friends. Their friends could be bullying another child due to his race and that child could join along to fit in. This also is a major problem in schools because that child that is bullied could resent his classmates and this can cause many more problems down the road. If a child can learn to not fall into the peer pressure of bullying others for being different then more children could  follow and there is the solution to bullying in schools. Children are very impressionable and the more we can teach them about tolerance and to be more open to others than the better off as a society we are. With less prejudice there wouldn’t be as much violence because much of the violence that happens has some sort of prejudice attached with it. Also, the more open we are then the fewer problems we will have because everyone will get along and focus on more important issues of the world.

Acquisition of Instagram by Facebook Essay Example | Topics and Well Written Essays - 1500 words

Acquisition of Instagram by Facebook - Essay Example A comprehension of the strategic reasons behind this acquisition is a critical aspect to gauge the long-term motives of the companies. Facebook is a social networking platform that helps to connect with family as well as friends along with facilitating in sharing own views and opinions, sending messages, sharing images and videos and playing games among others. On the other hand, Instagram Inc. founded in 2010, is a free photo sharing application software company. It provides a very beautiful, fast as well as amusing way of sharing photos with the family and friends. The company has become very popular with its photo sharing application but the acquisition of Instagram by Facebook at a valuation of $1 billon is really surprising for the whole industry because since the establishment of Instagram the company has no turnover up to now. It has only 35 million users of the application especially the Apple Smartphone users as well as other Android smartphone users. It is also very surpris ing for all because there are a lot of blog sites that are already accumulated with Facebook, despite this it has acquired such as a small application based company (Gavaghan & Warren, 2013). In this context, it is definitely required to be pointed out that understanding the strategies of the big companies is at times really quite complex. The term strategic management describes the process of analysing decisions as well as actions taken by an organisation in order to create and derive sustainable competitive advantages. Therefore, it is determined that managing the strategy of an organisation effectively as well as efficiently is the essence of organisational growth (The Social Media Guys, 2010). This essay intends to critically discuss the strategic opportunities and threats facing Facebook. Moreover, the different methods of strategic development that can be used by the companies will be identified. Consequently, amid these methods, the appropriate method applicable in case of Fa cebook’s acquisition of Instagram will be evaluated. In addition, with the aid of the TOWS matrix, a critical analysis would be made of the strategic decision taken by Instagram’s management to join forces with Facebook. Strategic Opportunities and Threats Facing Facebook In the global business world, every organisation has to deal with two types of environment i.e. internal environment as well as external environment. In this context, the parameters that will be described comprise the opportunities as well as the threats faced by Facebook by taking concern the external environment (Thompson & et. al., 2005). In the context of strategic opportunities for Facebook, firstly there is a need to highlight the acceptance of the global people of this innovative concept. The audience size of this social networking media and the talents who are associated with this concept is the significant strength as well as opportunity of this organisation for dealing with any hurdle coming from the global competitors. The term strategic opportunity is a broad concept because it is not only defined by the present business scenario simultaneously it also dedicatedly focuses on the sustainability as well as future prospects (Jeffs, 2008). In order to address the varied strategic opportunities, there is a need to determine the core strategic causes behind the acquisition of Instagram by Facebook. Behind this strategy, unquestionably it can be stated that Facebook acquired this company not because of the turnover generated by it but owing to the user acceptance related to the application. Facebook seeks to sustain in the global market through continuously providing innovative

The impact of social media on public relations practice Research Paper

The impact of social media on public relations practice - Research Paper Example Introduction There has been a significant change in the media landscape during the past couple of decades particularly due to the advent of social media which has singlehandedly revolutionized the concept of communication. The world of media and communications has taken giant strides towards development from its humble beginnings dominated largely by print media and radio broadcasts to the use of state-of-the art technological gadgets such as tablets, iPhones, digital recorders, and web enabled tools such as social networking services including blogs, webcasts, video blogs, YouTube and the likes (Breakenridge, 2008; Busy, 2004). Considering the vast outreach of technology and the unlimited access it offers, the gap between the public and the marketers has narrowed significantly. It would not be a far cry to claim that the generation of this era travels with technology in their pockets, thus enabling the public relations practitioners to smoothly and effectively deliver their messages to the targeted audiences, at a mere click of a button (Hazelton, Harrison-Rexrode, & Keenan, 2007). The revolutionary changes in the field of technology has also completely changed the manner in which the average consumers connect, access, interpret, and use the information made available to them. The change in the social media landscape has triggered off simultaneous changes in the practice of public relations as is evident from the growing amount of literature substantiating the claim. As these fields grow and evolve in response to the changes in the technology, the delivery of strategic information to the public is likely to change as well (Kelleher, 2009; Macnamara, 2010). 1.1. Definitions This section offers definition to key terms used in the paper, which includes – Public relations and Social media. Public Relations: The term ‘public relation’ is defined differently by different authors. In general terms it is used to describe the 'management functions' performed by a group of professionals with a pre-defined outcome in mind. The Chartered Institute of Public Relations (UK) has defined the term as "the planned and sustained effort to establish and maintain goodwill and mutual understanding between an organization and its publics" (qtd. in Watson & Noble, 2007: 6) Griswold defines public relations as "the management function which evaluates public attitudes, identifies the policies and procedures of an individual or an organization with the public interest, and plans and executes a program of action to earn public understanding and acceptance" (qtd. in Heath & Vasquez, 2001: 192). The Public Relations Society of America (1999) states that "Public relations helps an organization and its publics adapt mutually to each other" (qtd. in Health & Vasquez, 2001: 192). Social Media: According to Jue, Marr, & Kassotakis (2009: 4) the term social media refers to "the many relatively inexpensive and widely accessible electronic tools that enab le anyone to publish and access information, collaborate on a common effort, or build relationships". 1.2. Key objectives of the study The fundamental objectives underlying this research study are listed below: To identify various social media tools used by public relations practitioners and assess the manner in which such tools are used to manipulate the perceptions of the target consumers To examine and understand the manner in and extent to which the development and introduction of social media tools

The Attributes Of The Nurse Leadership Essay Example | Topics and Well Written Essays - 500 words

The Attributes Of The Nurse Leadership - Essay Example I have grown with my self-knowledge and this growth emanated from m interaction with other people. As a nurse, there was always the need to mingle with other officers to work together and in some cases take instructions from them. As all these interactions took place, there were avenues through which I easily pointed to some of my weaknesses and strengths and these generally make up for my self-knowledge. The lessons and topics have also gone a long way to teach me about differences in personalities and this has spiced up my self-knowledge. The class sections have really helped in shaping my interpersonal relationship with others. Before, I was the type who believed so much in my personhood and thus had very little time to pay attention to who other people were and what they did. Today, I have come to accept the need for social integration and the basic requirements for this; which includes the need to open up to other people and give them the chance to also express themselves freely. This has however not defeated the need for me to continue to be an active communicator instead of a passive one. As the topic areas in this course of leadership proofs to be more and beneficial to my studies and career as a nurse, it is important that I seek an avenue to continue to learn more topics regarding leadership. In this direction, some key topics I have penned down include but not limited to The knowledge they say is not vested in the head of one person alone. For this reason, I constantly feel the need to learn from other people to equip what I already know and have. For this reason, I pay particular attention to the attributes of other nurses and learn a lot from them during interactions with them. I am never shy to ask questions for clarity and ask for my mistakes to be corrected. Through such means, I am hoping to be a perfect nurse in the nearest future.

Asbestos hazards Essay Example | Topics and Well Written Essays - 750 words

Asbestos hazards - Essay Example The case of James Hardie Industries in Australia is a learning experience on how failure of the businesses to induce a mechanism of occupational health issues can remain critical to its operations. Occupational health hazards do exist in daily operations in most businesses. However, it remains the role of the managers and the health department to ensure that the staff and the target consumers are safe, during the process of conducting the sales as well as production. That is the reason the national department on safety does recommend that every business should have a safety program for its workers prior to kicking off its operations. Some of the business products are at the verge of posing long-term effects to the victims of the same. It, therefore, remains expensive to compensate the victims as long-term damage has already occurred in their system. Prevention is always better than cure. It is advantageous for a firm to come up with outlines of hazards prevention rather than coming u p with them when damage has already happened. Utilization of protective devices is also important especially in areas where various lethal gases or solids are at risk of coming into contact with the bodies of the victims.Deaths related to asbestos toxicity were on the increase. Everybody was aware that the firm was responsible for the effects. Mesothelioma was the main condition that the majority of people suffered from. More than 10000 deaths did occur in Australia due to the toxicity emanating from asbestos.

Artists Chosen to Depict This World in a Positive and Negative Sides Essay

Artists Chosen to Depict This World in a Positive and Negative Sides - Essay Example Art serves many purposes and for these purposes is to relate to its audience.  Ã‚   Relating to the audience can either be done either by painting the world in a positive light or otherwise by invoking the darker side of man and society.   Both methods are effective in rendering art. One of the artists that depicted in this world in a positive light is Claude Monet (1840-1926), a French impressionist painter famous for his ponds and water lilies.   He portrayed the world in a positive a light because he invokes fond memories among his audience when he paints his ponds, water lilies, garden, and beach.  Ã‚   Noticeably, Monet’s work is full of depicting waters in various form be it ponds or beaches, it invokes a positive feeling among his audience because it reminds them of outing, the family gets together, childhood and happy moments. The other approach that is opposite to Monet’s positive outlook is depicting the darker side of man and society.   This approac h is to bother and unsettle the audience by invoking negativity in the artwork.   One of the classic examples is Pablo Picasso with his distorted image of man and his surroundings.   His approach was so negative that he was first criticized for his negative approach in painting.   Finally, the audience caught up with him and understood the genius of his work that beauty can also be portrayed by evoking the negative aspect of man and society and not just by painting nice things and people which could sometimes be boring.

Brand Impact and Popular Culture Essay Example | Topics and Well Written Essays - 1500 words

Brand Impact and Popular Culture - Essay Example This paper illustrates that Matthew McConaughey is an American actor well known for his role in films like Dazed and Confused  (1993), Amistad  (1997), and Failure to Launch (2006). In recent years, McConaughey has featured in small, independent films and has featured in some exigent roles. Toyota Corolla was launched in 1966 primarily as a family car. It was positioned as a progressive and friendly vehicle. The newest version of the Corolla is focused on providing an instantaneous good feeling to the customer. There is a picture of a sleek, attractive Toyota Corolla zooming along the river side on the first slide of the theme board. The photograph of a smiling, friendly brand endorser on the same slide is used to encode the feeling of goodness. The Brand Typology model suggests that brands can be classified into eight categories namely Clean Slates, Weak Brands, Little Tigers, Defenders, Olympic, Classic, Specialist and Fading Stars by analyzing their momentum and familiarity in the marketplace. Olympic brands are illustrious and have a large customer base. These brands are usually the talk of the town and serve as benchmarks for other brands. At present Toyota Corolla is an Olympic brand. The car was launched in 1966 and is now pegged as the ‘World’s Most Popular Car’. The Japanese company has manufactured more than 40 million Toyota Corolla cars since its launch. The model is sold in more than 150 countries and regions around the world. McConaughey too is recognized worldwide. The experienced actor has staged a remarkable mid-career comeback and his popularity has increased tremendously in recent times. Good looks, humility, and award-winning performances have made McConaughey an admirable person.

The Rojas Murders of 1892 Research Paper Example | Topics and Well Written Essays - 1250 words

The Rojas Murders of 1892 - Research Paper Example Crime prevention presents a drain on limited budgets but this is considered as a necessary expense; otherwise, society breaks down. If prevention fails, law enforcement authorities have to resort to investigative techniques and forensic science to try to solve a crime that was committed. Forensics is the scientific and methodological gathering of evidence in the investigation of crimes with the aim of catching the criminal. The hope of eventually catching the real perpetrators of a crime depends to a big extent on how good the forensic investigator is. There are essentially two steps involved which are the keen sense of making detailed or accurate observations of a crime scene and properly document those same observations. Forensics is usually undertaken by experienced police investigators and helped in large part by expert forensic scientists. The act of gathering crime scene evidence may not always make the case but certainly, a good forensic investigation, interpretation of the cr ime scene evidence and an astute analysis will always make a prosecution case much better. In other words, good forensics can strengthen a weak case and help to catch a criminal based on anything left behind from the crime scene which would have otherwise escaped notice or detection. This paper talks and discusses on one such precedent-setting case in which fingerprint evidence was first used in a court case to convict a mother who killed her own two sons. Discussion Catching a criminal is always a risky business, risky in the sense that most crimes are committed in secret. A criminal is unlucky if he is not careful and is caught in the very act of the crime being committed, termed in Latin â€Å"in flagrante delicto† (originally used as euphemism for someone caught having sexual intercourse but has since been extended to the commission of any crime) and used in English and jurisprudence today as being â€Å"caught red handed.† If this happens then the case could be co nsidered as an â€Å"open and shut case† in which there are witnesses to the crime who can give their testimonies in open court and corroborate what they actually saw. However, majority of crimes are committed in secret with no witnesses to the crime and this is where forensic science can be a big help in solving the crime and catching the criminal. It is a highly-specialized field that requires the appropriate education, training, experience and use of good logic and deductive reasoning to be able to properly document the observations in crime scenes, preserve the evidence from tampering, prevent crime scenes from being inadvertently or intentionally altered and possibly reconstruct the most probable crime scenario to be able to give an expert opinion on what happened, how it happened and who did it. The novel by Sir Arthur Conan Doyle about a fictional detective named as Mr. Sherlock Holmes easily comes to mind when it comes to forensic investigative science and also of log ical reasoning in arriving at an expert opinion in a classic whodunit. In crime cases where there are no witnesses, police investigators must rely on the crime scene evidence to try to pin down the criminals based on circumstantial evidence through deductive reasoning and inference. Correctly connecting the crime and the criminal essentially requires establishing the very presence of the criminal at the crime scene. This is quite a tedious undertaking that calls for accuracy to remove any reasonable doubts. There is extreme

The digital stop clock Essay Example for Free

The digital stop clock Essay It is accurate because, it measures to 100ml 1. Pipette -To make sure the volume of acid used was as accurate as possible. The way we measured the acid was at eye level from the bottom of the meniscus. 1. gas syringe -To measure the volume of carbon dioxide gas produced. The syringe was precise because it measured volume in 1ml divisions. Throughout this reaction the carbon dioxide is colourless so without it I would have problems measuring and observing the reaction, so if a substance is added to give the carbon dioxide a colour, my final results might not be reliable. I have researched that using a gas syringe is a lot more efficient than using a measuring cylinder as problems occur with the air bubbles.. 1. The electronic balance We used to measure the amount of calcium carbonate we would need for each experiment. The balance is measured in grams (g) We used also used this equipment to ensure the experiment is precise because the electronic balance is measured to 3 decimal places which are helpful as I am using a mass of 0. 5grams. 1. The digital stop clock. -We used the stop clock to time how long the experiment would last for and to make sure that we didn’t go over the amount of time set to do each repeat. There is a start and reset button to start the timer and a stop button to stop the timer this makes it more easy to use. The digital stop watch is also precise because it measures to hundredth seconds which helped us accurately record the volumes of gas at our set intervals and making the experiment a fair test as every measurement was taken at certain time. 1. Stand clamp: The reason why we used this is because the stand clamp for safety reasons as we must ensure that ga syringe and the flask with the acid that are connected to each other are stable so they do not tip over, this is because it may affect the results, and if the acid spills it could be expensive to replace a new one. Same goes with the gas syringe. The reason we used a stand clamp is because the equipment were held steadily to increase the gas flow through the tubing. This will help the gas access the syringe to read the results more accurately. 1. Spatula: We used the spatula to take out the calcium carbonate from the jar because it was the only equipment small enough to fit through the jar. Using another piece of equipment, for example a spoon, would be too large to fit through. 1. Weighing Boat: We placed the calcium carbonate in the weighing boat after we measured it. The weighing boat is light, so it will not affect how we measure the calcium carbonate. 1. Goggles: We wore goggles as part of our health and safety rules that we had to follow to stop any injuries from happening. An example for when we need goggles is when we need to prevent acid from getting into your eyes as it may damage your eyes for the long term. 1. Conical flask with bung: We used this piece of equipment because we needed to put in the reactants (calcium carbonate and hydrochloric acid) that we used when measuring the amount of gas being produced. It attached onto the gas syringe so the gas that was produced in the reaction could pass through the tube to be measured. The bung is there to make sure that the gas being produced, does not escape from the conical flask. The method consists of several steps: 1. Put on your lab coat and goggles. 2. Gather all the equipment that you need e. g. gas cylinder with chronicle flask, two clamp stands, measuring boat, measuring cylinder, and stop watch. 3. Set your equipment up e. g. clamp the gas cylinder into one clamp stand, and clamp the chronicle flask into the other clamp stand, making sure they are at the same height 4. Measure the hydrochloric acid with a measuring cylinder. 5. Pour the acid into the chronicle flask 6. Weigh out the calcium carbonate with the electronic balance. 7. Pour the calcium carbonate into the chronicle flask 8. Place the bung on straight away, and start the digital stop watch 9. Take readings from the gas cylinder every 10 seconds. Main experiment – changing the surface area. The equipment we used was pipette. We used this to make sure the volume of acid used was as accurate as possible. The way we measured the acid was at eye level from the bottom of the meniscus. We used the gas syringe to measure the volume of carbon dioxide gas produced. The syringe was precise because it measured volume in 1ml divisions. We used the electronic balance to ensure the experiment is precise because the electronic balance is measured to 2 decimal places and we also used the stop clock as it is precise because it measured to hundredth seconds. This helped us accurately record the volumes of gas at our set intervals. In the surface area we made sure that we kept the 2M of the hydrochloric acid for each experiment of the surface area. We also used a mercury thermometer as it gives us a better precise reading and allows us to see whether the temperature of the hydrochloric acid makes a difference to the results. The method of the experiment of surface area was on the first experiment we used small calcium chips with the mass of 1. 5g. We measured this by using an electronic balance and we used 2M of hydrochloric acid of a volume of 30ml, by using a measuring cylinder which allowed us to measure the volume accurately. The second experiment we used medium calcium chips with the mass of 1. 5. We measured this by using an electronic balance and we used 2M of hydrochloric acid of a volume of 30ml by using a measuring cylinder which allowed us to measure the volume accurately. For the third experiment we used large calcium chips with the mass of 1. 5g. We measured this by using an electronic balance and we used 2M of hydrochloric acid of a volume of 30ml by using a measuring cylinder which allowed us to measure the volume accurately. For every experiment for the surface area we poured the hydrochloric acid into the conical flask, and then added the calcium chips as fast as possible to ensure the gas does not escape into the air, and not in the gas cylinder. As soon as we placed the bung inside the conical flask, we immediately started the stop watch and timed it up to 120 seconds. For every 10 seconds the person in role of the stop watch would shout at every 10 seconds, and the other person reading the gas cylinder will shout how fast the rubber, tubing is moving out of the gas cylinder. Then we would record the results in the table and repeat the same experiment 5 times to make the results precise and reliable. Results for surface area. We first started off with calcium carbonate powder (1. 5g)with hydrochloric acid (30ml) but the reaction took place within 5 seconds and immediately reacted. Therefore it was very fast and it was impossible for us to take any readings. Because of this we decided to use calcium carbonate chips so it is easier to take the reading. Table 4. Results for small chips of calcium carbonate Calcium Small Chips 1. 5g Hydrochloric Acid 2M 30ml Volume Of Gas Produced (ml) Time Repeat1 (ml) Repeat 2 (ml) Repeat 3 (ml) Repeat 4 (ml) Repeat5 (ml) Averages Evaluating the results for small chips of calcium carbonate Table 4 shows the surface area of small calcium chips. We did this by using 1. 5g of small calcium chips and 30ml of volume of 2M hydrochloric acid. There does not seem to be any outliers; a good start for the first results. As you can see we repeated the experiment 5 times to result precision. From the Table 4, we can see that the volume of gas produced increased fast towards the average of 110. From this we were keen to find out if the medium calcium chips made a more noticeable difference. Table 5. Evaluating results for medium chips of calcium carbonate Calcium Medium Chips 1. 5g Hydrochloric Acid 2M 30ml Volume Of Gas Produced (ml) Time Repeat1 (ml) Repeat 2 (ml) Repeat 3 (ml) Repeat 4 (ml) Repeat 5(ml) Averages   Outliers Evaluating results for medium chips of calcium carbonate. In Table 5, we show the surface area of medium calcium chips. We did this by using 1. 5g of medium calcium chips and 30ml of volume of 2M hydrochloric acid. In this graph there seems to be an outliner which is highlighted in blue. For the averages we did not include the outlier to give us a more reliable and precise average. As you can see we repeated the experiment 5 times to assure result precision. From Table 5 we can see that the volume of gas produced has gradually increased towards the time of 120 seconds. This shows that medium chips are the best results so far. To make sure we have concluded the right decision we wanted to check if large calcium chips would make a stronger difference. Table 6. Evaluating results for large chips Calcium Large Chips 1. 5g Hydrochloric Acid 2M 30ml Volume Of Gas Produced (ml) Time Repeat 1 (ml) Repeat 2 (ml) Repeat 3(ml) Repeat 4 (ml) Repeat 5 (ml) Averages Outliers Evaluating results for large chips of calcium carbonate. In Table 6 we show the surface area of large calcium chips. We did this by using 1. 5g of large calcium chips and 30ml of volume of 2M hydrochloric acid. In this graph there seems to be an outliner which is highlighted in blue. In the outlier the temperature on the hydrochloric acid was 23EC, which is an inconvenience and the rest of the results that don’t have an outlier have all got 24EC. This tells us the that the change in temperature may be a reason why there may be an outlier. For the averages we did not include the outlier to give us a more reliable and precise average. As you can see we repeated the experiment 5 times to assure precision in results. From the Table 6 we can see that the volume of gas produced has gradually increased towards the time of 120 seconds. This shows that large chips results are also reliable. Graphs for surface area. In the graph I can see that small chips used in the reaction releases more volume of gas in (ml) is better as it increases the amount of carbon dioxide produced till 100 seconds so the amount of carbon dioxide produced from 100 – 120 seconds becomes constant. The medium chips starts releasing gas at 10 seconds at a volume of 9ml. The volume of gas then increases up to 120 at a volume of 83ml. The large chips starts releasing gas at 10 seconds at a volume of 9ml and the volume of gas then increases up to 120 seconds at a volume of 85ml. Because we did not carry on timing the experiment we do not know if the rate of reaction decreases at 120 seconds and more because both large and medium chips seem to be increasing the volume of gas. As you can see from these results in the graph.large and medium chips release almost the same amount of carbon dioxide. This means that both the differences between large and medium are insignificant. as the range bars overlap. Conclusion for surface area In the surface area there was more area available for collisions to take place. If the reactant is a solid it is necessary to break it into smaller pieces to increase surface area. In the surface area results, we found out that as the mass of the calcium chips are larger; it increases the speed of the particles. The faster the particles move, the greater the number of collisions, and therefore the rate of the reaction increases. Chemical reactions take place by chance. Particles need to collide with enough velocity so that they react. As surface area is increased the particles move faster since they have more energy. This means that they are colliding more often and most of the collisions have enough velocity to cause a reaction. Since there are more collisions the chemical reaction takes place faster. Main experiment – changing concentration. The equipment we used was pipette. We used this to make sure the volume of acid used was as accurate as possible. The way we measured the acid was at eye level from the bottom of the meniscus. We used the gas syringe to measure the volume of carbon dioxide gas produced. The syringe was precise because it measured volume in 1ml divisions. We used the electronic balance to ensure the experiment is precise because the electronic balance is measured to 2 decimal places. Qe also used the stop clock as it is precise because it measured to hundredth seconds which helped us accurately record the volumes of gas at our set intervals. In the concentration we made sure that we kept the calcium carbonate small chips of 1. 5g and the hydrochloric acid 30ml but just changed the M to 0. 5M, 1M, 1. 5M, 2M for each experiment for the concentration. We also used a mercury thermometer as it gives us a more precise reading and allows us to see whether the temperature of the hydrochloric acid makes a difference in the results. The method of the experiment for the concentration was on the first experiment as we used small calcium chips with the mass of 1. 5g. We measured this by using an electronic balance and we used 0.5M of hydrochloric acid of a volume of 30ml by using a measuring cylinder which allowed us to measure the volume accurately. In the second experiment we used small calcium chips with the mass of 1. 5. We measured this by using an electronic balance and we used 1M of hydrochloric acid of a volume of 30ml by using a measuring cylinder which allowed us to measure the volume accurately. For the third experiment we used small calcium chips with the mass of 1. 5g. We measured this by using an electronic balance and we used 1. 5.

History of the Atomic Bomb

History of the Atomic Bomb Around the world, there is a debate whether Americas choice of dropping of the atomic bombs on Japan was moral or immoral. The horrific bombing at Hiroshima and Nagasaki, two important cities in Japan, helped end the Second World War. America had hatred towards Japan because they bombed Pearl Harbor, Hawaii, on December 7, 1941, which was the last straw before America entered the war. Harry S. Truman, the United States thirty-third president, gave authorization to bomb the two cities, in hopes of ending the war. America bombed Hiroshima with Little Boy, the name of the bomb, on August 6, 1945, at 8:16 in the morning. The bombing of Nagasaki happened on August 9, 1945, at 11:02 in the morning. The bomb used in this attack was named Fat Man. During the years of World War II, 1939-45, Hiroshima was the headquarters of the Second Army of Japan and Chugoku Regional Army. Nagasaki, on the other hand, was a major seaport. Killing 220,000 people between the two bombs, the explosions were the most lethal bombings ever. The Allies, an alliance between Italy, France, the United Kingdom and the United States, demonstrated their first signs of bombing Japan during the Tokyo fire bombings. Killing several 100,000 people during the first few months of the firebombing caused a higher death toll than both atomic bombings of Hiroshima and Nagasaki. Those two atomic bombs killed less people. Nonetheless, the atomic bombs caused a quick, devastating catastrophe that would affect Japanese lives for decades. The atomic bomb has its pros and cons, which allows the world to think if it was worth all the effects to end this deadly war. Albert Einstein, a German physicist who came up with the theory of relativity, thought of the idea of the atomic bomb with other noted physicists. In the beginning of World War II, Fritz Strassmann and Otto Hahn, German physicists, thought of splitting uranium atoms by nuclear fission. Later in the war, a group of American scientists began The Manhattan Project, formally known as The Manhattan Engineer District. General Leslie Groves led the project and the scientific research department managed by physicist J. Robert Oppenheimer, known as The Father of the Atomic Bomb. The experiment created atomic bombs, which were funded by the Americans, Canadians, and the British. The Manhattan Project had four laboratories where they created bombs. The locations were Richland, Washington, Oak Ridge, Tennessee, Los Alamos, New Mexico, and Chalk River, Ontario, Canada. Shockingly, Franklin Delano Roosevelt, the thirty-second president of the United States, kept the production of the bombs a secre t from Congress and the public during World War II. In fact, Truman figured out about this project when he was sworn into his presidency. The scientists created three bombs, the Gadget, Little Boy and Fat Man. The Gadget was a similar type of bomb as the Fat Man; however, the scientists were unsure if either of this type of bomb would work. The test, called Trinity, conducted to detonate the Gadget in New Mexico on July 16, 1945, at 5:30 in the morning. Every scientist was thrilled by the success of the bomb, and citizens one hundred miles away from the testing location could feel and see the bright light from the explosion. Astonishingly, a blind girl saw the flash up 120 miles away (Bellis). The Trinity was the green light that the bombs were usable. They would be used three weeks later in Japan. On August 6, Colonel Paul Tibbets flew the B-29 Enola Gay, named after Tibbets mother. The B-29 was a type of plane flown in World War II and the Korean War. Taking off at the United States base in Tinian, which is an island outside of Japan, the Enola Gay left with Little Boy. Flying 26,000 feet above Hiroshima, Tibbets cc rew dropped the bomb, which ignited a few thousand feet above ground (1945: Atom bomb hits Nagasaki). The crew put on their safety goggles immediately, turned away from the mushroom shaped explosion, and returned home safely. Three days later, Major Charles W. Sweeney flew the B-29 named Bockscar, which is a pun on boxcar and after Frederick C. Bock the Commander of the plane. At 11:02, the crew dropped Fat Man with a parachute attached, because this bomb was much heavier than Little Boy and it would hit the ground quicker. The American plane wanted to be as far away from the explosion as possible in order to ensure their safety. The bomb exploded 1,625 feet above ground and it destroyed Nagasaki almost instantly (1945: Atom bomb hits Nagasaki). The two atomic bombs still frightens people today because they can destroy a city instantly, and the pilots that dropped the bombs would not be harmed. Furthermore, the city that was attacked would be too wounded to rebel. Truman wanted to end the war immediately because many American soldiers died and he feared of losing more lives. The war was slowing down and Germany, a country of the Axis Powers that opposed the Allies Powers, surrendered on May 7, 1945. They surrendered because the Soviet Army was coming from the East, and the Americans were attacking from the west. The Armies would eventually trap Germany and attack. Furthermore, the Nazi leadership, controlled by Adolf Hitler, knew the war was over. Hitler realized his defeat and was afraid of other countries capturing him, which caused him to commit suicide and the other Nazi leaders surrendered. Japan was the last country to surrender, which bothered the whole world, because every country wanted the war to end. The bombing of Hiroshima and Nagasaki saved many American and Japanese lives. A few months before the nuclear attack, the battles of Iwo Jima and Okinawa occurred, which the Japanese fought to their death for honor. In these two battles, the casualties totaled to 128,375 people (US Troops in Action). However, the American casualties were 84,525 people (US Troops in Action), which is considerably less people. If Japan continued fighting, America was planning to invade Japans Island of Kyushu in November of 1945. This attack would cause 20,000 more dead Americans (Cooper). Since Japan did not know how many atomic bombs the United States possessed, they were frightened that more bombs would attack them. Five days after the bombing of Nagasaki, the Japanese agreed to an unconditional surrender that ended the war. This event saved thousands of Japanese and American soldiers lives. If Japan did not surrender after the two atomic bombs strike, America was planning to invade Japan in the fall. Furthermore, many European countries were developing an attack in the spring. In October 1944, the Battle of Leyte Gulf, the largest naval battle in World War II, destroyed the Japanese Navy. Since Japan had a devastated Navy, their ports were unprotected. Therefore, they had a shortage of food because they did not get any imported. Their population was suffering because their food was mostly being distributed to the troops. The Japanese people were having trouble holding their dignity, because of their hunger, and The Allies from many angles were attacking them. Once Little Boy and Fat Man exploded, the Japanese did not know how many more atomic bombs America obtained. They feared that one airplane could fly by dropping a bomb killing thousands and not be affected by the blast. Though the fire bombings of Tokyo killed more people over a longer period, the Japanese were app rehensive that there would be more atomic bombings killing their citizens in a shorter period. The amount of casualties suffered by the Japanese was appalling. There were 150,000 casualties at Hiroshima and approximately half were killed instantly (Effects of the Atomic Bomb). At Nagasaki 35,000 people were killed. Around twenty to thirty percent of deaths were caused by flash burns, fifteen to twenty percent of radiation sickness and fifty to sixty percent died of other related injuries (Effects of the Atomic Bomb). Sadly, the Japanese citizens had no warning of these brutal attacks. They were going about their daily tasks, when a bright, sudden flash would permanently devastate their lives. Many of the civilians would never see their families again. Since the people had no warning of the attack, they were unable to find shelter or stay behind with their loved ones. The surprise of the atomic bombs killed many people instantly during their daily routines. The lucky died instantly from the blast. Otherwise, they could have suffered radiation poisoning. Surprisingly, there was more radiation poisoning in Hiroshima than Nagasaki, because they were different types of bombs. The s ickness from radiation came in many forms including diarrhea, vomiting, impulsive hemorrhaging, blurring of the eye lens, and temporary infertility in boys, intensive burns, blood cell irregularity, fevers, depression, fatigue, and hair loss (Anhalt). Furthermore, many people got infections in their wounds because radiation lowers the immune system. Since many of the doctors were injured or died from the bomb, the hospitals in Hiroshima opened five days later for patients. This wait cost many people their lives that had a chance of recuperating. Some statistics from Hiroshima and Nagasaki estimates that ninety to one-hundred percent of all losses happened within the first two weeks (Solomon 270). In addition, the Japanese police records says that half of the peop le who were severely injured died by the sixth day; an additional twenty-five percent past by day twelve, and ninety percent of all deaths caused by the bombings happened before forty days (Solomon 270). Another long-term effect of the atomic bombs was cancer. Doctors were realizing that people were growing more tumors after the bombs struck. However, the radiation did not cause the tumors, yet it enhanced the tumor growth (Solomon 331). On the other hand, leukemia, cancer of the blood, was another type of cancer that increased after the bombing. The higher rate of leukemia was the longest seen side effect for the Japanese people. However, since tumors are not present in this type of cancer, many people died without knowing they had this disease. Radiation poisoning causes a horrendous death. Many years following the bombing, babies were suffering from birth defects. The radiation mutated the DNA, which is the genetic instruction for all living organisms, causing the DNA to cut at places and rejoin at others. This would change the code of the DNA, which would increase birth defects and the likelihood of cancer. Three years after the bombing, the Atomic Bomb Casualty Commission (ABCC) demanded that all pregnant women in their fifth month tell the government (Neel 3). The Japanese government would give the pregnant women additional supplements rather than the supplements they obtained before. In fact, all Japanese citizens had to take vitamins after the bombing to improve their health. This investigation allowed the ABCC to be aware out of the 76,626 births occurring over this six-year period, statistics of feasibility, birth defects, number of infant deaths, gender, and birth-weight (Anhalt). After the six years of testing was over, the government ended the study because o f the lack of evidence. However, the government did say that the information documented should be used for further study in the future. TToday, the infant mortality rate is lower than it was right after the bombings, it is believed that the remains of radiation are gone (Y). The two atomic bombs were unnecessary; instead, America should have shown the Japanese a video of the testing of the Gadget. Truman could have threatened Japan by saying that if they do not surrender, bombs like the one shown would decimate their cities. However, he would not announce the number of bombs that America had produced. If the Japanese did not believe him, Truman could have showed them pictures of the bombs already made and tell them a time frame for the possible bombings. However, this would just be a threat and America would never bomb Japan. The Japanese government would become worried and would consider surrendering. Though the most important thing to the Japanese was honor, there could have been a more civilized way of ending the war. Instead of forcing Japan to an unconditional surrender, the countries should have made a truce. This would have saved many more lives and been the peaceful way of solving the issue. Furthermore, Truman could have been more sympathetic to the Japanese by realizing the amount of casualties and the long-term effects of the bombing. It is a shame that innocent families died in a war that they did not favor. Families never had a chance to say goodbye to their loved ones because they had no warning. People were minding their own business in the street and were suddenly killed. Children were wondering the streets looking for their families and coming across their scorched mother or father dead on the pavement. These types of memories will always be imprinted in their brains. This same type of situation happened in Pearl Harbor. Nonetheless, the Americans that lost their families would not want anyone else to deal with the situation either. Anyways, two contemptible actions do not cancel each other out and make everything fine. No one needs to endure this agony, including your enemy. Truman would not back down to the Japanese, and forced an unconditional surrender, which entails no promises to the surrendering faction. In fact, Truman said that he always intended using the bomb by saying, I regarded the bomb as a military weapon and never had any doubt that it should be used† (The Atomic Bomb and Japans Surrender The Great WWII Debate). Before the bombing of Japan, the Potsdam Declaration, also known as The Proclamation Defining Terms for Japanese Surrender, was written. This document was an agreement between Truman, United Kingdoms Prime Minister Churchill, and Chinas president Chaing Kai-shek. One of the points said, â€Å"We call upon the government of Japan to proclaim now the unconditional surrender of all Japanese armed forces, and to provide proper and adequate assurances of their good faith in such action. The alternative for Japan is prompt and utter destruction† (Truman). This point means that if Japan is unwilling to surrender uncondition ally, the three countries involved in the declaration will bomb Japan until it would not exist anymore. Since Japan did not surrender, America dropped the bomb. On August 14, after witnessing his distressed country, Japans Emperor Hirohito pronounced their surrender. Truman was pleased with the results of the bombing, because he achieved what he wanted, an end to the war. Approval of the atomic bombing is debated by its pros and cons. A poll was taken and it showed that seventy-three percent of people over the age of fifty-five approved the bombing (Christoffersen). Furthermore, Peter A. Brown, assistant director of the Quinnipiac University Polling Institute, stated, Support drops with age, from the generation that grew up with the nuclear fear of the Cold War to the youngest voters, who know less about World War II or the Cold War (Christoffersen). This means younger people are less likely to approve of the use of the atomic bombs. They did not have to live through the drills in school. The drills in school consisted of the children climbing under their desk while protecting their heads. However, people do not believe these drills would help anymore, because there would be no warning for the bombs, the explosion would be too powerful, and the desk would become useless. Religion, political views and race all had an effect on their beliefs on the bomb ing too, since all of those categories educate peoples morals (Christoffersen). People will always support or oppose the atomic bomb because of the deaths and affects it caused to end the frightful war. On August 6 and August 9, 1945, the bombings of Hiroshima and Nagasaki occurred, respectively. Though the bombing ended the war almost immediately, the Japanese were suffering from total war and they were unaware of how many more bombs were to come. Additionally, the Japanese were unable to find shelter or say goodbye to their loved ones. In addition, Japan lost thousands of innocent civilians by a huge explosion that shocked them caused by an atomic bomb. These bombs saved countless American lives but destroyed hundreds of thousands of Japanese, whether they died immediately or suffered from its lasting effect. Many people think there could have been a civil way of negotiating with the Japanese to save more lives and end the war quicker. Though it was a wakeup call for the Japanese, a threat could have been just as satisfying. However, the future could not be pr edicted and everyone should interpret and learn from history, so the remorseful events are never repeated. The bombing of Hiroshima and Nagasaki will never be justified and forever will be debated.

Cold War and Its Effects Essay -- World History

The end of the cold war signified a new era of history that has changed the entire world. The face of Europe and Asia has changed dramatically. Vast changes have been felt socially, politically, and especially economically. Also the effect the cold war had on foreign policy was paramount. The effect of these changes is not only felt across the ocean but can be felt here in America. The goal of this paper is to define what the cold war specifically was, and reflect upon the various choices throughout the world as a result of the end of the cold war. The cold war was a period of time in which the United States was the world power in the western world. The Soviet Union (now Russia) was the leading power in the eastern world. While this would seem typical in any planet to have two world powers this case is extremely interesting because they had different governmental structures that were completely the opposite. On one hand there was America. We are a free market economy that is defined as being capitalist. Capitalism is a social and political system that means every person must fend for themselves. This is true economically and politically. Each individual has the ability to do whatever they choose with their life. They can make their own choices, and move wherever they want. While there are laws, the government has no say so over things that we take for granted everyday such as freedom of expression, religion, the right to bear arms, and even march down the street in support of the Ku Klux Klan if you so choose! The Soviet Union at that time was represented by a form of governmental control called communism. Communism was formed by a man named Karl Marx. The belief is that the government should control ev... ... It all comes down to choice. After the Cuban missile crisis ended both superpowers realized the severe consequences of nuclear war. They knew the implications involved, and religion was not the issue. The Russian government suppressed it to an extent. It was humanity. What good would it do to blow up the earth? What good did it do to drop atomic bombs on Japan? Imagine what Bush felt on Sept. 11 and the choices he made to vow that this would not happen again. These are all choices that countries think about everyday, and the cold war is the latest and most powerful example of something that almost ended the world. References: http://www.aaup.org/publications/Academe/03so/03sowall.htm, "After the Cold War", by Mitchell B. Wallerstein, 11 pages. Twentieth Century World History, by William J. Duikker, 1999, Wadsworth Publishing, page 337 and page 166.

F. Scott Fitzgeralds The Great Gatsby :: essays research papers

Then wear the gold hat, if that will move her; If you can bounce high, bounce for her too, Till she cry Lover, gold-hatted, high-bouncing lover, I must have you! Thomas Parke D'Invilliers Jay Gatsby went through most of his life striving for a new beginning, a chance to start over and succeed. He forced that aspect of life, into his own, by changing his identity. He was James Gatz a man who's unknown soul was left to linger in the past. Now he is Jay Gatsby. Gatsby does not realize that life can be difficult. You can not just move on and pretend that the past never happened. If you do not face the real and original you, you will never find success or happiness in the way you wish to live your present life. All through Gatsby's life he looked to the green light on the dock across the bay for hope and reassurance. He needed to know that his dream was still as bright as it was the day he met Daisy. Gatsby lived for an American dream. The truth was that Jay Gatsby of West Egg, Long Island, sprang from his Platonic conception of himself. He was a son of God - a phrase which, if it means anything, means just that. (Pg.104) Gatsby created himself to be his own hero, through the eyes of a seventeen year old boy. He began to wear that gold hat and rise in society with money, friends, and a love life he dreamed of returning. You see I usually find myself among strangers because I drift here and there trying to forget the sad thing that happened to me. (Pg.71-72) Gatsby smothered himself in popularity to try and block out the memory of the man he was before his change. He has been grieving for a love that he lost when drafted to the war. His only hope left is a green light across the bay which seems to shine through the unhappiness in Gatsby's life. Daisy, as pure and sweet as the flower itself, is the only thing left that is needed for him to complete his dream. He wanted nothing less of Daisy than that she should go to Tom and say, I never loved you. (Pg.116) We know that Gatsby is asking for to much of Daisy, he knows it too. Can't repeat the past?

Differences between men and women Essay

What is the difference between males and females? We notice the different dressing styles, different roles in the workplace and how we spend our leisure time, how we wear our emotions, and also how differently we think. But a question arises. Are males and females really different in every aspect? The first question we ask when a baby is born is: â€Å"Is it a boy or a girl?† Though most people accept most of the socially prescribed roles for the gender they were born with, some struggle against what they see as rigid and arbitrary social norms. In this essay, I will describe and give my input on the roles of human sexuality and gender. Most people think of sex and gender as one and the same when in fact they are not. Wood, Wood, and Boyd (2005) define sex as â€Å"a biological term, while gender is more commonly used to refer to the psychological and social variables associated with one’s sex† (p. 410). In the biological approach, when defining the sociocultural characteristics of masculinity and femininity, cultures look into the behaviors each gender should act upon. Males should be the dominant figure. They should be strong, competitive, be able to stand their ground, confident, and independent. Women on the other had are expected to be the exact opposite. They should be dependent, caring, encouraging, emotional, and nurturing. As children approach the age of two or so, they start to realize the roles such as attitudes, interest, and behaviors, in which males and females are supposed to portray. This is referred to as gender typing. When understanding which roles are to be taken, then they can star t their development. In the psychoanalytic theory, Freud asserts that children’s thoughts about gender occur out of a clash relating to their feelings about their parents. Generally, they would like to tie a bond between the opposite-sex parent but end up doing so with the same-sex parent in order to settle this clash, taking on that’s parent’s gender-related behavior and ideas. â€Å"At the same time, they defer their love for the opposite-sex parent in the hope that someday they will be able to achieve a sexual relationship with a partner who is similar to him or her† (Wood et. al., 2005, p. 411). I can agree with Freud’s psychoanalytic theory to a certain extent. What  would the opposite-sex parent do in a family with no boys or no girls? Would he/she take over some traits that the same-sex parent would give to the children? My mother and father had four boys including myself. Being in the situation my mother was in considering there were no girls, she felt a need to rub off some of her traits to us boys. While my father taught us the game of baseball and how to mow the lawn, my mother taught us our table manners and to how to do the laundry. We shared a bond to both of our parents equally. But overall, we all feel the same way in which we want our future wives to be close to, if not exactly like our mother. In the social learning theory, children look for role models to follow, where they imitate that person and want to be like him/her. But say if a boy started doing something that is out of his gender role, such as trying on his mother’s high heels, he will be informed by his father that it is not appropriate for him to do such a thing. Psychologists say that yes imitating and reinforcing may play a part in the gender role development, but it does not offer a complete clarification of this occurrence. Lawrence Kohlberg’s cognitive developmental theory â€Å"suggests that an understanding if gender is a prerequisite to gender role development† (1966; Kohlberg & Ullian, 1974, p. 412). This theory explains that children go through three stages that are necessary to developing the concept of gender. The first stage happens when the child is around the ages of two and three, which is gender identity, or the sense of being male or female. The next stage occurs at four and five, which is gender stability, the understanding that boys will be boys and girls will be girls forever. Then the last stage is when the child has reached six and eight. It is known as gender constancy, or the knowledge that gender will not change, despite the clothes they wear or the activities they participate in. But Kohlberg failed to mention â€Å"why many gender-role appropriate behaviors and preferences are observed in children as young as age 2 or 3, long before gender constancy is acquired† (Bussey & Bandura, 1999; Jacklin, 1989; Martin & Little, 1990, p. 412). I guess it just depends on the educational techniques used on the children. My brothers and I were taught a lot at a very young age, so we had a little bit of a head start. Like the cognitive developmental theory, Sandra Bem’s gender schema theory (1981) emphasizes that children begin to use gender as a way to pick up and sort out information. But the gender schema theory says that this process happens earlier with the gaining of gender identity other than gender constancy. Also like social learning theory, the gender schema theory indicates â€Å"young children are motivated to pay more attention to and behave in ways consistent with the gender-based standards and stereotypes of their culture† (Wood et. al., 2005, p. 412). I think television can become a major factor in a child’s behavior because they can watch shows that are unsuitable for their viewing, and while growing older they can become more fascinated with sexual activity. When becoming sexually involved with another person, both males and females experience four phases of when engaged in sex, called the sexual response cycle. The first phase is the excitement phase, and this is simply when the female undresses for the male and the male uses verbal expressions of affection to stimulate the female. The blood flow starts pumping and the heart beats faster and faster until they reach the second phase, which is the plateau phase. Here excitement keeps rising for the preparation of the third phase, the orgasm. While males only have one, females can have multiple. After that, everything starts to slow down and goes back to its unaroused state. This is known as the resolution phase or the tapering-off period. Sexual activity varies from culture to culture. Furthermore, â€Å"what is perceived as sexually attractive in males and females may differ dramatically† (Woods et. al., 2005, p. 421). Agreed, differences in attraction may occur, even with the same sex. Someone’s sexual orientation describes the preferences at which someone is attracted to either the opposite or that of their own sex. Studies show that males are twice as likely to be homosexual than females. Berenbaum & Snyder (1995) say that if the androgens, or hormones that make one masculine, are too high or too low, can make the brain develop more masculine or feminine which homosexual orientation is more likely. Most of the time it is all in the genes, but other times it is that person’s choice to be homosexual, even  if others may not be on the same page. Some people can be homophobic, which in my view is extremely improper. Whoever thinks that it is wrong should take a step back, let those people live their lives and start worrying about their own. I have known many people who were homophobic and it just pushed my buttons to see how cruel they can be to someone with a different sexual orientation. I do see where they are coming from, on the other hand. I do think it is weird to see two homosexual men holding hands or kissing, but I always come to an understanding that they are who they are and nothing can change that. They want to feel the comfort of another. In general, they want to love just as much as heterosexual couples do, so I praise them for that. With homosexual activity and even heterosexual activity, there comes a price if a couple chooses to have unprotected sex. There are many sexually transmitted diseases (STDs), but the major ones are Chlamydia, gonorrhea, and syphilis, which all can be cured by antibiotics. Chlamydia and gonorrhea are critical to women because if they in fact do have any of these, they do not have any early stages of infections. Since they do not treat it on time, then it can lead to infertility. Viral STDs include genital herpes, genital warts, and acquired immune deficiency syndrome (AIDS), which cannot be cured. The human immunodeficiency virus (HIV) is the virus that causes AIDS. It attacks the immune system, and can cause cancer or other dysfunctions. In order to prevent spreading STDs one should avoid sex with multiple partners, and also use a latex condom with a spermicide. With the growing rate of STDs nowadays, and the amount of television commercials informing teenagers and adults to practice safe sex and get tested for HIV or AIDS, I do not understand why people still have unsafe sex. It is not that difficult to â€Å"strap up† before â€Å"doing the deed† or â€Å"keep it in your pants,† that is unless you are prepared to have a child and have been tested along with your partner. I have known many males and females who have had unprotected sex and regret ever doing so, a couple of which becoming pregnant. From their point of  view, they feel lost because they cannot support their children and give them the attention they need in order to have a secure, fulfilling childhood.

Loneliness of Curley’s wife Essay

The author never tells us the name of Curley’s wife in the novel, which could be for many reasons. E. g. she wasn’t important enough or even because she was a woman. But I think it was because she was regarded as one of Curley’s possessions, and because of this everyone approached her with haste. They were all afraid of Curley and didn’t want any bother from him so they left her alone. They didn’t speak to her and ignored her most of the time which could after a while make a person very lonely and feel unwanted. She didn’t like this so she tried to do something about it. She put on attractive clothes, and was heavily made up with full rouged lips and widely spaced eyes. Fingernails painted red and hair in little clusters like sausages. Obviously she wanted to attract some attention from the workers on the ranch, she just wanted somebody to notice her. But as in doing this she is labelled ‘a tart’ and ‘jailbait’. George doesn’t see past the outer cover when she comes back and sees a woman trying to get someone arrested or killed, so he strictly warns Lenny to keep away from her. Another reason for Curley’s wife’s loneliness could have been that she was the only woman on the ranch so she has no other female to gossip to, and all the men are ignoring her so she has absolutely nobody on the ranch to chat with except Curley. Curley isn’t a good husband as he regards her mainly as a possession and not his wife, and therefore doesn’t treat her all that well. He is one of the main reasons that she feels so unhappy. He forces his wife to stay at home alone every day as he forbids her to leave the house in fear that she might go and stray off with one of the ranch workers. He himself is not all that loyal either as he visits brothels with the other men at the end of the month even though he is married. She admits to us when chatting with Lenny that she doesn’t love Curley. She only married him because of her mother. She had met a film producer that had said he was going to put her in the movies, and when the letter didn’t come from him she thought her mother had stolen it. So she moved of and married Curley maybe as a way to get revenge on her mother. Whereas it is more likely that the man wasn’t a film producer and probably wanted just to get her to sleep with him. When talking with Lenny she also tells him all the things she wanted in her life. She wanted to wear nice clothes, stay in big hotels, have pictures taken of her and to be an actress. She even hinted that she was going to leave Curley someday by saying ‘maybe I will someday’ when talking about an acting career. Curley’s wife seems awfully lonely and gets great pleasure out of talking with Lenny in the barn. She even lets him stroke her hair causing a great ruckus and eventually leading to her violent death. But it was instantaneous and when Candy looked at her body he saw that her face was sweet and young. She hadn’t a care in the world. All the ache for attention and discontent were gone from her face and she was finally at peace. I personally don’t think she is the cause of all the trouble because she was only seeking a bit of company. She hardly talked to anyone on the ranch for ages and when she finally gets the chance, you can’t blame her for wanting to take it. It maybe is a bit her fault as she let Lenny stroke her hair, but she didn’t know what he was going to do when he wouldn’t let go and started to panic. She did initially get Lenny killed but I don’t think she did it intentionally as she speaks no desire to get herself killed. It is a bit of everybody’s fault, if the men had spoken to her she may not have wanted to go into the barn with Lenny and therefore not have been killed. Lenny and George’s dream may have came true if Curley’s wife had not been killed so in a way this major event changed all of their lives forever. 30/04/2007 Simon Gurney Show preview only The above preview is unformatted text This student written piece of work is one of many that can be found in our GCSE John Steinbeck section.

Tok – Art as an Area of Knowledge

TOK Assignment Art can be of speckled forms, ranging from instillations to painting to music to dance. Each of these practices of art have diverse impacts on society. However today irrational exuberance of the contemporary art market is about the breeding of money and have lost the fertility of art. I really believe that art is what humans created as a highest explanation level to fully clarify the perspectives and especially emotions of human beings. Art does not have any specific meaning, there are so many varied elements in an art work that a myriad of viewers can appreciate as well as criticize.I have always believed that after an artist finishes a painting or a dancer finishes a show, their dedication, commitment and meaning for those forms of art becomes highly negligible. It is how the audience reciprocates to it, and perceives it is what is important. Interpreting art allows us to interpret the psychological complexity within a person, their reactions to forms of art their em otions and perceptions towards it makes it easier to analyze their characters. For instance at the Kala Ghoda Art Festival, this instillation highly struck me.The color is what created the main impact. Black placed ahead of golden, the first thing than came to my mind was how is today’s world it is always the evil that has taken over the good. Since I’ve always perceived black to be evil, and golden/yellow being the good or the brighter color showing the brighter side of life. It also showed me how the good always follows the bad, and in reality especially in today’s fast growing generation this is how the world has started functioning. This gives a very negative outlook about life, and thus I personally did not like this concept much.First look, it appears to be neat and nice but gradually upon analyzing it I did not like the concept at all. Art is more than just self-expression and communication. It is a type of language, understanding and emotional outlook of an individual. If we go to see, art is everywhere. The world revolves around the different forms of art, every part of the world has its own unique art forms. This has been passes on from our ancestors, therefore it does shape our society till an extent. There have been instances when society has revolted against certain art forms, leading to a high controversy.This is highly debatable as every individual has their own rights, however cultural beliefs and society pressures leads to them compromising on those rights. Some countries have always portrayed women in the artworks, showing the gender discrimination. However due to this, the society’s opinion towards women has changed drastically. If they change this, and suddenly only men are seen all over the artworks be in instillations or painting or sketches, it will shape the growing generation’s mindset in a different manner.Taking art in the form of music or maybe dance, definitely affects and reflects emotion. It is that form of art which can be taken and the musician’s or dancer’s knowledge can be extracted through it. At the Kala Ghoda Festival the live performance was completely breath taking. It appealed to the audience and was able to reach their senses. That also brought out the Indian ethnicity with it. Those beats were brilliant and I personally was very appealed by that performance. Performing arts is another very broad medium of art, allowing varied amounts of portrayals.It is where language and reasoning can be effectively demonstrated with the help of language certain times. Thus to conclude, art is very broad comprising of different forms which all ass to a different meaning. However, its interpretation can differ from the person’s culture to their mood to their personal values. It acts as an opportunity for the growing kids to find out their strengths and gives them an opportunity to explore various fields. Their skill in different forms of art is also very vi tal in gaining knowledge about them as a person.

Case Study – Appendicitis

I. DEFINITION/PREVALENCE Acute disease of the GI tract may be caused by the pathogen itself or by a bacterial or other toxin. Acute inflammatory disorders such as appendicitis and peritonitis result from contamination of damaged or normally sterile tissue by a client’s own endogenous or resident bacteria (Lemone and Burke, 2008, page 766). Appendicitis is the inflammation of the vermiform (wormlike) appendix; the appendix is a small fingerlike appendage about 10 cm (4 in) long, attached to the cecum just below the ileocecal valve, which is the beginning of the large intestine.It is usually located in the right iliac region, at an area designated as McBurney’s point. McBurney’s point, located midway between the umbilicus and the anterior iliac crest in the right lower quadrant. It is the usual site for localized pain and rebound tenderness due to appendicitis during later stages of appendicitis. The function of the appendix is not fully understood, although it reg ularly fills and empties digested food. Some scientists have recently proposed that the appendix may harbor and protect  bacteria  that are beneficial in the function of the human colon.Appendicitis  is the most common cause of acute inflammation in the right lower quadrant of the abdominal cavity. The lower quadrant pain is usually accompanied by a low-grade fever, nausea, and often vomiting. Loss of appetite is common. In up to 50% of presenting cases, local tenderness is elicited at Mc Burney’s point applied located at halfway between the umbilicus and the anterior spine of the Ilium. Rebound tenderness (ex. Production or intensification of pain when pressure is released) may be present.The extent of tenderness and muscle spasm and the existence of the constipation or diarrhea depend not so much on the severity of the appendiceal infection as on the location of the appendix. If the appendix curls around behind the cecum, pain and tenderness may be felt in the lumbar region. Rovsing’s sign may be elicited by palpating the left lower quadrant. If the appendix has ruptured, the pain become more diffuse, abdominal distention develops as a result of paralytic ileus, and the patient’s condition worsens.The disease is more prevalent in countries in which people consume a diet low in fiber and high in refined carbohydrates. It is the most common reason for emergency abdominal surgery, affecting 10% of the population. Although appendicitis affects a person at any age, the peak incidence is between the ages of 20 and 30 years old in which the vast majority of clients are most common in adolescents and young and slightly more common in males than females. About 7% of the population will have appendicitis at some time in their lives (Lemone and Burke, 2008 page 766).The major complication of appendicitis is perforation of the appendix, which can lead to peritonitis, abscess formation (collection of purulent material), or portal Pyle phlebitis , which is septic thrombosis of the portal vein caused by vegetative emboli that arise from septic intestines. Perforation generally occurs 24 hours after the onset of pain symptoms include a fever of 37. 7 degree Celsius or 100 degree Fahrenheit or greater, a toxic appearance and continued abdominal pain or tenderness. II. TYPES/CLASSIFICATIONAppendicitis can be classified as simple, gangrenous, or perforated, depending on the stage of the process. In simple appendicitis, the appendix is inflamed but intact. When areas of tissue necrosis and microscopic perforations are present in the appendix, the disorder is called gangrenous appendicitis. A perforated appendix shows evidence of gross perforation and contamination of the peritoneal cavity (LeMone & Burke, 2008 page 766). Peritonitis can be primary or secondary. Primary peritonitis is an acute bacterial infection that is not associated with perforated viscus, or organ.Bacterial infection is the usual cause and may be associated wi th an infection by the same organism somewhere else in the body, which reaches the peritoneum via the vascular system. Tuberculosis peritonitis, which originates from tuberculosis elsewhere in the body, is a type of primary peritonitis. Clients with alcoholic cirrhosis and ascites, in the absence of a perforated organ, often manifest peritonitis, which may be due to leakage of bacteria through the wall of the intestine. Secondary peritonitis is usually caused by bacterial invasion as a result of perforation, or rupture of an abdominal viscus.It can also result from severe chemical reactions to: pancreatic enzymes, digestive juices, or biles released into the peritoneal cavity (Gould & Dyer, 2011). III. DEMOGRAPHIC PROFILE Patient’s name is Mr. Ruptured Acute Appendicitis, 24 years old, male, residing at 820 General Kalentong, Daang Bakal, Mandaluyong City. He is the second child among 3 siblings, a Roman Catholic, single, a 3rd year college Information Technology student. IV. FAMILY MEDICAL HISTORY (Family Genogram)COD: TB COD: TB A: 83 -S, -D A: 83 -S, -D Not Recalled Not Recalled c c A: 20 +S, +D A: 20 S, +D A: 24 +S, +D A: 24 +S, +D A: 27 -S, -D Skin allergy A: 27 -S, -D Skin allergy A: 42 +S, +D A: 42 +S, +D A: 64 +S, +D HPN, Stroke A: 64 +S, +D HPN, Stroke c c A: 46 -S, +D Asthma A: 46 -S, +D Asthma A: 51 -S, +D A: 51 -S, +D patient patient LEGEND: LEGEND: male male married married deceased male deceased male S- smoker D- drinker COD- cause of death S- smoker D- drinker COD- cause of death female female deceased female deceased female V. PAST MEDICAL HISTORY He was first hospitalized last 2006 due to dengue at the same hospital: Mandaluyong City Medical Center (MCMC).He has no other further illnesses except the typical fever, cough and cold. Other than that, he has no allergies, hypertension, or diabetes mellitus. VI. HISTORY OF PRESENT ILLNESS 1 week prior to admission patient experienced abdominal pain all over abdomen. He consulted at ER MCMC si gned out AUPD (Acute Peptic Ulcer Disease) and was given Omeprazole & HNBB (Buscopan). Whole abdominal ultrasound done and revealed tiny cholecystolethiasis. He was given Diclofenal and HNBB tab and eventually discharged. Few days prior to consultation, the patient still experienced abdominal pain.He consulted at Emergency Room and was opted for surgical intervention – EXPLORATORY LAPAROTOMY APPENDECTOMY under the service of Dr. Abram Del Valle, M. D. VII. GORDON’S PHYSICAL ASSESSMENT i. Health Maintenance – Perception Pattern Before admission: The patient used to smoke cigarette 3 sticks per day. And he also drinks alcohol daily specifically beer of more than 2 bottles per session. He was not using drugs and he has no allergies at all. During time of care: The patient is not smoking cigarette or drinking alcohol. ii. Nutritional – Metabolic PatternBefore admission: The patient was on a high protein diet because he was used to go to the gym 2-3 times a we ek. He was also taking vitamins (CENTRUM). He has normal appetite and has no difficulty swallowing. He usually eats 3 times a day (breakfast, lunch and dinner) and most of the time he also has his snacks. He also usually drinks 2-3 liters of water a day. e During time of care: The patient is on NPO (nothing per orem) for 5 days due to post-operative appendectomy and he was on his 2nd day of NPO status when we cared for him. He has also NGT lavage connected. ii. Elimination Pattern Before admission: The patient’s normal bowel movement was 3 BM a day and has no difficulty in bladder habits. His last bowel movement was last July 17, 2012. He usually urinates 6-7 times a day without difficulty. During time of care: The patient has absence of bowel movement and even flatus and has no bowel sounds upon auscultation. He has foley catheter and with urine output of 480 cc per shift. iv. Activity and Exercise Before admission: The patient could do his activities independently without a ssistance.He usually goes to gym 2-3 times a week. During time of care: The patient’s functional level or self-care ability level is 2 which mean he requires help from another person for assistance. v. Sleep/Rest Pattern Before admission: The patient usually sleeps at 4 or 5 am and wakes up at 8 or 9 am. He has no difficulty in sleeping and he feels rested after sleep. During time of care: The patient has regular sleeping habits. He sleeps at 10 am, wakes up at 6 am with uninterrupted sleep. vi. Cognitive – Perceptual PatternBefore admission: The patient was alert and coherent, has normal speech, with mild level of anxiety, has normal hearing, and with impaired vision of his left eye due to cataract. During time of care: The patient is alert and coherent. He has normal speech (Filipino as his spoken language), he has moderate level of anxiety, has normal hearing, and with impaired vision of his left eye due to cataract. He also complained of acute pain and described it as a cramping pain. Pain management (Tramadol) was given. vii. Role – Relationship Pattern Before admission: The patient was a student and single.His support system was his family, relatives & friends. During time of care: The patient’s support system is his mother who is always at his bed side assisting him in whatever he needs. Upon asking his mother if she has any concerns regarding hospitalization, she said that she is more concern about the fast recovery of her son. viii. Sexuality – Reproductive System Before admission and during the time of care: The patient still didn’t have his testicular exam. ix. Coping – Stress Tolerance/Self – Perception/Self – Concept Pattern The patient’s major concern regarding his hospitalization is s all about self-care.Due to the contraptions attached to him, he cannot independently do his activities. His major loss was his stepfather when he died of kidney failure. His rated his outlook on future as 5, 1 being poor and 10 being very optimistic. He further explained why he rated 5 because he is not sure if when he finished college he can be able to find a job suited for him. x. Value – Belief Pattern Our patient is a Roman Catholic and he always goes to church every Sunday together with his family. VIII. GROWTH AND DEVELOPMENT DEVELOPMENTAL TASK| THEORIST| STATUS| Intimacy vs.Isolation * Develops commitments to others and to a life work (career)(Daniels, et. al. , 2010). | Erikson| The patient had a relationship with his opposite sex but he said that they just broke up a week before he was hospitalized due to some personal and private reasons. Currently, he is in 3rd year college, an IT student. | Genital * Emergence of sexual interests and development of relationships with potential sexual partners (Daniels, et. al. , 2010). | Freud| As what had written above, the patient had a relationship with his opposite sex but because of some reasons they decided to end u p their relationship. Formal Operations * Able to see relationships and to reason in the abstract (Daniels, et. al. , 2010). | Piaget| He perceived that relationships (any kind of relationship) are important especially at his age. He can also reason out in an abstract way. He can express his opinions intellectually and precisely. | Early Adulthood * Select a partner, learn to live with a partner, start a family, manage a home, establish self in a career/occupation, assume civic responsibility, and become a part of a social group (Daniels, et. al. , 2010). Havighurst| According to our patient, he didn’t expected that something like that will happen to them (referring to his girlfriend). He was really expecting that they are really meant for each other and that she (his gf) will be his future wife. He is also establishing himself to a future career, that’s why he is studying in preparation for his future. During our time of care also, his ‘barkadas’ visited him and he said that they were his ‘tropa’. | Postconventional * Individual understands the morality of having democratically established laws (Daniels, et. al. , 2010). Kohlberg| Upon asking the patient if he is familiar with the democratically established laws in the Philippines, he immediately responded with a yes. He also said that these laws help us, Filipinos, to have safe and secure country though there may come a time that we may experience something unexpectedly. | IX. PHYSICAL ASSESSMENT * Vital Signs TIME| Initial 8AM (07/24/12)| 10 AM| 12 NN| 8 AM (07/25/12)| 12 NN| Last 8AM(07/26/12)| T| 36. 3| 37. 3| 37. 4| 36. 4| 37. 3| 36| P| 83| 84| 71| 75| 81| 68| R| 23| 25| 21| 19| 19| 20| BP| 120/80| 120/80| 120/80| 120/80| 120/80| 110/80| Sequence: BY SYSTEMS NORMAL FINDINGS| BOOK FINDINGS| PATIENT FINDINGS| SIGNIFICANCE| I. NEUROLOCIGAL SYSTEM Alert and coherent; with normal body temperature of 36. 3 °C – 37. 6 °C| * Fever (usually >38 °C although hypo thermia may be present w/ severe sepsis); chills * Thirst * Pain| * Complained of pain in the incision site (lower longitudinal midline of the abdomen)| Pain results from the increased pressure of fluid on the nerves, especially in enclosed areas, and by the local irritation of nerves by chemical mediators such as bradykinins (Gould, et al. 2011). | II. RESPIRATORY Normal respiration with a rate of 12-20 breaths per minute| * Tachypnea; shallow respirations| * RR: 23 bpm w/ shallow respiration| Acute pain usually initiates physiologic stress response with increased respiratory rate (Gould & Dyer, 2011). | III. INTEGUMENTARYPink or brown and in uniform color, no edema, no lesions, moistSkin temperature is normally warmIntact skinWhen pinched, skin springs back to previous state| * Dry lips and mucous membranes * Swollen tongue * Poor skin turgor| * Dry lips and mucous membranes * Skin turgor:3-5 seconds * Presence of surgical incision at lower longitudinal midline of the abdomen * Sk in is warm to touch and is reddened| Dry mucous membrane and poor skin turgor are signs of dehydration (Gulanick, et al. 1994). Redness may indicate inflammation (Weber & Kelly, 2007). Redness and warmth are caused by increased blood flow into the damaged area (Gould & Dyer, 2011). | IV. CARDIOVASCULAR Normal pulse rate of 60-100 bpm| * Tachycardia * Diaphoresis * Pallor * Hypotension * Tissue edema| * Pulse rate: 83 bpm| Acute pain usually initiates a physiologic stress response with increased heart rate (Gould & Dyer, 2011). | V. MUSCOLOSKELETALAbility to do Activities of Daily Living (ADL)| * Difficulty ambulating * Weakness| * Difficulty ambulating due to post-op condition * Weakness| Constant pain frequently affects daily activities and may become a primary focus in the life of an individual (Gould & Dyer, 2011). | VI. GENITO-URINARY Normal urine output of 30cc/hrColor: Amber, transparent, clear| * Decreased urinary output * Dark color urine| * Dark color urine * Urine output: 480 mL/shift * Specific gravity: 1. 30| Decreasing output of concentrated urine with increasing specific gravity suggests dehydration/need for increased fluids (Doenges, et al. , 2006). | VII. GASTROINTESTINAL Abdominal skin may be paler than the general skin tone because this skin is so seldom exposed to the natural elementsAbdomen is free of lesions or rashesA series of intermittent, soft clicks and gurgles are heard at a rate of 5-30 per minuteNormally no tenderness or pain is elicited or reported by the clientNo rebound tenderness is presentAbdomen is non-tender and soft.There is no guarding| * Loss of appetite * Nausea & vomiting(usually projectile) * Constipation of recent onset * Diarrhea(occasional) * Sudden, severe, generalized abdominal pain * Abdominal distention; rigidity * Decreased/absence of bowel sounds * Inability to pass stool/flatus * Muscle guarding (abdomen) * Psoas’ Sign (flexion of or pain on hyperextension of the hip due to contact between an inflammat ory process & the psoas muscle) * Obturator Sign (the internal rotation of the right leg with the leg flexed to 90 degrees at the hip and knee and a resultant tightening of the internal obturator muscle may ause abdominal discomfort) * Rovsing’s Sign (pressure on the left lower quadrant of the abdomen causes pain in the right lower quadrant) * Rebound tenderness (a sign of inflammation of the peritoneum in which pain is elicited by the sudden release of the fingertips pressing on the abdomen) | * Board-like abdomen * Sudden, severe, generalized abdominal pain * Absence of bowel sounds in all four quadrants * Absence of flatus/stool * Presence of surgical incision| Signs indicating the onset of peritonitis include a rigid â€Å"board-like† abdomen (Gould & Dyer, 2011).Pain recurs as a steady, severe abdominal pain as peritonitis develops (Gould & Dyer, 2011). Absence of bowel sounds may be associated with peritonitis or paralytic ileus (Weber & Kelly, 2007). When inflam mation persists, nerve conduction is impaired, and peristalsis decreases, leading to obstruction of the intestines (paralytic ileus) (Gould & Dyer, 2011). | X. DIAGNOSTIC TESTS DIAGNOSTIC TEST| NORMAL| RESULT| SIGNIFICANCE| WHOLE ABDOMINAL ULTRASOUND (July 21, 2012) | The organs examined appear normal (Cosgrove, et al. , 2008). | Liver is not enlarged.It has homogenous echopattern with smooth border. The intrahepatic ducts are not dilated. No evident focal mass lesion seen. CD measures 3. 9mm. Gallbladder is normal in size and wall thickness. There are multiple tiny echogenic shadowing foci seen within the gallbladder lumen. Pancreas & spleen are normal in size & echopattern. No focal mass lesion seen. Both kidneys are normal in size & echopattern. Right kidney measures 10. 1Ãâ€"4. 2Ãâ€"5. 46cm with cortical thickness of 1. 7cm while the left kidney measures 10. 5Ãâ€"4. 8Ãâ€"4. 1cm with thickness of 19cm. No evident caliectasis, lithiasis, seen bilaterally.Urinary bladder is unf illed. Impression:Tiny cholecystolithiasesNormal liver, pancreas, spleen, kidneys by UTZUnfilled urinary bladderNot dilated biliary tree | Abdominal ultrasound is the most effective test for diagnosing acute appendicitis (LeMone & Burke, 2007). | HEMATOLOGY REPORT/COUNT (July 21, 2012)| RBC: 4. 2-5. 6 M/uLPlatelets: 150-400 x 10/LWBC: 3. 8-11. 0 K/mm3Hemoglobin: 135-180g/LHematocrit: 0. 45-0. 52DifferentialNeutrophils: 0. 50-0. 81Lymphocytes: 0. 14-0. 44Monocytes:0. 02-0. 06Eosinophils: 0. 01-0. 05Basophils:0. 00-0. 01| WBC Count: 12. 6 K/mm3RBC: 4. 1 M/uL (normal)Hematocrit: 0. 45 (normal)Hemoglobin: 153g/L (normal)Differential Count:Neutrophils 0. 90Lymphocytes 0. 10 (normal)| Elevated WBC is seen in acute infection (LeMone & Burke, 2007). Neutrophils: elevated in bacterial infection (LeMone & Burke, 2007). | URINALYSIS (July 21, 2012)| Color: Light straw to amber yellowAppearance: ClearOdor: AromaticpH: 4. 5-8. 0Specific gravity: 1. 005-1. 030Protein: 2-8mg/dLGlucose: NegativeKet ones: NegativeRBCs: RareWBCs: 3-4Casts: Occasional hyaline| Color: Dark YellowTransparency: TurbidUrine pH: 6. 0 Specific gravity: 1. 30Sugar: NegativeProtein: +4Microscopic examPus cells 4-6/HPFRBC 1-2/HPFCrystals: Amorphous Sulfate Moderate| A dark yellow to brownish color is seen with deficient fluid volume (LeMone & Burke, 2007). Hazy or cloudy urine indicates bacteria, pus, RBCs, WBCs, phosphates, prostatic fluid spermatozoa, or urates (LeMone & Burke, 2007). | CLINICAL CHEMISTRY (July 21, 2012)| Sodium (Na): 135-142 mmol/LPotassium (K): 3. 8-5 mmol/L| Sodium: 132 mmol/LPotassium: 4. 02 mmol/L| Sodium is decreased in SIADH & vomiting (LeMone & Burke, 2007). | XI. ANATOMY & PHYSIOLOGY OF APPENDIX (LARGE INTESTINE)The large intestine, which is about 1. 5 m (5 ft) long and 6. 5 cm (2. 5 in. ) in diameter, extends from the ileum to the anus. It is attached to the posterior abdominal wall by its mesocolon, which is a double layer of peritoneum. Structurally, the four major regions o f the large intestine are the cecum, colon, rectum, and anal canal. The opening from the ileum into the large intestine is guarded by a fold of mucous membrane called the ileocecal sphincter (valve), which allows materials from the small intestine to pass into the large intestine. Hanging inferior to the ileocecal valve is the cecum, a small pouch about 6 cm (2. 4 in. ) long.Attached to the cecum is a twisted, coiled tube, measuring about 8 cm (3 in. ) in length, called the appendix or vermiform appendix (vermiform = worm-shaped; appendix = appendage). The mesentery of the appendix, called the mesoappendix, attaches the appendix to the inferior part of the mesentery of the ileum. The open end of the cecum merges with a long tube called colon, which is divided into ascending, transverse, descending colon are retroperitoneal; the transverse and sigmoid colon ascends on the right side of the abdomen, reaches the inferior surface of the liver, and turns abruptly to the left to form the right colic (hepatic) flexure.The colon continues across the abdomen to the left side as the transverse colon. It curves beneath the inferior end of the spleen on the left side as the left colic (splentic) flexure and passes inferiorly to the level of the iliac crest as the descending colon. The sigmoid colon begins near the left iliac crest, projects medially to the midline, and terminates as the rectum at about the level of the third sacral vertebra. The rectum, the last 20 cm (8 in. ) of the GI tract, lies anterior to the sacrum and coccyx. The terminal 2-3 cm (1 in. ) of the rectum is called the anal canal.The mucous membrane of the anal canal is arranged longitudinal folds called anal columns that contain a network of arteries and veins. The opening of the anal canal to the exterior, called the anus, is guarded by an internal anal sphincter of smooth muscle (involuntary) and an external anal sphincter of the skeletal muscle (voluntary). Normally these sphincters keep the anus c losed except during the elimination of feces (Tortora & Derrickson, 2006). XII. PATHOPHYSIOLOGY NARRATIVE Appendicitis, inflammation of the vermiform appendix, is a common cause of acute abdominal pain.It is the most common reason for emergency abdominal surgery, affecting 10% of the population (Tierney et al. , 2005). Appendicitis can occur at any age, but is more common in adolescents and young adults and slightly more common in males than females (LeMone & Burke, 2007). The development of appendicitis usually follows a pattern that correlates with the clinical signs, although variations may occur because of the altered location of the appendix or underlying factors (Gould & Dyer, 2011). Obstruction of the proximal lumen of the appendix is apparent in most acutely inflamed appendices.The obstruction is often caused by fecalith, or hard mass of feces. Other obstructive causes include a calculus or stone, a foreign body, inflammation, a tumor, parasites (e. g. , pinworms), or edema of lymphoid tissue (LeMone & Burke, 2007). Following obstruction, the appendix becomes distended with fluid secreted by its mucosa and microorganisms proliferate. Pressure within the lumen of the appendix increases, impairing its blood supply because blood vessels in the wall are compressed thus the appendiceal wall becomes inflamed and purulent exudate forms.Within 24 to 36 hours, the increasing congestion and pressure within the appendix leads to ischemia and necrosis of the wall, resulting in increased permeability. Bacteria and toxins escape through the wall into the surrounding are. This breakout of bacteria leads to abscess formation or localized peritonitis. An abscess may develop when the adjacent omentum temporarily walls off the inflamed area by adhering to the appendiceal surface. In some cases, the inflammation and pain subside temporarily but then recur. Localized infection or peritonitis develops around the appendix and may spread along the peritoneal membranes.Increas ing pressure inside the appendix causes increased necrosis and gangrene in the wall (infection in necrotic tissue). The wall of the appendix appears blackish. The appendix ruptures or perforates, releasing its contents into the peritoneal cavity. This leads to generalized peritonitis and would lead to septicemia and into septic shock and will result to death (Gould & Dyer, 2011). XIII. PATHOPHYSIOLOGY DIAGRAM Risk Factors Non-modifiable: * Age (Adolescents & young adults) * Gender (Male) Modifiable: * Fecalith * Calculus/Stone * Foreign body * Inflammation * Tumor * Parasites Edema of lymphoid tissue Obstruction of the appendiceal lumen Obstruction of the appendiceal lumen Buildup of fluid inside the appendix Buildup of fluid inside the appendix Proliferation of microorganisms Proliferation of microorganisms Abdominal pain Abdominal pain Increased pressure within the lumen of appendix Increased pressure within the lumen of appendix Compression of blood vessels Compression of blood v essels * Fever * Obturator Sign * Psoas Sign * Rovsing’s Sign * Rebound tenderness * Fever * Obturator Sign * Psoas Sign * Rovsing’s Sign * Rebound tenderness Decreased blood flow into the appendixDecreased blood flow into the appendix Inflammation of appendiceal wall Inflammation of appendiceal wall (July 21, 2012) Hematology Count * WBC count: 12. 6 K/mm * Neutrophils: 0. 90 Urinalysis * Transparency: turbid (July 21, 2012) Hematology Count * WBC count: 12. 6 K/mm * Neutrophils: 0. 90 Urinalysis * Transparency: turbid Ischemia & necrosis of the wall Ischemia & necrosis of the wall Increased permeability Increased permeability Bacteria and toxins escape through the wall Bacteria and toxins escape through the wall Abscess formation/localized bacterial peritonitisAbscess formation/localized bacterial peritonitis Proliferation of localized peritonitis around the appendix and peritoneal membranes Proliferation of localized peritonitis around the appendix and peritoneal me mbranes Increased pressure inside the appendix Increased pressure inside the appendix * Sudden, severe, generalized abdominal pain * Abdominal distention & rigid â€Å"boardlike† abdomen * Absence of bowel sounds/(-) flatus/(-) BM (July 24, 2012) * Sudden, severe, generalized abdominal pain * Abdominal distention & rigid â€Å"boardlike† abdomen * Absence of bowel sounds/(-) flatus/(-) BM July 24, 2012) Increased necrosis and gangrene in the wall Increased necrosis and gangrene in the wall Appendectomy with NGT lavage (July 22, 2012) Appendectomy with NGT lavage (July 22, 2012) Perforation of the appendix Perforation of the appendix Intestinal bacteria leak out into peritoneal cavity Intestinal bacteria leak out into peritoneal cavity * Low-grade fever & leukocytosis * Tachycardia * Hypotension * Vomiting * Low-grade fever & leukocytosis * Tachycardia * Hypotension * Vomiting Generalized peritonitis Generalized peritonitis XIV. NURSING PROCESSProblem #1: ABDOMINAL PAIN – July 24, 2012 * Subjective Cues: * â€Å"Nurse wait lang, ang sakit kasi parang nagcacramps,† patient verbalized while having a conversation with him. How does it feel like: Abdominal cramping Precipitating factor: â€Å"Kapag nililinisan pero kadalasan bigla-bigla na lang sumasakit† (â€Å"Whenever wound cleaning is performed but oftentimes it just suddenly happened†) Relieving factor: Pain reliever (but not all the time pain reliever is being given) Does it radiate to the other parts of the body (back, legs, chest, etc): No Duration of pain: â€Å"Paiba-iba din eh.Minsan sobrang tagal mga 2-3 minutes, minsan naman mga ilang Segundo lang† (â€Å"It differs, sometimes it’s too long (2-3 minutes) and sometimes it just happened for a second†) * Patient rated the pain as 8/10 where 0 signifies no pain and 10 signifies unbearable pain. * Objective Cues: * Facial grimace * Guarding of the incision site * Rigid (board-like) abdomen * Abd ominal distention * Location of pain: Surgical site * RR: 25 bpm * Nursing Diagnosis Acute Pain related to inflammation of the tissues secondary to post-op surgical incision.Inflammation or nerve damage gives rise to changes in sensory processing at peripheral and central level with a resultant sensitization. In relation, prostaglandins are chemotactic substances drawing leukocytes to the inflamed tissue. It plays a vasoactive role; it is also a pain and fever inducer (Lemone and Burke, 2007). Acute Pain related to infection & inflammation of the peritoneal membranes secondary to peritonitis The peritoneum consists of a large sterile expanse of highly vascular tissue that covers the viscera and lines of abdominal cavity.This peritoneal structure provides a mean of rapid dissemination of irritants or bacteria throughout the abdominal cavity. Abdominal distention is evident, and the typical rigid, board-like abdomen develops as reflex abdominal muscle spasm occurs in response to invol vement of the parietal peritoneum (Gould & Dyer, 2011). * Goal/NOC: Pain Control Outcomes Short Term: After 30 minutes of nursing intervention the patient will report a decrease in pain from pain scale of 8/10 to 4-5/10. Long Term:After 8 hours of nursing intervention the patient will demonstrate an understanding about the proper way of controlling pain as evidenced by proper splinting and deep breathing exercise and will report a decrease or most probably will be free from pain from pain scale of 4-5/10 to 1-2/10. * NIC: Pain Management Independent: * Assessed pain including its character, location, severity, and duration. Both preoperatively and postoperatively, the client’s pain provides important clues about the diagnosis and possible complications.Abdominal distention and acute inflammation contribute to the pain associated with peritonitis. Surgery further disrupts abdominal muscles and other tissues, causing pain (LeMone & Burke, 2007). * Monitored vital signs every 2 hours. Vital Signs, especially respiratory rate (RR), are usually altered in acute pain. (Sparks and Taylor, 2005). * Kept the client at rest in semi-Fowler’s position. Gravity localizes inflammatory exudate into lower abdomen or pelvis, relieving abdominal tension, which is accentuated by supine position (Doenges et al. , 2006). * Provided diversional activities (texting, sound trip, etc).Refocuses attention, promotes relaxation, and may enhance coping abilities and diverts attention from pain (Doenges et al. , 2006). * Taught post-op health teaching (e. g. , proper splinting & deep breathing exercises). The use of non-invasive pain relief measures can increase the release of endorphins and enhance the therapeutic effects of pain relief medications (LeMone & Burke, 2007). * Encouraged early ambulation. Promotes normalization of organ function; stimulates peristalsis and passing of flatus, reducing abdominal discomfort (Doenges, et al. , 2006). Give hot and cold compress. Hot , moist compresses have a penetrating effect. The warm rushes blood to the affected area to promote healing. Cold compresses may reduce total edema and promote some numbing, thereby promoting comfort. (Doenges et al. , 2006). Dependent: * Administered analgesic as prescribed (TRAMADOL 50 mg/IV Q 8 ° x 3 doses) Time given: 8 AM. Post-operatively, analgesics are provided to maintain comfort and enhance mobility (LeMone & Burke, 2007). * Kept on NPO. Decreases discomfort of early intestinal peristalsis and gastric irritation/vomiting (Doenges et al. 2006). * Evaluation Short Term: Goal partially met. After 30 minutes of nursing intervention the patient reported of a decrease in pain from a pain scale of 8/10 to 6/10 in which 4-5/10 was the expected outcome. Long Term: Goal met. After 8 hours of nursing intervention the patient displayed control of pain as evidence by deep breathing exercise and proper splinting. He also reported of a decrease in pain with a pain scale of 2/10 from 6/ 10. Pain reliever – TRAMADOL was given @ 8 am via IV. Problem #2: ABSENCE OF FLATUS– July 24, 2012 * Subjective Cues: â€Å"Nurse wait lang, ang sakit kasi parang nagcacramps (referring to abdominal cramping),† patient verbalized while having a conversation with him. * Pain scale of 8/10 * Objective Cues: * (-) Flatulence * (-) BM (Last BM was July 17, 2012) * Absence of bowel sounds upon auscultation of all four quadrants * Nursing Diagnosis Dysfunctional gastrointestinal motility related to inflammatory process of peritonitis secondary to absence of flatulence. The inflammatory process of peritonitis often draws large amounts of fluid into the abdominal cavity and the bowel.In addition, peristaltic activity of the bowel is slowed or halted by the inflammation, causing paralytic ileus, impaired propulsion of forward movement of bowel contents (LeMone & Burke, 2007). * Goal/NOC: Ambulation Outcomes Short Term: After 8 hours of nursing intervention the client wil l report/experience flatus and will understand and demonstrate the need for early ambulation following abdominal surgery. Long Term: After 2 days of nursing intervention the client will report/experience either flatus or bowel movement or both. * NIC: Impaction Management; PositioningIndependent: * Assessed abdomen including all four quadrants noting character to determine increased or decreased in motility; Assessed for further abdominal tenderness & auscultated for any abdominal sounds. To help identify the cause of the alteration and guide development of nursing intervention (Sabol & Carlson, 2007). * Monitored and recorded (intake) and output every hour or 2 hours. Intake and output records provide valuable information about fluid volume status (LeMone & Burke, 2007). * Encouraged early ambulation.Promotes normalization of organ function; stimulates peristalsis and passing of flatus, reducing abdominal discomfort (Doenges, et al. , 2006). * Assisted in moving from side to side o r up in bed from time to time. Frequent repositioning helps in proper oxygenation and usually prevents complications like pressure ulcers, deep vein thrombosis, etc. (Gulanick, et. al. , 1994). Dependent: * Administered antacid as ordered (RANITIDINE 50g/IV Q 12 °. Antacids either directly neutralize acidity, increasing the  pH, or reversibly reduce or block the secretion of acid by gastric cells to reduce acidity in the stomach (Gabriely, et al. 2008). * Evaluation Short Term: Goal partially met. After 8 hours of nursing intervention the patient didn’t experience flatus or even bowel movement but was able to have an understanding with regards to early ambulation as evidenced by letting his mother assist him in moving up in bed going to the chair but refused to walk because of complaint of having a lot of contraptions attached to him which causes him to have difficulty in moving. Long Term: Goal met. After 3 days of nursing intervention the patient reported of a flatus fo r 3 times.Problem #3: RISK FOR DEHYDRATION – July 24, 2012 * Subjective Cue: * â€Å"Nanghihina na ako kasi limang araw ako hindi pwede kumain pati tubig bawal din kaya nagnunuyo na yung labi ko,† as verbalized by the patient. * Objective Cues: * NPO for 5 days * Dry mucous membrane * Dry lips * Capillary refill= 2 seconds * Skin turgor= 3-5 seconds * Urine output/shift= 480 mL * Urine color: Dark Yellow * Urine specific gravity: 1. 030 (Normal value: 1. 005-1. 030) * Absence of bowel sounds of all the four quadrants * (-) Flatus, (-) BM * BP: 120/80 mmHg * PP: 83 bpm * Nursing DiagnosisRisk for deficient fluid volume related to postoperative restriction secondary to NPO for 5 days Inflammation of the peritoneum with sequestration fluid and NPO status can lead to dehydration and electrolyte imbalance (Doenges, et al. , 2008). * Goal/NOC: Knowledge: Treatment Regimen; Hydration; Oral Hygiene; Tissue Integrity: Skin & Mucous Membranes Outcomes Short Term: After 30 minute s of nursing intervention patient will have an understanding with regards to maintaining fluid balance as evidenced by willingness of following the prescribed regimen given by the medical staffs. Long Term:After 3 days of nursing intervention the patient will be able to maintain adequate fluid balance as evidenced by moist mucous membrane, good skin turgor, stable vital signs, and individually adequate urine output. * NIC: Fluid Management; Fluid Monitoring; Vital Signs Monitoring Independent: * Monitored BP & Pulse. Variations help identify fluctuating intravascular volumes, or changes in vital signs associated with immune response to inflammation (Doenges, et al. , 2006). * Inspected mucous membranes; assessed skin turgor and capillary refill. Indicators of adequacy of peripheral circulation and cellular hydration (Doenges, et al. 2006). * Monitored intake and output; noted urine color/concentration, specific gravity. Decreasing urine output of concentrated urine with increasing s pecific gravity suggests dehydration/need for increased fluids (Doenges, et al. , 2006). * Auscultated bowel sounds. Noted passing of flatus, bowel movement. Indicators of return of peristalsis, readiness to begin oral intake (Doenges, et al. , 2006). * Provide clear liquids in small amounts when oral intake is resumed, and progress diet is tolerated. Reduces risk of gastric irritation/vomiting to minimize fluid loss (Doenges, et al. 2006). * Stressed the importance of having him on a NPO status and provided the necessary information with regards to his condition and the medications being administered (e. g. , IVF). It provides the patient a full understanding with regards to his condition thus encouraging him to participate and work hand in hand with the staff (Gulanick, et al. , 1994). * Gave frequent mouth care with special attention to protection of the lips. Dehydration results in drying and painful cracking of the lips and mouth (Doenges, et al. , 2006). Dependent: * Maintaine d gastric suction as indicated.Although not frequently needed, an NG tube may be inserted preoperatively and maintained in immediate postoperatively phase to decompress the bowel, promote intestinal rest, and prevent vomiting (Doenges, et al. , 2006). * Administered IV fluids (D5LR 1L x 8 ° or 30 gtts/min) and electrolytes (D5 Balanced Multiple Maintenance Solution w/ 5% dextrose 1L x 8 ° or 30 gtts/min). The peritoneum reacts to irritation/infection by producing large amounts of intestinal fluid, possibly reducing the circulating blood volume, resulting in dehydration and relative electrolyte imbalances (Doenges, et al. , 2006). * EvaluationShort Term: Goal met. After 30 minutes of nursing intervention the patient was able to have a full understanding with regards to maintaining fluid balance as evidenced by verbalizing, â€Å"So kaya pala hindi pa ako pwede kumain ngaun para maiwasan mairritate ang tiyan ko. † Long Term: Goal met. After 3 days of nursing intervention th e patient was able to maintain adequate fluid balance as evidenced by moist mucous membrane, good skin turgor (1-2 seconds), stable vital signs (please see page __ ), and adequate urine output of 620 mL with an appearance of amber yellow. Problem #4: RISK FOR INFECTION – July 24, 2012 Subjective Cues: â€Å"Nurse, sobrang kailangan ba talaga ang paghuhugas ng kamay bago linisan o hawakan sugat niya? †, asked by the mother. * Objective Cues: * Post-operative condition – presence of surgical incision * Surgical site is warm to touch and reddened * Temp: 36. 3 °C * Nursing Diagnosis Risk for infection related to inadequate primary defenses secondary to post-operative surgical incision It is risk to be invaded by pathogens especially if surgical site is near at the perineal area, pathogens can also develop by poor personal hygiene and poor wound cleaning (Doenges, et al. 2006). * Goal/NOC: Risk Control (For Infection) Outcomes Short Term: After 30 minutes of nursi ng intervention the patient will be able to have partial understanding about infection control and will verbalize understanding of and willingness to follow up prescribed regimen. Long Term: After 3 days of  nursing intervention  the  patient will be free of sign and symptom r/t infection. * NIC: Incision Site Care; Infection Control; Wound Care Independent: * Monitored vital signs. Noted onset of fever, chills, diaphoresis, changes in mentation, and reports of increasing abdominal pain.Suggestive of presence of infection/developing sepsis, abscess, peritonitis (Doenges, et al. , 2006). * Inspected incision and dressings. Noted characteristics of drainage from wound/drains, presence of erythema. Provides for early detection of developing infectious process, and/or monitors resolution of preexisting peritonitis (Doenges, et al. , 2006). * Instructed proper hand washing. Practiced aseptic wound care. Reduces risk for infection (Doenges, et al. , 2006). * Encouraged adequate nutr itional intake after the NPO status of the patient and when the patient is allowed to eat.Adequate intake of protein, Vitamin C and minerals is essential to promote tissue and wound healing (Sparks and Taylor, 2005). Dependent: * Administered antibiotics (CEFUROXIME 750mg TID Q 8 ° x 2 doses & METRONIDAZOLE 500g/IV Q 8 ° x 2 doses) as ordered. Therapeutic antibiotics are given if the appendix is ruptured or abscessed or peritonitis has developed (Doenges, et al. , 2006). * Prepare for/assist with incision and drainage (I&D) if indicated. May be necessary to drain contents of localized abscess (Doenges, et al. , 2006). * Evaluation Short Term:Goal met. After 30 minutes of nursing intervention the patient was able to have an understanding about infection control as evidenced by verbalizing, â€Å"Para maiwasan ang pagkaroon ng impeksyon kailangan kong maghugas ng kamay palagi at kinakailangan din ang araw-araw na paglilinis ng sugat ko kahit na sa tuwing nililinisan ito makirot s a pakiramdam. † Long Term: Goal met. After 3 days of  nursing intervention  the  patient was free of sign and symptom r/t infection. Problem #5: INABILITY TO PERFORM ACTIVITY/IES OF DAILY LIVING (ADL) – JULY 24, 2012 * Subjective Cues: â€Å"Hirap talaga ako gumalaw, maglakadlakad, o kahit man lang umupo dahil sa mga nakakabit na ito sa akin,† as verbalized by the patient. â€Å"Nakakapanghina pa kasi masakit nga yung tahi tapos madalas din nagcacramps ang tiyan ko,† he added. * Objective Cues: * Presence of surgical incision * Presence of contraptions (urinary catheter, NGT lavage & IV fluid @ left hand) * Nursing Diagnosis Impaired physical mobility related to body weakness, presence of surgical incision, pain, & presence of contraptions attached Physical immobility can be usually associated with post-operative conditions (Gulanick, et al. 1994). * Goal/NOC: Activity Tolerance Outcomes Short Term: After 30-45 minutes of nursing intervention the pat ient will be able to have a clear understanding with the use of identified techniques to enhance activity tolerance and to apply it as well as evidenced by participating in ROM exercises, lower leg & ankle exercise, ambulation, or even moving up in bed. Long Term: After 2-3 days of nursing intervention the patient will be able to continually participate in a simple form of activity and will report an improvement with regards to his activities. * NIC: Exercise Therapy: BalanceIndependent: * Performed passive ROM exercises. ROM exercises and good body mechanics strengthen abdominal muscles and flexors of spine (Gulanick, et al. , 1994). * Encouraged lower leg and ankle exercises. Evaluated for edema, erythema of lower extremities, and calf pain or tenderness. These exercises stimulate venous return, decrease venous stasis, and reduce risk of thrombus formation (Gulanick, et al. , 1994). * Noted emotional and behavioral responses to immobility. Provided diversional activities. Forced i mmobility may heighten restlessness and irritability.The Cardiovascular SystemDiversional activity aids in refocusing attention and enhances coping with actual and perceived limitations (Gulanick, et al. , 1994). * Assisted with activity, progressive ambulation, and therapeutic exercises. Activity depends on individual situation. It should begin as early as possible and usually progresses slowly, based on client tolerance (Gulanick, et al. , 1994). * Assisted in moving from side to side or up in bed from time to time. Frequent repositioning helps in proper oxygenation and usually prevents complications like pressure ulcers, deep vein thrombosis, etc. Gulanick, et al. , 1994). * Noted client reports of weakness, fatigue, pain and difficulty accomplishing tasks. Symptoms may be result of/or contribute to intolerance of activity (Gulanick, et al. , 1994). Dependent: * Administered pain medication (TRAMADOL 50 mg/IV Q 8 ° x 3 doses, time given: 8 AM) as prescribed and on a regular sch edule. Client’s anticipation of pain can increase muscle tension. Medications can help relax the client, enhance comfort, and improve motivation to increase activity (Gulanick, et al. , 1994). * Evaluation Short Term:Goal partially met. After 30-45 minutes of nursing intervention the patient was able to have a clear understanding with the use of identified techniques to enhance activity tolerance and was able to use all of the techniques except for the ambulation. He refused to walk because he complained of pain whenever the catheter tube slipped into his legs. Long Term: Goal partially met. After 2-3 days of nursing intervention the patient was able to continually participate in all of the identified techniques but still refused to participate in ambulation.He also reported of an improvement with regards to his activities as evidence by his verbalization, â€Å"Medyo natotolerate ko na rin yung mga activities kahit pautay-utay muna. Hindi ko lang talaga muna kaya maglakad p ero pagnaalis na siguro yung catheter baka kayanin ko na. † XV. BIBLIOGRAPHY * Cosgrove DO, Meire HB, Lim A, & Eckersley RJ. (2008). Grainger & Allisonn's Diagnostic Radiology: A Textbook of Medical Imaging (5th edition). New York, NY: Churchill Livingstone * Doenges M. , Moorhouse, M. ; Murr, A. (2006).Nursing Care Plans Guidelines for Individualizing Client Care across the Life Span (7th Edition). F. A. Davis Company, Philadelphia * Doenges, M. , Moorhouse, M. ; Murr, A. (2006). Nurse’s Pocket Guide Diagnoses, Prioritized Interventions, and Rationales (11th Edition). F. A. 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