Analysis Of Midsummer Night s Dream - 1251 Words

Midsummer Night’s Dream is a perfect example of just how deceit can tear people apart. When trying to force a situation into something/ a situation you wish it to be you can end up putting yourself in quite the compromising position. It is a good story on the struggles of true love, parents wills, and fighting for what one believes in, with just a hint a magical alure to it and a slight pull of betrayal to make things even more interesting. In the end though, just as almost every other love story, true love wins out, things are returned to normal, and all is as it was- for the most part. With all of the characters love going for different people than supposed to they now have to find a way around it all, get the love spell lifted, and†¦show more content†¦Senecas second ideal states that plays are set to be modeled for the use of technical devices such as solliliquies, asides, and confidantes. Midsummer Night’s Dream was written in iambic pentameter, rhymed ver se, and catalectic trochaic tetrameter. Throughout the play there are many times where the characters seem to talk for hours. Going on and on about something or other, that they desire more than anything, or need to happen, something they’ll avenge. Although this may seem annoying to the reader, they are useful examples for Sennecas third ideal because of their length. For example Take Helenas Monologue at the end of Act I Scene I; How happy some o er other some can be! Through Athens I am thought as fair as she. But what of that? Demetrius thinks not so. He will not know what all but he do know. And as he errs, doting on Hermia’s eyes, So I, admiring of his qualities. Things base and vile, holding no quantity, Love can transpose to form and dignity. Love looks not with the eyes but with the mind. And therefore is winged Cupid painted blind. Nor hath Love’s mind of any judgment taste— Wings and no eyes figure unheedy haste. And therefore is Love said to be a child, Because in choice he is so oft beguiled. As waggish boys in game themselves forswear, So the boy Love is perjured everywhere. For ere Demetrius looked on Hermia’s eyne, He hailed down oaths that he was only mine. The third ideal states that Senneca would make use of Elaborate speeches. One of

The Effects of Underage Drinking Essay - 853 Words

Every year, thousands of minors die from the use of alcohol. Many young adults abuse the drinking age policy. It is put in effect for substantial reasons, which contribute in making the safest environment for all. Drinking underage is not only illegal, but also damages one’s health tremendously. Furthermore, drinking in large amounts is extremely dangerous and can cause detrimental things to occur. There have been numerous attempts to create a law to lower the drinking age, but none have gone through. In contrast to what some people may say, the drinking age should not be lowered because it would decrease maturity, promote poor behavior, and damage reputations. If the drinking age is lowered, the maturity in people would decrease. From†¦show more content†¦Stating that drinking at a younger age causes more health hazards proves that having the drinking age higher would be safer for oneself and the community as a whole. In addition, younger adults could easily become exposed to alcoholism. It is stated by the National Highway Institute in a study done on alcohol abuse among teens that â€Å"the overall risk for alcoholism decreases 14 percent with each year of age that drinking is postponed† (Boulard 52). The drinking age should not be lowered because the higher the drinking age, the less risk there is for alcoholism. Not only does drinking cause health related problems, but it also produces risks of injury or death. It has been proven that â€Å"youth alcohol use contributes to higher incidences of drunk driving, traffic accidents, unwanted pregnancies, and sexually transmitted diseases (STDs)†¦Ã¢â‚¬  (â€Å"Update: Alcohol Issues† 1-2). Not only is underage drinking illegal, but drinking and driving is as well. Therefore, maintaining the drinking age would prevent the number of accidents and deaths. However, some believe that drinking wine is good for the heart. This is only true for drinking in moderation. If one drinks more than a couple of glasses, this does not go into effect, and the number of bad health related consequences outnumbers the good. Studies have shown that â€Å"The lower death rate among moderate drinkers is due to the reduction in heart disease, specifically atherosclerosis orShow MoreRelatedThe Effects Of Drinking On Underage Drinking3458 Words   |  14 Pages Effects Drinking has on Underaged Drinkers Underage drinking is the most abused substance in the U.S, and accounts for over 4,300 deaths yearly. Drinking, is not only unhealthy but even worse for developing teens. The human brain doesn’t stop developing until 25. It impairs judgment, causes brain damage, and most importantly lifestyles. Nineteen percent of underage people 16 to 20 got in the car with intoxicated drivers. This caused $68 billion dollars in medical bills. When an underage drinkerRead MoreCause and Effect of Underage Drinking780 Words   |  4 Pagespaper I will exam the causes of underage drinking and they effects that this may place on the individual, their families, and society. According to the United States Department of Health and Human Services, Young people begin to take risks and experiment as they transition from childhood to adulthood. Without support and guidance, some young people may engage in behaviors that place them and others at risk Ââ€" including using alcohol. (Youth and Underage Drinking: An Overview, 2004). As a childRead MoreEffects of Underage Alcohol Drinking1923 Words   |  8 PagesUnderage alcohol drinking can have devastating effects on teenagers. It can affect teens grades, health and many other things as well. The reasons why teenagers consume alcohol are pretty clear. What aren’t clear are the solutions to eliminating, or at least reducing the number of underage drinkers. 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In the journal article â€Å"The Use of Caffeinated Alcoholic Beverages Among Underage Drinkers: Results of a National Survey† they examine the relationship between the tendencies underage drinkers who drink non-traditionalRead More Effects of Underage Drinking on Society Essay1100 Words   |  5 PagesUnderage Drinking Anyone who is below eighteen years of age is considered as underage and laws in many countries prohibit such a person from consuming alcohol. Alcohol happens to be the most commonly abused drug not only among the youth but also among adults. This paper explores underage drinking, its effects on the society and outlines what can be done to curb it. Young people are considered to constitute the largest number of alcohol consumers and they account for a large portion of alcoholRead MoreThe Effects Of Alcohol On The Prevention Of Underage Drinking1280 Words   |  6 Pages Suggestions of a possible solution a. Education i. Nature. What, specifically, is the plan? 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Although many ideas have been made and put into practice, like raising the drinking age, harsher punishments, and, at one point, banning it all-together, nothing people do can stop teensRead MoreIs Underage Drinking Not Only Effect Their Live?1650 Words   |  7 Pages Actually underage drinking not only effect their live, but also affect teenager’s health. Research has shown that about 40% of teens drinking of 14-19 degree is achieved the level of short-term risk of harm. So what harm does alcohol do to your body? First of all, alcohol can poison the liver, cause the liver function damage. Excessive drinking consumption increased the burden on the liver. Mainly depends on the oxidative decomposition, damaged liver cell degeneration. Eventually lead to cirrhosisRead MoreEffects Of Underage Drinking On Public Health1797 Words   |  8 PagesChristopher Duffey HSC 401: Public Health and Policy Professor James D. Blagg Public Health Issue/Health Policy Analysis Paper April 10, 2016 Impact of Underage Drinking on Public Health: Minimum Legal Drinking Age Policy Overview of the Issue The adult consumption of alcohol, in moderation and in a responsible manner, is perfectly fine. Issues arise when the consumption of alcoholic beverages are done so in a way that is excessive, risky, done so as a coping mechanism, illegally, and done so inRead MoreThe Effects Of Television On Children s Decision Of Underage Drinking Essay2291 Words   |  10 PagesWhat would you do if you were to find out, that just by watching an advertisement on television, it can lead you to drug problems, health issues, or even death? With this, alcohol distributors poison the mind of the young and make them believe that drinking can really bring all the pleasures portrayed in the advertisements, like the beach parties, celebrations, and fun at sporting events Alcohol, that may be consumed, has been a very important aspect of the world. Many people enjoy being able to have

Information Systems Analysis Design And Systems Development

Question: Discuss about the Information Systems Analysis Design And Development. Answer: Introduction This report emphasizes on the development of an Information system for Data Science School. The organization is a registered training facility which offers specialized training to domestic as well as international students. The aim of this report is to develop an Information system for the organization to transform their manual process into automated one which will eventually facilitate the reduction in human errors. The development of an Information system is essential for increasing efficiency of the organization by supporting the current business processes. The major problem that exists within the current organization is that only staff is able to access information that are important that often creates a bottleneck particularly when the staff is at a remote location. The discussion in this report are carried out to demonstrate upon the approach that can be taken for systems development and determination of the system requirements. Further, a project schedule has been prepared and evaluation of the project is done with Cost benefit analysis. The last section of this report is dedicated to discussion on the various techniques for System information requirement investigation. Approach to Systems Development The analysis of the current system describes that the present system is not capable to meet the requirements of the organization. The requirement analysis showed that the traditional approach will be suitable for the organization to overcome the problems with existing system. A feasibility study for adoption of traditional approach has been conducted to determine the risks and preparing mitigation plans against the identified risks for efficient development of the Information system. Various types of data have been collected to reduce the time for development as well as cost such as different software and resources to design and develop the system by integrating different plug-in. The development of the project will be initiated with the help of a system development model which is traditional. The system will be developed aligning with the business processes and requirements of the organization. Hence, the iterative model has been chosen as the approach to systems development for developing the Information system. This approach will facilitate development of the Information system with the help of repetitive cycles (Vaishnavi and Kuechler 2015). The development of Information system using this approach will be divided into various phases as well as modules. It will be dependent on validation of the requirements along with testing after each phase is complete to ensure that the system meets the desired goals and objectives. The system developer is aware of the system requirements that needs to be fulfilled so, iterative model has been chosen to be used for development of the Information system. The selection of iterative model is suitable for this project in te rms of functionality and flexibility to incorporate new technology to develop the Information system (Richey and Klein 2014). Systems Requirements The determination of system requirements mainly comprises of two types of requirements that is functional and non-functional requirements. For this project to develop the Information system for Data Science School (DSS) the system requirements have been categorized and provided as below: Functional requirements The major functional requirements that have been identified for developing the information system of DSS are tabulated as below: Functional Requirements Description Registration This functionality will help the students as well as agents to register or enrol themselves into the system for accessing the services of DSS. Login It is required to ensure that authorized persons can only access the system and the agents are also able to use the system by logging in with the help of specific username and password. Searching The data of the students and the agents can be looked by the administrators and receipt of the specialists can be sought utilizing the develop information system. Logout The session of the clients lapses on tapping the logout button and the client would be diverted to the landing home page. Status update The status of the receipt and the instalment is required to be appeared on the information system and a notice ought to land to the administrator with respect to the due date of a critical occasion. Tracking The system administrator ought to have the capacity to track the records of students and accumulate their subtle elements for expanding the productivity of the information system. Mail services A mail administration is required to be designed for empowering intercommunication with the students as well as agents associated with the DSS. Automatic report generation The information system ought to have the capacity to produce month to month report comprising of all the instalment action of the agents as well as the students. Non-functional Requirement Non-functional Requirement Description Security The information system database is required to be secured from unapproved authorization and it is required to be encrypted for expanding the security of the framework. Authorization The DSS information system users ought to be provided with specific username as well as password to access the system. Storage The information is required to be put away in cloud server for remote openness and accessibility. Availability The accessibility of information is imperative in light of the fact that the inaccessibility of information may stop a particular group of users from utilizing the system. Project Cost Benefit Analysis This section comprises of the calculation of total costs that will be incurred for the project as well as the benefits that will achieved from the project in the form of profits over 5 years (Nas 2016). In this section, the analysis is done by listing the project expenses and then calculating the profits that will achieved in return for 5 years. Costs and Benefits Tangible Benefits Category In $US Savings on costs for staffs $ 30,000.00 Reduction in costs for overpaid agents $ 48,000.00 Total Tangible Benefits $ 78,000.00 Tangible One-Time Costs Category In $US Total costs for development $ 150,000.00 Total Tangible One-Time Costs $ 150,000.00 Tangible Recurring Costs Category In $US Costs for maintenance related activities $ 60,000.00 Total Tangible Recurring Costs $ 60,000.00 Cost benefit Analysis Cost Benefit Analysis Benefits of option Year 1 Year 2 Year 3 Year 4 Year 5 Savings on costs for staffs $ 30,000 $ 30,000 $ 30,000 $ 30,000 $ 30,000 Reduction in costs for overpaid agents $ 48,000 $ 48,000 $ 48,000 $ 48,000 $ 48,000 Total Benefits $ 78,000 $ 78,000 $ 78,000 $ 78,000 $ 78,000 Costs of option Year 1 Year 2 Year 3 Year 4 Year 5 Total costs for development $ 150,000 $ - $ - $ - $ - Costs for maintenance related activities $ 60,000 $ 60,000 $ 60,000 $ 60,000 $ 60,000 Total Costs $ 210,000 $ 60,000 $ 60,000 $ 60,000 $ 60,000 Net benefits/costs $ (132,000) $ 18,000 $ 18,000 $ 18,000 $ 18,000 Cumulative benefits/costs $ (132,000) $ (114,000) $ (96,000) $ (78,000) $ (60,000) Net benefits/cost (NPV @ 5%) ($125,714.29) $16,326.53 $15,549.08 $14,808.64 $14,103.47 Cumulative NPV ($125,714.29) ($109,387.76) ($93,838.68) ($79,030.03) ($64,926.56) Table 1: Cost benefit Analysis for the development of Information System Figure 1: Cost benefit Analysis graph (Source: Created by Author) The above graph represents the analysis of cost and benefit for the project to develop the Information system for Data Science School (DSS). The red line in the graph indictaes the net benefits that will be achieved over the next 5 years at a discount rate of 5% and the greem line represents the cumulative net present values for the project. Project Schedule WBS Task Name Duration Start Finish Predecessors 0 DSS Information System Development 125 days Mon 5/1/17 Fri 10/20/17 1 Project Startup 1 day Mon 5/1/17 Mon 5/1/17 2 Requirements Analysis Phase 17 days Tue 5/2/17 Wed 5/24/17 2.1 Arrange meetings with stakeholders 4 days Tue 5/2/17 Fri 5/5/17 1 2.2 Gather required information 5 days Mon 5/8/17 Fri 5/12/17 3 2.3 Preparing project plan 6 days Mon 5/15/17 Mon 5/22/17 4 2.4 Approval of project plan 2 days Tue 5/23/17 Wed 5/24/17 5 3 Procurement phase 90 days Thu 5/25/17 Wed 9/27/17 3.1 Arrange for resources 7 days Thu 5/25/17 Fri 6/2/17 6 3.2 Procure equipments 15 days Mon 6/5/17 Fri 6/23/17 8 3.3 Setup of inventory system 12 days Mon 6/26/17 Tue 7/11/17 9 3.4 Selecting suitable SDLC model 4 days Wed 7/12/17 Mon 7/17/17 10 3.5 Developing the project team 6 days Tue 7/18/17 Tue 7/25/17 11 3.6 Preparing a plan for communication 10 days Wed 7/26/17 Tue 8/8/17 12 3.7 Identifying the functional module 3 days Wed 8/9/17 Fri 8/11/17 13 3.8 Coding for development of functional module 18 days Mon 8/14/17 Wed 9/6/17 14 3.9 Integrating the module 8 days Thu 9/7/17 Mon 9/18/17 15 3.10 Testing to check functionality of the module 4 days Tue 9/19/17 Fri 9/22/17 16 3.11 Deploying the Information system 3 days Mon 9/25/17 Wed 9/27/17 17 4 Training phase 16 days Thu 9/28/17 Thu 10/19/17 4.1 Development of training program 7 days Thu 9/28/17 Fri 10/6/17 18 4.2 Prepare user manuals 4 days Mon 10/9/17 Thu 10/12/17 20 4.3 Identifying the staffs for training 3 days Fri 10/13/17 Tue 10/17/17 21 4.4 Hiring of trainers 2 days Wed 10/18/17 Thu 10/19/17 22 5 Project Closure 1 day Fri 10/20/17 Fri 10/20/17 23 FIGURE 2: Gantt chart for the project (Source: Created by Author) System Information Requirement Investigation Techniques For development of the Information system to support the business processes of DSS, the following stakeholders will be associated with the project: Stakeholders Impact Interest Me John Smith (Owner / Project Sponsor) High High Project Manager Medium High Agents Low High Students Low High Resource Manager Medium Low System Analyst High Medium Investigation technique Interviewing: The partners related with the association are met for breaking down the prerequisite and it done by organizing gatherings with the partners. Meeting the partners, for example, the sponsor for project would comprehend the monetary allowance designated for the advancement of the project and the time inside which the project is required to be finished (Martinelli and Milosevic 2016). Questionnaires: An arrangement of inquiries is required to be readied and they can be sent to the partners through email to get input from them. The polls are utilized for taking criticism from the partners remotely without direct meetings. This lessens the investigation time and precise information can be found with the utilization of an arrangement of legitimate questionaries. Observation: Observing authoritative process would comprehend the prerequisite of the project and in this manner expanding the likelihood of fruitful improvement. The present procedure took after by the association is required to be checked for comprehend the necessities of the present business processes (Hale and Stanney 2014). This helps the team for development to build up the Information system by adjusting the necessities of the association. Reflections and Conclusions The limitation confronted in terms of developing the Information system for DSS is that it ought to record the whole operator and the understudy data and would have the capacity to react to any question made with respect to the understudy and the specialists. The execution of the data framework in the present business procedure of the association would help the association to expand its effectiveness and lessen the activities required to deal with the records physically. From the above report it can be reasoned that for the improvement of the framework a project plan and a work breakdown structure is required to be readied that would help the project administration group to effectively build up the project. An analysis of cost benefit is additionally performed on the project to discover the time in which the project cost would be recuperated. References Burke, R., 2013. Project management: planning and control techniques.New Jersey, USA. Galliers, R.D. and Leidner, D.E., 2014.Strategic information management: challenges and strategies in managing information systems. Routledge. Grinsven, M., Heusinkveld, S. and Cornelissen, J., 2016. Translating management concepts: towards a typology of alternative approaches.International Journal of Management Reviews,18(3), pp.271-289. Hale, K.S. and Stanney, K.M., 2014.Handbook of virtual environments: Design, implementation, and applications. CRC Press. Heagney, J., 2016.Fundamentals of project management. AMACOM Div American Mgmt Assn. Kerzner, H., 2013. Project management: a systems approach to planning, scheduling, and controlling. John Wiley Sons. Lientz, B. and Rea, K., 2016.Breakthrough technology project management. Routledge. Martinelli, R.J. and Milosevic, D.Z., 2016.Project management toolbox: tools and techniques for the practicing project manager. John Wiley Sons. MINE, P.O. and AREA, C., 2015. Cost Benefit Analysis. Mir, F.A. and Pinnington, A.H., 2014. Exploring the value of project management: linking project management performance and project success.International Journal of Project Management,32(2), pp.202-217. Nas, T.F., 2016.Cost-benefit analysis: Theory and application. Lexington Books. Pritchard, C.L. and PMP, P.R., 2014.Risk management: concepts and guidance. CRC Press. Richey, R.C. and Klein, J.D., 2014.Design and development research: Methods, strategies, and issues. Routledge. Schwalbe, K., 2015.Information technology project management. Cengage Learning. Stark, J., 2015. Product lifecycle management. InProduct Lifecycle Management(pp. 1-29). Springer International Publishing. Turner, J.R., 2014.The handbook of project-based management(Vol. 92). New York, NY: McGraw-hill. Turner, R., 2016.Gower handbook of project management. Routledge. Vaishnavi, V.K. and Kuechler, W., 2015.Design science research methods and patterns: innovating information and communication technology. Crc Press. Valacich, J.S., George, J.F. and Hoffer, J.A., 2015.Essentials of systems analysis and design. Pearson Education. Wasson, C.S., 2015.System Engineering Analysis, Design, and Development: Concepts, Principles, and Practices. John Wiley Sons.

Writing Guide for Academic Journals

Several Tips How to Write for Academic Journals The strategy is not just a plan what you have to do in order to succeed; it is a complex thing that covers internal and external motivators. Internal motivators deal with your reasons and purpose of writing. External motivators are more materialistic points, as they bring some benefits to you. In particular, it may be high points in research assessment, a presentable profile in some specific field, or a career promotion. You should also pay attention to planning aspects such as a number of researchers in the field, an existence of the journal in which you want to be published, group of scholars or scientific conversation on the issue of your interest. Before you start writing an article, we recommend you to choose on the pages of which journal you want to see it. In this way you won’t have to adjust the paper according to the requirements of this or that journal, so you can save your time and energy. The key point is to maintain the motivation and be ready to wait, as it may take a long period to get the article published. Scan and analyze writings of your field In other words, you have to explore requirements to the writings on the subject of your interest. For that you have to take several journals and take a close look at them. First of all, scan the abstracts and the whole text, pay special attention to the first and last sentences, and the vocabulary used in different parts of the text. Thanks to that you can determine not only tendencies of research, but also different types of papers and their structures. Create a plan and follow it It is very hard to create something without any preparation and background, besides it is a pretty way to get lost. The best decision is to combine just writing with creating an outline. You should work hard and make the outline as detailed as possible. Create your plan in accordance with the requirements of the journal you want to be published in. The type of headings, the number of sections and subsections, what content and arguments to include – all these points should be described. Ask and consult with others Most people ask for feedback when the paper is already written, but you should not be limited only by this option. From the very beginning you should discuss your ideas with others. In this case you will be able to correct and improve the article step by step. If you have done some particular part of work, show it to your tutor, colleagues or friends, and find out their opinions. The writer should be single-minded, patient, persistent and flexible at the same time It is a common practice when people work on several issues at the same time, but you should keep in mind one thing – a worthy idea should mature. Not everything you are working on right now will be published in the near future. Some ideas will remain just ideas. When you feel that the point has a powerful potential for research, focus on it. Look at this point from different perspectives, ask what others think about it, and research deeply. You may be criticized or feel tired, but such situation means that you are moving, probably, in the right direction. Analyze the thoughts of reviewers No matter, whether you will get a positive or negative feedback after submission, this is your experience, that’s why you have to learn from it. Make a list of points you have to pay attention to and work on them. Think about yourself To prepare the excellent article is a very responsible and troublesome step. While writing for the journal you are constantly under pressure, and this fact may have a negative impact on your health. You can face risks concerning your mental health, diseases of the musculoskeletal system and some others. In order to avoid negative effects you have to take a break from time to time, eat well and sleep enough.

The Philosophy Of Trees Essays - Botany, Biology, Forest Ecology

The Philosophy Of Trees The portrait of a tree is not to be mistaken or over looked. Every one can see the beauty of a tree whether it be an ever green or disigous. This may be the key to our future. To look from the ground up standing under a tree the leaves may slowly turn around you enrapture you with all thier green. You may stand there unfulfilled this is when you should look closer; look pasted the tree's green and beautiful leaves and find all the liveing creatures that have thier home in this tree. Even the smalliest ant or callipiter these are still life it shelters and breads, yes, the trees. Still touch the soft green petals we call leaves but, wait what this on the back of those liveing leaves? Tiny little dots you see these are eggs also another soon to be moving living creature. See the trees beauty and stiil your life will become more free. Speech and Communications

How to Diagnose Fluid Volume Deficit Signs and Care Plan

How to Diagnose Fluid Volume Deficit Signs and Care Plan SAT / ACT Prep Online Guides and Tips Looking for information about fluid volume deficit? We’ve got you covered! In this article, we’ll explain the fluid volume deficit nursing diagnosis (AKA deficient fluid volume) and describe the causes, symptoms, and signs. We’ll also provide guidance on creating a fluid volume deficit care plan. What Is Fluid Volume Deficit? Fluid volume deficit (also known as deficient fluid volume or hypovolemia) describes the loss of extracellular fluid from the body. Extracellular fluid is the body fluid not contained within individual cells. It constitutes about 20% of our body weight and includes blood plasma, lymph, spinal cord fluid, and the fluid between cells. Importantly, this fluid isn’t just water- it also contains electrolytes and other essential solutes. Fluid volume deficit is often used interchangeably with the term â€Å"dehydration,† but they aren’t exactly the same thing. Dehydration refers specifically to the loss of body water as opposed to body fluid. What’s the difference? Electrolytes. If a patient has just lost water but no electrolytes, they’ll have slightly different issues- and require slightly different treatment- than a patient who has lost wholesale body fluids, which contains water and electrolytes. Well, some of these things are electrolytes. What Causes Fluid Volume Deficit? There are a number ways the body can lose fluid. Here are some major causes of deficient fluid volume: Blood loss from cuts/wounds Through the gastrointestinal system: vomiting and diarrhea Abnormally excessive urination (polyuria); can be caused by excessive intake of diuretic substances or medications or from renal disorder. Excessive sweating; typically sweating is more likely to cause dehydration than fluid volume deficit because the body generally expels far more water than electrolytes, but sweating can also cause deficient fluid volume in some cases. Bleeding disorders Burns (because the skin no longer protects against excessive fluid loss) The fluids in the body also constantly need to be replenished. Patients can experience deficient fluid volume if they aren’t taking in enough fluid. This is particularly an issue with infant and elderly patients. Patients can also experience fluid volume deficit if they are losing body fluids to a place inside the body where the fluid is not easily accessed by other organs and body systems; e.g. from edema or internal bleeding caused by trauma or as a complication of surgery. This is known as third spacing. Types of Fluid Volume Deficit While fluid volume deficit refers to the loss of both water and solutes from the body, there are three major types of fluid volume deficit: Isotonic: Caused by losing fluids and solutes about equally; solute concentration in the remaining extracellular fluid then remains relatively unchanged Hypertonic: Caused by losing more fluids than solutes, leading to increased solute concentration in the remaining fluid. Hypotonic: Caused by losing more solutes than fluid leading to decreased solute concentration in remaining fluid. This is the rarest type. The type of fluid volume deficit (as determined through lab work) may inform care, especially what fluids are offered to the patient to replace the lost fluid/solutes. She doesn't look very happy to be getting IV therapy. Signs and Symptoms of Fluid Volume Deficit There are a variety of fluid volume deficit signs and symptoms to check for. First we’ll discuss what major symptoms the patient may experience, and then address some ways to determine it the fluid volume deficit nursing diagnosis applies. Major Fluid Volume Deficit Signs Dizziness (orthostatic/postural hypotension) Decreased urination (oliguria) Dry mouth, dry skin Thirst and/or nausea Weight loss (except in third spacing, where the fluid will still be in the body but inaccessible) Muscle weakness and lethargy If fluid volume deficit is severe (more than 20% of body fluid volume is lost), the patient may go into hypovolemic shock. The more fluids that are lost, the more severe the symptoms will become. The following shock symptoms may manifest: Very pale skin Cool, clammy extremities (from the body trying to conserve blood flow to essential systems) Confusion and anxiety Rapid, weak pulse Fast, shallow breathing Unusual sweating Loss of consciousness Coma Get this tired dog some fluids, stat! How to Diagnose Fluid Volume Deficit There are a variety of indicators you can use to diagnose deficient fluid volume. (Well before the patient reaches coma stage!) Vital Signs Increased heart rate: with less fluid available to the circulatory system, the heart pumps faster to bring oxygen to the body. However, the pulse will also feel weaker than usual. Decreased blood pressure: in adults, lower fluid volume means lower pressure in the veins. However, note that children may still maintain high blood pressure when experiencing fluid volume deficit. You may also want to take the patient’s orthostatic vital signs (vital signs in both supine/lying down and standing positions). A decrease in the systolic blood pressure of 20 mmHg or more or in the diastolic blood pressure of 10mmHg or more when standing indicates fluid deficit. So does an increase in the heart rate of 20 bpm or more. Other Fluid Volume Deficit Signs and Symptoms Decreased skin turgor/tenting. If you pinch the patient’s skin on the back of the hand or forearm and it and â€Å"tents† for a moment before returning to normal instead of immediately snapping back into position, this is a sign of decreased fluid volume. However, because elderly individuals already have low skin elasticity, this is not a reliable test of fluid volume deficit for those patients. If you examine the tongue, you’ll most likely see several small furrows instead of the usual one main furrow. With severe fluid volume deficit, you will see signs of decreased tissue perfusion: the nail will take more than three seconds to return to normal coloration when pressed in a capillary refill nail test. Patient’s eyes may appear sunken. Skin may be pale. Neck veins will appear flat when the patient is laying back in a supine position. Lab Results BUN (blood urea nitrogen) to serum creatinine ratio in the blood will likely be abnormally elevated–20:1 or more. Urine specific gravity and osmolality will be elevated, indicating more highly concentrated urine. Urine may also appear a deep amber color, and there will be decreased urine output. Hematocrit (the percentage of red blood cells in blood plasma) increases (unless fluid was lost due to hemorrhage, in which case you would likely see a drop in hematocrit post-hemorrhage) Depending on the cause of the deficient fluid volume, you may also see: Hypokalemia (decreased potassium in the bloodstream) is commonly caused by vomiting, diarrhea, excessive sweating, or renal (kidney) disorder. Hyponatremia (decreased sodium in blood) OR hypernatremia (increased sodium in the blood) could be present depending on the types of fluid lost. An increase in vasopressin/antidiuretic hormone may also occur as the body constricts the blood vessels and retains remaining body fluid to maintain blood pressure. The other kind of lab! Potential Complications of Fluid Volume Deficit When left untreated, severe fluid volume deficit can lead to: Renal failure Heart failure General organ failure (from lack of oxygen) Death Even if patient’s life is saved through fluid infusion, if they reach the point of organ failure they may experience irreversible damage to some body systems. Fluid Volume Deficit Care Plan A nursing care plan is a written document that tracks what you have done and will do to take care of a particular patient’s individual needs. Nursing students generally need to create fairly detailed care plans fully from scratch at part of their training in order to learn nursing best practices and to practice the analytical skills critical for good nursing. However, if you are a working nurse, your place of work probably has a computer system that partially generates a care plan based on the input of the relevant nursing diagnoses. We'll go through the four parts of a nursing care plan (the diagnosis, goals for patient recovery, nursing orders or interventions, and evaluation) tailored to fluid volume deficit. We also have links to useful examples of completed fluid volume deficit care plans. Diagnosis First, you'll identify the relevant nursing diagnosis or diagnoses. Unlike medical diagnoses, which typically identify the specific medical condition at issue (i.e. diabetes, bronchitis, celiac disease), nursing diagnoses describe the more immediate and ongoing physical and psychological needs of the patient. According to the standards set by NANDA International, a nursing diagnosis is typically written in a three-part manner: first the diagnosis, then what the diagnosis is related to (its direct cause), and finally the evidence for that diagnosis. You can reference the common direct causes and diagnostic signs and symptoms of fluid volume deficit as noted above for help creating your diagnostic statement. An example fluid volume deficit nursing diagnosis statement might look something like this: â€Å"Fluid volume deficit related to diarrhea and vomiting secondary to gastroenteritis as evidenced by decreased skin turgor, low blood pressure, and decreased urine output.† â€Å"Risk for fluid volume deficit† or â€Å"risk for deficient fluid volume† is a slightly different nursing diagnosis that can be used to describe patients who, while not yet exhibiting serious signs of fluid volume deficit, are at particular risk of developing the issue. A risk nursing diagnosis only has two parts: the diagnosis (â€Å"risk for fluid volume deficit†) is related to whatever the cause of the potential future issue is (â€Å"diarrhea and vomiting†). So the risk diagnosis would be â€Å"risk for fluid volume deficit related to diarrhea and vomiting.† The patient may also have other nursing diagnoses in addition to fluid volume deficit. These should be included in the care plan. Any other diagnoses you made would be specific to the patient and based on a head-to-toe assessment (coming soon). I diagnose this owl with incredible cuteness. Goals The overall goal of a nursing care plan for a stable patient with deficient fluid volume is to safely restore fluids and necessary electrolytes to the body, but you’ll want to be more specific than that. Good goals for your care plan should be specific to the patient and measurable (so you can definitively assess whether the goal has been met). Depending on the patient, here are some example goals that might be appropriate for treating fluid volume deficit. Patient is no longer deficient in fluid volume as evidenced by: Urine output of at least 30 mL/hour (720 mL/day) Systolic blood pressure restored to patient baseline (or 90 mmHg) Patient heart rate of 60-100 bpm (or patient baseline) Improved skin turgor Normal BUN and hematocrit lab values Orders/Interventions While the particular interventions you choose in your care plan should be tailored to the patient and the severity of their condition, here are some potentially appropriate nursing interventions for fluid volume deficit. Note that some of these deficient fluid volume interventions are not highly specific because they would need to be tailored to the individual patient. If you do use these interventions in a care plan, be sure to select appropriate benchmarks for the patient and add more information. Administer intravenous fluid therapy as prescribed; monitor fluid replacement levels closely to ensure patient does not experience fluid overload Administer blood transfusion products as prescribed Offer electrolyte-rich oral fluids (like a sports drink) if tolerated/appropriate; assist patient in drinking if necessary Assess patient mental state for signs of confusion/agitation Provide oral hygiene to patient at least two times a day (so patient can respond to the sensation of thirst) Maintain record of patient intake and output of fluids Weigh patient daily in the same clothes on the same scale Monitor lab values: hematocrit (assess every 30 mins to 4 hours as appropriate); BUN to creatinine; others as appropriate Monitor skin turgor and moisture of mucous membranes Monitor vital signs (blood pressure and heart rate), including orthostatic vital signs Assess amount, color, and osmolality of urine Provide necessary education about maintaining appropriate hydration to patient Patient can name fluid volume deficit symptoms that indicate a need to seek medical care Evaluation In your fluid volume deficit care plan, you’ll use this section to track what interventions and orders were successfully implemented, assess patient progress towards the goals, and evaluate whether each of the fluid volume deficit interventions (and interventions for any other diagnoses you made) described in the plan should be ceased, continued, or revised. Well, this dog seems pretty happy with how everything is going. Example Fluid Volume Deficit Care Plans There are several sources of example care fluid volume deficit care plans. Here are some you may find useful: Prenhall Nursing Care Plan- Deficient Fluid Volume This example nursing plan is free supplemental material from a Prentice Hall nursing textbook. It offers a detailed case study with a nursing care plan for fluid volume deficit tailored to the particular patient. Nursing Concept Blogspot- Deficient Fluid Volume This care plan is quite detailed and offers explanations and rationale for lots of different potential nursing interventions for fluid volume deficit. Additionally, it segments out which interventions might be appropriate for different patient populations. Nurses Labs Deficient Fluid Volume Care Plan This is a very detailed care plan with detailed suggestions for nursing assessment and nursing interventions, along with rationales. It could be a helpful resource for students who need to write rationales for their care plans. Nurses Labs- Hypovolemic Shock Care Plan This care plan is specifically for addressing hypovolemic shock caused by fluid volume deficit, with specific interventions. RN Speak Hypovolemia Nursing Management This isn’t a complete care plan, but it does offer lots of specific assessment and interventions that could be incorporated into a fluid volume deficit nursing care plan. RN Central Fluid Volume Deficit Care Plan This care plan is laid out similarly to the computer care plans generated in hospitals, where the nurse simply selects the relevant components of the diagnosis, outcome, and interventions. It’s not very detailed but it gives a good idea of how quick care plans are generated in the field. Delmar Learning Fluid Volume Concept Map This isn’t laid out like a traditional care plan. However, nursing students may find it helpful as it lays out how all of the different parts of the fluid volume deficit care plan are conceptually related to each other. Plans are very important! Key Takeaways: Fluid Volume Deficit â€Å"Fluid volume deficit† (which is the same as â€Å"deficient fluid volume† or hypovolemia) is a nursing diagnosis that describes a loss of extracellular fluid from the body. Gastrointestinal issues, blood loss (internal or external), inadequate fluid intake, and renal disorder are all things that can place a patient at risk for fluid volume deficit. There are a variety of signs and symptoms of fluid volume deficit you can look for, including dizziness, dry mouth and skin, thirst and/or nausea, low blood pressure, and an increased heart rate. If the fluid loss is very serious, the patient will go into hypovolemic shock and you might see the following severe fluid volume deficit symptoms: Pallor, confusion, cool/clammy extremities, fainting, and even coma. Deficient fluid volume can be diagnosed through a combination of observation and assessment of patient body systems, vital signs, and lab work. Finally, we also discussed how to make a fluid volume deficit care plan and listed potential goals, outcomes, and nursing intervention. The main deficient fluid volume interventions are to monitor the patient’s fluid levels and safely restore the lost fluid. What's Next? Looking for a blood pressure chart? We've got you covered. If you're looking for ICD-10 codes, we have the codes for abdominal pain and diabetes. Got a patient with shingles? We have pictures of the infamous rash, common shingles treatments, and some methods of transmission to avoid. Need help converting fluid measurements? Find out how many cups four quarts is here.

Hearsay Evidence Essay Example | Topics and Well Written Essays - 3000 words

Hearsay Evidence - Essay Example "Hearsay evidence can be thought of as:- any statement made otherwise than by a person while giving oral evidence in the proceedings, which is tendered as evidence of the matters stated." http://www.forensicmed.co.uk/hearsay.htm Hearsay evidence is the second hand information that is used as evidence and it does not have any proof of its existence. It cannot be proved beyond doubt, and the doubt always exists even after the judgement. It is impossible to say that this really happened, but even the most brilliant law expert can only say that it might have happened. This made it unpalatable for the use of courts in earlier days. But now the act, looking at the importance and possibilities it holds, has made it admissible. "It occurs when a witness testifies NOT about something they personally saw or heard, but testifies about something someone else told them or said they saw. Hearsay usually involves an attempt to get some crucial fact entered into evidence that cannot be entered into evidence by any other means," http://faculty.ncwc.edu/toconnor/405/405lect11.htm In entering this as real evidence, Court will be depriving the other side a chance to process the evidence, by cross examining the witness, or verifying the evidence. There is nothing to cross-examine, as it is a kind of story, compared to other hard evidences, which glorify under solid proof. But there is an exception in the confession statement, where hearsay evidence is upheld. "The most important exception to the hearsay rule is admission or confession evidence. It is generally assumed that a party in a case would not make a statement against his or her own interests unless the statement was true" http://oasis.gov.ie/justice/evidence/hearsay_evidence.html As the confessions are an exception to the rule of Hearsay Evidence, even before the Act, a person stating another person's confession of a crime in the court, had been admissible. Victims of domestic violence sometimes could find it difficult to testify in the Courts for a variety of reasons and the statements of prosecution on their behalf might take the form of hearsay statement, or a secondary statement. While admitting these statements, Court does adhere to a lot of conditions and circumstantial proof. Statements made by the patients to the Medical officers usually are not disclosed as it comes under the priviledged category. But if disclosed, keeping the context in view, they might be admissible, even though it comes under the hearsay evidence category. The relevant rules for the hearsay evidence, are the best evidence rule, the opinion evidence rule and the self-serving evidence rule. Before the Act in question came into being, the rule prevalent was: "A.2.1. The Rule: Written or oral statements, or communicative conduct made by persons otherwise than in testimony at the proceeding in which it is offered, are inadmissible, if such statements or conduct are tendered either as proof of their truth or as proof of assertions implicit therein." http://www.irb-cisr.gc.ca/en/about/publications/weighevid/evidence_app_e.htm Hearsay evidence was thought to be untrustworthy, for the following