Shezan International Limited Essay Example for Free

Shezan International Limited Essay In 90s or earlier people hadn’t liked such drinks e.g. cold drinks, juices made by companies, at that time people had preferred fresh juice,sattu,sardai, jam-e-shireen etc in summer. But later there is new trend comes in exist that is coke and Pepsi become more prominent in market or among the people. To compete this market indirectly, different companies made focus on manufacturing juice like shezan, country, nestle etc. Although juice line of shezan is going well, it has enough market share but in last 5 years shezan introduce its two products Quench in competition of tang and shezan syrups in competition to qarshi syrups. Strategy in Action Organizational Culture Shezan International has excellent organizational culture. The culture is very professional but yet very enjoyable, the environment is very easy and casual. Shezan international gives lot of importance to its junior employees and seniors are always ready to listen to their juniors and are also willing to act upon their advices and suggestions if considered feasible. Employees are free to pursue and select their goals and objectives and HR department is always there for employees to provide them with the best guidance.The priority is always given to the job by the staff. The employee working there declares Shezan international a best place to work in and to make a reputable name in the corporate market, with a very open career ahead Organizational Structure of Shezan Human resources management: Human resource management involves the training and development of workers and employees in order to increase their productivity and efficiency.For this purpose company make their employees to work with the seniorworker to get the experience, apart from this on-the job training, they haveseparate training program for new employees. The company has goodplanning, quality control systems and future orientation, which althoughdoes contribute directly in value addition and increase the effectiveness of whole process. Long-term goals and Objectives As our company produces variety of juices with competitive market prices to make market stable for long period of time and company has expanded its production capacity and exports. For long term objective company set units in different cities for the comprehensive range of production in the fruit processing field in Pakistan Top Level Strategy Shezan uses related diversification strategy to grow its business. Shezan is owned by Shahnawaz group of industries. Shezan buys sugar from the shahtaj sugar mill,owned by Shahnawaz group. Shezan have its own fruit farms to fulfill its needs.Shezan also have its own cod storage to store the raw materials. These all related diversifications provide Shezan an edge over its competitors. Shezan creates value for its customers by providing quality and rich in taste products.

The character of Macbeth throughout the play Essay Example for Free

The character of Macbeth throughout the play Essay Macbeth is one of Shakespeares four great tragedies, which contain witchcraft, treason, and bloody murder. In the following essay, I will be writing about the way I feel towards the character of Macbeth throughout the play and the way in which he changes. Does Shakespeare present him in such a way that we can to some extent understand, even feel for this disloyal, self seeking murderer or can we relate to Malcolms description of him as the dead butcher? Our views on Macbeth change throughout the play because Shakespeare portrays him in many different ways. At the beginning of the play he is seen as a brave soldier, at the top of his profession and rewarded by King Duncan of Scotland. He is spoken about as Brave Macbeth and Worthy gentlemen after his heroism in battle, only to later become cruel and unjust. He had defeated the Norwegians and on his way home meets three witches. The audience in Shakespeares time believed in witches and their sinister side, leaving the audience sceptical when Macbeth communicates with them, leading us to believe he is connected with evil. The witches then give Macbeth three predictions: All hail Macbeth! Hail to the thane of Glamis! All hail Macbeth! Hail to thee thane of Cawdor! All hail Macbeth! That shalt be king hereafter. Macbeth is already thane of Glamis but chooses not to believe the witches because he feels that the Thane of Cawdor is alive. Soon after some messengers come and deliver, the news to Macbeth that he has been granted the thaneship of due to a treasonous crime committed on the Thane of Cawdors behalf. Macbeth starts to believe that a third prediction is likely to occur, given that the first two appear to have. Two truths are told, as the happy prologues to the swelling act of the imperial theme. Macbeths fatal flaw of ambition then overcomes him and he begins to contemplate regicide which, he feels is the only way of becoming King, My thought, whose murder is yet but fantastical. The attitude of the audience changes completely, however, the next time Macbeth meets up with the witches. Sympathy cannot be felt for Macbeth, as it is he who goes to the witches, not the contrary. At this stage, we cannot help but speculate concerning Macbeths apparent involvement with the evil forces, suggesting that he may have some evil present in him. One of the witches confirms this when admitting, Something wicked this way comes. Macbeth turns to the witches because of his insecurity. He is the subject of growing suspicion among many people, despite obtaining his ambition of kingship. On the contrary, he was enlightened when first meeting the witches that Banquos sons would be kings. This implies that children will be unable to follow Macbeth in the line of royalty and intrinsically apprehends Macbeth. In an attempt to find out how to keep his throne, Macbeth confronts the witches about his future. He is consequently granted three apparitions: Beware Macduff, None of woman born shall harm Macbeth. Moreover, Macbeth shall never vanquished be until Great Birnam wood to high Dunsinane hill shall come against him. These apparitions are all ambiguous, deliberately intended to mystify Macbeth and the audience. Why does Macbeth have to be cautious of Macduff? If no born son of a woman can harm Macbeth then who can? It is possible for a wood to move of its own accord so did Macbeth have nothing to fear? The ambiguousness of these apparitions and the manner in which Macbeth interprets them makes Macbeth over confident with regards to his safety because we later learn in the play that Macduff was not born of woman but of caesarean. We also learn that Macduff and Malcolms army cut down Birnam Wood and uses it as camouflage to get closer to Macbeths fortress without him seeing them. With the information they feed him with, the witches offer a hand of encouragement for Macbeths decisions (e.g. he kills Banquo because the witches say that Banquos sons will be kings) but are never responsible for what Macbeth does. They simply put ideas into his head, acting as a catalyst for his actions. The main influence on Macbeth, however, is his wife, Lady Macbeth, portrayed as a manipulative and domineering power. When Lady Macbeth hears about the predictions of the witches she immediately ponders murdering king Duncan. She realises, however, that although Macbeth is very ambitious, Thou art not without ambition, he is too compassionate to carry out the murder, I fear thy nature, is too full o th milk of human kindness. Lady Macbeth therefor formulates a plan. Lady Macbeth honours and loves her husband very much. She also conscious of her husbands reluctance to be thought of as a coward and when refusing to go ahead with murdering the king We will proceed no further in this business, uses the weakness to insult his manliness Was the hope drunk Wherein you dressed yourself? She therefor manipulates him into agreeing to commit the regicide. At this point in the play, we feel some compassion towards Macbeth, as he is weak in resisting his wifes ever growing influence. We become wary of the responsibility Lady Macbeth has on her husbands change of heart. Interesting to note, also, that at Shakespears time the husband would have been the dominant partner, and therefor the audience would have been cynical towards Lady Macbeth for her scheming ways and rare ability of being authoritative over her husband. In the scene just before Macbeth goes to kill Duncan he initially decides himself in his soliloquy to murder Duncan, despite the profound reasons not to. Macbeth appreciates Duncans fine qualities- his humility and his integrity in carrying out to perfection the tasks of kingship and knows that to destroy such virtue would be a crime against heaven. This leaves the audience divided in their opinions concerning Lady Macbeths influence on the plot. At this stage, I remain indefinite as to whether Macbeth really is the ruthless party in the murder or whether his wifes influence is the decisive passage. Lady Macbeths moral conscience is not as evident as her husbands. She is now the stronger of the two, and Macbeth cannot stand up to her accusations that he is a coward, lacking in manliness, and a traitor to his word. He yields to her, and in order to prove himself a man in his eyes submits to a womans guidance. Despite this, the couple has an affectionate relationship My dearest Love. Eventually the only loyalty that Lady Macbeth and have is their loyalty for each other. Disloyalty is shown when Macbeth murders the king just to make sure he keeps the throne. Unreasonable ambition takes over, with the consequence of loosing the things that were once important to the both of them. Lady Macbeth not only influences Macbeth on the murder of King Duncan but Macbeth also advances in killing his dearest friend Banquo and the wife and children of Macduff. When hearing of these unruly murders and realising that her husband is behind them she is driven insane by the sheer grotesqueness of them, The thane of Fire had a wife; where is she now? before her eventual act of suicide. Although not greatly evident King Duncan himself is a significant influence on Macbeth. Duncan is a very bad judge of character. He trusted the Thane of Cawdor He was a gentleman on whom I built absolute trust. However, The Thane of Cawdor turned out to be a traitorous villain. Duncan then gives Macbeth the thaneship of Cawdor. This is Dramatic irony as he is giving Macbeth the title of a traitor. This is also the wrong step because it raises Macbeth above all the other lords. Duncan praises Macbeth for his bravery at war, consequently making the other lords envious of Macbeth, and raising Macbeths ego. These three influences, the witches, Lady Macbeth and Duncan contribute significantly to Macbeths change in character throughout the play. The story unfolds as follows: The first time we hear about Macbeth is when the witches mention his name. This would make the audience feel uneasy and they would wonder why Macbeth is associated with evil. Their minds are then put at rest when the captain refers to him as Brave Macbeth. Macbeth is portrayed as a hero. He defeats the Norwegians and is rewarded with the thaneship of Cawdor so the audience admires him. They think that he is a loyal and worthy subject to the king. Then the witches meet with Macbeth; the audience would begin to have doubts about his loyalty when he starts contemplating about murdering the king. Macbeth then admits If chance will have me king, why, chance may crown me, without my stir. This emphasises that he is still unsure about having to murder King Duncan and at this point feels that if the witches have predicted it then fate will make him king without him having to do anything. King Duncan then names his son Malcolm as heir with Macbeth realising that he cannot become king unless he does something about it, That is a step On which I must fall down, or else oer-leap. Macbeth thinks a great deal about murdering the king and reasons for it and in his soliloquies the audience would see his thoughts and begin to feel sorry for him because his ambition is so strong that it is having a psychological effect on him. Nevertheless, in the end, despite the many doubts ultimately decides himself to kill Duncan. The audience can no longer feel sympathy for his actions because the decision to kill the king is his own; they would feel horror and dissatisfaction because of what he has done. During the time that Shakespeare was alive and Macbeth was first shown on stage people thought that regicide was a horrific crime and he who commits it, was eternally damned to hell. After Macbeth kills Duncan, he meets with Lady Macbeth. This scene (act 2 scene 2) is the plays most tense and dramatic. At the beginning, we see Lady Macbeth by herself in an agitated state. Every small noise unsettles her Hark! When Macbeth intrudes the pace changes, with the distinct exchange of questions and answers between them. This emphasises their state of nerves. We get an insight into Lady Macbeths character and the part she has played in the murder and also a little hint of weakness on her behalf when discovering that she went to kill Duncan but couldnt because he reminded her of her father, Had he not resembled My father as he slept, I had donet. We hear how Macbeths preoccupation with not being able to pronounce amen after hearing the prayer demonstrates his state of mind his guilt and his awareness that he has sold out to evil and the powers of darkness. Because Macbeth is so tense he forgets to leave the daggers at the murder scene and when Lady Macbeth tells him to take them back he says, I am afraid to think what I have done; Look ont again I dare not. Therefore, Lady Macbeth takes them back. When she goes to return the daggers Macbeth has a short soliloquy. This gives us an insight into his state of mind. He is full of guilt, will all great Neptunes ocean wash this blood Clean from my hands? This means that he cannot rid of the guilt. As a knocking is heard on the castle gates, Lady Macbeth returns but her husband is already regretting what he has done saying, Wake Duncan with thy knocking! I would thy couldst! Duncans sons Malcolm and Donalbain then flee the country for fear that their turn to be murdered will come so Macbeth becomes king. Despite having this title he is still insecure, with the prediction from the witches of Banquos sons becoming king, Macbeth decides that he has to prevent this fate and therefor hires murderers without Lady Macbeths knowledge to kill Banquo. This shows the audience how their relationship is breaking up. We are shocked at Macbeths decision to kill Banquo because he was Banquos best friend. After Banquo is murdered Macbeth hallucinates, he sees the ghost of Banquo covered in blood sitting in his chair at a banquet. All Macbeths lords are present but they cannot see the ghost, Lady Macbeth tries to relax him when saying, you look on but a stool. She tells him that what he is seeing is merely an illusion like the air drawn dagger which led him to Duncan. This indicates that after the murders Macbeth has a guilty, unquiet mind. He fears every one and in front of all the lords, he proclaims himself unstable. To the audience it appears as if Macbeth is turning insane and they sympathise with him because he has lost every thing dear to him: his best friend, his absolute trust and loyalty to his wife and the security of lots of friends who support him. Because of this insecurity, Macbeth pays the witches a visit with them showing him the three apparitions. With theses apparitions Macbeth is re-assured, his interpretation of them leads him to think that he cannot be harmed Then live, Macduff: what need I fear of thee? Macbeth then finds out that Macduff has fled to England in an attempt to encourage Malcolm to bring an army to fight Macbeth, filling him with anger. This provokes him to get revenge on Macduff: The castles of Macduff I will surprise, Seize upon Fife, give to thedge othsword His wife, his babes, and all unfortunate souls That trace him in his line. This would horrify the audience; the modern day audience would be more horrified at this murder than the 17th century audience who would think that regicide is worse. The modern day audience would feel nothing but contempt for Macbeths act of slaughtering women and children. Macbeths character at this point is completely destroyed; No heroism, loyalty, or any good qualities that he once had are left. No sympathy can now be given from the audiences point of view or any other character in the play. Lady Macbeth commits suicide because of guilty conscience regarding what she has done and what Macbeth has done. Macbeth subsequently hears that Malcolm and Macduff are coming towards him with a great army, He is not too worried because of the witches apparitions and he says I will not be afraid of death and bane Till Birnam forest come to Dunsinane. Macbeth receives the news of his wifes death and through his soliloquy reveals that he cannot grieve for her, due to having his mind in the direction of battle She should have died hereafter. Only at this point does Macbeth realise that he has nothing left and all because of his over ambition. A messenger later comes and announces that Birnam wood is moving. The armies of Malcolm and Macduff have cut down the forest and used it as camouflage. Macbeth begins to lose hope and feels like they have tied him to a stake. In addition, he cannot fly. Nevertheless, he decides that he will fight on Ill fight, till from my bones my flesh be hacked. Macbeth then sets out to fight he kills a man and still holds on to the apparition from the witches that no one born of a woman shall harm him, Swords I smile at, weapons laugh to scorn, Brandished by man thats of a woman born. Macduff confronts Macbeth and Macbeth is not very fearful of him because of the witches apparition. He says to Macduff: With thy keen sword impress as make me bleed: Let fall thy blade on vulnerable crests, I bear a charmed life, which must not yield To one of woman born. Macduff then replies saying that he was not of woman born; he was from his mothers womb Untimely ripped Macbeth now knows that Macduff is going to kill him but he shows a last bit of courage and he fights on. The audience cannot feel admiration for Macbeth because of what he has done only sympathy because he has noting left, and he knows it. Macduff then kills Macbeth and hails Malcolm as King. At the end of the play, we see Macbeth a respected hero turned into a vengeful villain through unreasonable ambition, with the influences of people around him. He commits regicide, murder, and vengeful slaughter. After the murder of Duncan, Macbeth is horrified to think of what he has done. Shakespeare contrasts Macbeth and his wife in their attitudes of the murder. Lady Macbeth is bold and confident, because she does, not understand that the deed is morally wrong: he only concern is to destroy the evidence. Macbeth, on the other hand, awakens to a consciousness of guilt that will remain with him until his death. At times, Shakespeare encourages the audience to feel sympathy and understanding for Macbeth but at times all that the audience can feel for Macbeth is horror, anger, disgust, and contempt, although at the end of the play he shows tremendous character when facing certain death.

Evaluating The Congestive Heart Failure Nursing Plan Nursing Essay

Evaluating The Congestive Heart Failure Nursing Plan Nursing Essay As defined by Phipps (Monahan, F, Sands, J, Neighbours, M, Marek, J.F, 2007) congestive heart failure occurs when, the myocardium of the heart is unable to uphold a sufficient cardiac output to meet the bodys metabolic needs. Heart failure can result from either systolic or diastolic dysfunction (Monahan, F, Sands, J, Neighbours, M, Marek, J.F, 2007). Assessment tools that will be used in the assessment of Mr. Toscana include, head to toe, physical, and systems assessments. A risk assessment will also be done on Mr. Toscana to insure that he is safe in hospital (Berman, A, Kozier, B, Erb, G.L, 2008,). As Mr. Toscana suffers from congestive heart failure a wide range of education and psychosocial support is available to help with his condition (Heart Foundation, 2010). A nursing care plan has been made to show four nursing diagnoses and interventions to reduce the impact of the diagnosis. These nursing diagnosess can be solved through a variety of diagnostic tests to make sure that ev ery possible outcome is looked at (Berman, A, Kozier, B, Erb, G.L, 2008). Mr. Toscana is taking a few medications at the present time to manage his cardiac issues along with other medical conditions he suffers from, these medications are, Lasix, digoxin, aspirin, warfarin and perindopril. (Tiziani, A, 2010), (Better Health Channel, 2010) PATHOPHYSIOLOGY OF CONGESTIVE CARDIAC FAILURE Both systolic and diastolic heart failure are second to myocardial injury. Progression of heart failure is highly dependent on the level of ventricular remodelling, this occurs after myocardial injury (Monahan, F, Sands, J, Neighbours, M, Marek, J.F, 2007). The changes in ventricle shape and dimension will cause a decrease in its effectiveness as a pump. An increase on diastolic pressure possibly will further change the shape of the left ventricle, thus resulting in papillary muscle rearrangement and mitral insufficiency. It is more common for congestive heart failure to begin in the left ventricular systolic dysfunction. Some of the common causes for decreased left ventricular stenosis include that of, CAD, systemic hypertension, and aortic stenosis. CAD by diminishing the oxygen supply to the myofibrils decreases contractility. Hypertension causes the left ventricle to contract more with more force to eject blood into the aorta. (Monaha n, F, Sands, J, Neighbours, M, Marek, J.F, 2007) Over a period of time hypertrophy of the muscle fibres happens and an increase in myocardial oxygen consumption occurs. Aortic stenosis, the left ventricle must increase its pumping force to deliver blood through the tight valve. Heart failure will be the result when the hearts need of oxygen cannot be met and blood remains at the end of systole. (Mccance, K, Huether, S.E, Brashers, V.L, Rote, N.S, 2010,) CLINICAL MANIFESTATIONS OF CONGESTIVE HEART FAILURE As stated in Monahan, F, Sands, J, Neighbours, M, Marek, J.F, 2007, Page 814, the clinical manifestations of heart failure occur secondary to elevated filing pressure and tissue hyperfusion Clinical manifestations of congestive heart failure can be broken down into the systems in which they affect the respiratory, cardiovascular, gastrointestinal systems and show effects in both cerebral and psychosocial. Clinical manifestations in respiratory are, dyspnoea, orthopnea, a persistent cough, crackles in the lungs. The cardiovascular system is affected by, the onset of angina, tachycardia, increase of systolic blood pressure and an increase in systolic blood pressure. Gastrointestinal clinical manifestations include that of, enlargement of the right upper quadrant of the abdomen, nausea and vomiting, pain in the epigastric region, anorexia and bloating. Confusion and restlessness can be seen as manifestations of cerebral, and anxiety is associated with manifestations to psychosocial. Generalised manifestations include oedema; either pitting or peripheral, weight gain and fatigue. (Monahan, F, Sands, J, Neighbours, M, Marek, J.F, 2007), (Mccance, K, Huether, S.E, Brashers, V.L, Rote, N.S, 2010,), (Better Health Channel, 2010) NURSING ASSESSMENT OF MR. TOSCANA For Mr. Toscana a variety of nursing assessments will be done upon admission. As well as the usual monitoring of vital signs, assessments such as, head to toe, physical and systems assessments, need to be completed. A head to toe assessment will be performed to give a detail initial assessment studying the whole body to see if there is any other factors that may cause harm or pain, in a head to toe assessment circulatory problems, pressure areas, existing wounds, can all be seen as well as gaining an in depth assessment of the skin. A physical assessment will be done on Mr. Toscana will also be performed, a physical assessment includes, inspection; which is the visual inspection of a person, palpation; the examination done by touch, auscultation; a form of examination by listening to the sounds made by the body (heart, lung and bowel), percussion; the examination done by tapping, percussion is done to listen for abnormal sounds and detect issue (Berm an, A, Kozier, B, Erb, G.L, 2008,). A systems assessment of Mr. Toscana will be beneficial because, along with the other forms of assessment a systems will be able to give a base mark of where he is, a systems assessment covers, central nervous (CNS), cardiovascular (CVS) assesses, respiratory (RESP), gastrointestinal (GIT), renal (RENAL), skin integrity (SKIN), and psychosocial (PSYCH). Together these forms assessment will provide a detailed amount of information to create a nursing care plan for Mr. Toscana, including interventions that need to be made, and things to implement to further his recovery and aid in his discharge. (Berman, A, Kozier, B, Erb, G.L, 2008,). NURSING CARE PLAN Please refer to appendices one for full nursing care plan. (Berman, A, Kozier, B, Erb, G.L, 2008,). (Monahan, F, Sands, J, Neighbours, M, Marek, J.F, 2007), (Heart Foundation, 2010), (Holmesglen, 2009), (Better Health Channel, 2010) DIAGNOSTIC TESTS For Mr. Toscana there are a number of diagnostic tests that will help with the assessment, management and detection of underlying issues. Tests that can be performed on Mr. Toscana are as follows, a chest X-ray to see if there are any problems with his lungs, or vascular congestion, or congestion of the liver (this can suggest right sided failure) (Monahan, F, Sands, J, Neighbours, M, Marek, J.F, 2007), a full blood test including electrolytes, an ECG to check the rhythm of the heart, and determine the causes for Mr. Toscanas symptoms. The use of urine analysis to see if infection is present, function of kidneys, traces of blood in relation to fluid build up. The combination of these tests will provide a baseline for assessment, guide the nursing care, and rule out all other possible causes of the symptoms that Mr. Toscana has presented with. (Monahan, F, Sands, J, Neighbours, M, Marek, J.F, 2007) RISK ASSESMENT From the history of Mr. Toscana a risk assessment can be done. Assessments such as falls, and pressure care. A falls risk assessment will be done on Mr. Toscana to determine the risk he is of falling, and if further measures need to be implemented to insure that he is safe while in hospital, a suitable framework for a falls risk is the FRAT tool, (Falls Risk Assessment Tool), (Department Of Human Services Victoria, 2005) a FRAT tool will show the level of risk that Mr. Toscana is, and risk factors. A pressure area risk check can be done by using the Braden risk assessment tool (Berman, A, Kozier, B, Erb, G.L, 2008,), (South Australia Health, Date Unknown). this will help minimise the risk of Mr. Toscana developing pressure areas where possible. Things at home can also be deemed a risk, things such as; not being compliant with his medications can lead to poor health, and stress can all affect his general wellbeing and lead to further the progression of medical condition s. EDUCATION AND PSYCHOSOCIAL SUPPORT For Mr. Toscana education is a must, education about the maintenance of his congestive heart failure, about the importance of taking medication on a regular basis. How to manage the affects of his congestive cardiac failure, and avoid the effects, support for Mr. Toscana is also imperative to aid in his recovery things such as providing strategies to minimise the health problems, referral to a social worker to help with issues that are affecting him at home. Support groups set up by the heart foundation of Victoria will help with the emotional issues related to having this condition. (Heart Foundation, 2010) The importance of education and psychosocial support will be seen through less medical admissions or problems, increased quality of life and will give Mr. Toscana the ability to be able to deal with small problems before they grow into something much bigger. (Monahan, F, Sands, J, Neighbours, M, Marek, J.F, 2007) , (Berman, A, Kozier, B, Erb, G. L, 2008,) (Better Health Channel, 2010) MEDICATIONS Mr. Toscana is taking a number of medications including, warfarin and digoxin. The action of Digoxin is, it increase the myocardial contraction force in the failing heart, decreases conductivity of the heart in particular the A-V node, increase on vagal activity this results in the slowing of the sinoatrial nodal rate, increases myocardial excitability this can result in ectopic beats this happens mostly through high doses of digoxin, oral digoxin effective in an approximate time frame of 1 hour, maximal effect is reached between four and six hours. The use of digoxin for Mr. Toscana is, to treat his congestive heart failure. Digoxin may produce a false ST-T wave change on an ECG if tested during exercise. Digoxin can cause the following adverse effects, gastrointestinal issues including, anorexia, nausea, vomiting, diarrhoea, and pain in the abdomen. Cardiovascular effects, ectopic beats, bradycardia, heart block. Tachycardia (ventricular). The adverse effect of toxicity is a decrease on appetite, nausea, vomiting, diarrhoea, severe stomach pains, weakness and tiredness, a slow and irregular heartbeat, blurred vision, drowsiness, mental depression or confusion, fainting and headaches. Nursing points/precautions which should be followed are that the tablet should never be halved; neither IM nor SC routes are recommended due to unpredictable absorption, because prolonged or intense pain and necrosis of the muscle to the client (Intramuscular), severe irritation may occur when given via a subcutaneous injection. A rapid IV administration should be avoided as it may cause hypertension and vasoconstriction. The action of warfarin is a suppressant of vitamin-K dependant synthesis of prothrombin in the liver, this prevents the extension of a clot that is already established of the formation of a new one, warfarin has an anticoagulant effect that is produced after 36-72 hours and can persist for between 4 and 5 days after the discontinuation of therapy. Th e use of warfarin is, as a prevention and management of the following, deep vein thrombosis (DVT) or pulmonary embolism, thromboembolism in atrial fibrillation, and can be used as an adjunct to therapy for coronary occlusion. For Mr. Toscana there is no relevant interaction with this drug. The adverse effects of warfarin are fatal or non fatal bleeding, nausea, vomiting, diarrhoea, alopecia, fever, hypersensitivity reaction, an overdose is seen by bleeding from the gums and haematuria, in rare cases skin necrosis is also seen. Some of the nursing points and precautions with warfarin are, that all intramuscular injections be avoided, and subcutaneous injection sites should be closely monitored for haematoma, make sure that the does is given the same time daily to Mr. Toscana, observation for the early signs of overdose things such bleeding especially important from the gums.( Tiziani, A, 2010) CONCLUSION Through a range of assessments, diagnostic testing, education and the development of a nursing care plan Mr. Toscanas condition should improve as well as his general wellbeing. Goals set out in the care plan will be achieved by interventions put in place insuring a quicker recovery for Mr. Toscana. Education is particularly important for Mr. Toscanas medication regime, support strategies will help with the improvement of overall health and wellbeing.

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ESSAY John Steinbeck novel, ‘Of Mice and Men’, contains three characters who could be described as social misfits. In this essay I am going to describe Candy, Crooks, and Curley’s wife and examine what Steinbeck is attempting to tell the reader about the lives and situation of each of these characters. The book, ‘Of Mice and Men’, was set in the depression of 1930s in California in a place called Soledad. ‘Of Mice and Men’, can be viewed as a compassionate story of John Steinbeck for the hard life, poor, old age ,unskilled workers displaced by the depression a bad economic and high unemployment with no hope and no future. They had to leave their families and homes just to make money. Candy is such a character. He is the bunkhouse cleaner and he is old and has no family and the only old man on the ranch. We are told him in the book, that he is a good natured old gossip. He is a useful source of information about all the character at the ranch. We know because when George and Lennie arrive in to the ranch, Candy tells them about all the characters and also tells them about what is going on in the bunkhouse, for example when he says to George and Lennie about Curley, â€Å"Curley like a lot of little guys. He hates big guys†¦.† So first of all they know that how aggressive and bad guy Curley is. He is fond of his dog even though it is old and smelly. Candy had that dog since it was a pup. His dog is his only friend; old same like Candy. Carlson offers to shoot his dog. But Candy resists for his old, smelly, nameless dog, â€Å"No, I couldn’t do that. I had `im too long.’ Candy knows if he allows his dog to be shot he will become lonelier because that is the only companion he got and he will lose it. But Carlson is determined. Eventually he leads the dog out into the darkness of the night and to its death.

Process Paper How To Get On Th :: essays research papers

Process Paper: How to get on the net The Internet is a very important tool for communicating, learning, and just surfing. To utilize the capabilities of the “Net'; one must have a phone line, a computer with a modem, and an Internet Service Provider (ISP). Computers can usually be found at any electronic store. The store should also have information on how a local ISP can be found. The Internet Service Provider that you find will give you the essential software needed to connect to the Internet. Once the software is successfully installed, make sure a phone line is hooked up with the computer’s modem. You can do this buy running phone wire from the nearest phone jack to the back of your computer. A modem slot can be found in the back of you computer, and it will usually have “Modem'; written above it. Once the phone line is hooked up, you can enter your computer and start up your web browser. Your web browser icon should say “Internet Explorer,'; “Netscape,'; or “The Internet.'; Once you have located the icon, double click it (click twice with the primary mouse button). This should bring up a “Dial-up Networking'; window with “username'; and “password'; spaces. Type in the username and password that your ISP gave you. As soon as all the data is entered, click the “Connect'; button at the bottom of the window. It should take about one minute before a window pops up with a timer telling you how long you have been connected. This is important so if you have a limited number of hours for the month, you can manage your time connected to the Internet. Now that you are connected, it is possible to take advantage of the Internet’s capabilities. You should start off by going to a search engine: yahoo.com, lycos. com, altavista.com, hotbot.com, and many others. You can start these by going to the file menu, clicking open, and then typing in the address (i.e.

Early American Literature Essay examples -- essays papers

Early American Literature (1620-1820) In the first half of the 17th century the New World found two groups of people colonizing. The first group, the Puritans, had left England after years of exile due to their lack of faith in the Church of England. With the reading and understanding of the Bible almost completely laid in the hands of the preacher, the congregation was forced to believe all the words that the preacher said. This all came to an end with John Calvin. His ideas were that God likes certain people better than others and those "chosen" ones would get more land and more money. This idea took off with the Puritans as they seeked religious freedom, a chance to start new churches and purification of the Church of England. As life moved on in the New World for the Puritans they seemed overwhelmed with the fact that they were the chosen ones and proceeded to act out life and every aspect of it for God and God only. The other group was far more open minded. The Enlightenment that swept the world impacted these people greatly and caused them to question the acts of the Puritans. Puritan life in the New World seemed only to consist of Church and all daily life outside the Church was to be done in the name of the Lord. There are countless quotes throughout the text of "God's will" in reaction to everything from the death of a child to the lack of food or water. "If excellence abide below, How excellent is He that dwells on high,". With this quote one can see the presence that God has in the life of a Puritan. They believed that everything that we on the Earth was God's will. If a tree fell on their house killing all insid... ...and through eduction answered those questions forming a foundation for their beliefs. Upon that we see many different branches of the many different religions that make up the country today. With this reasoning present people seemed to build off the Puritan ideas and make these churches. In the event that the Puritans were the only religious colony to settle in America then what happened in England would most definitly happen here. The Puritan Church would be roughly the same as the Church of England and those that didn't believe in it would have to move elsewhere seeking religious freedom, the cycle would repeat itself. Thus, both groups of settlers complimented each other and made the foundation of modern American religion. Although those that did this may not be able to see it today, they found their religious freedom.

A Comparison between Drug Policy as Social Control

Nicolas Beltran English 101 /Ms. Jackson March 13 2012 While reading â€Å"Drug Policy as Social Control† by Noam Chomsky and â€Å"Crito† by Plato I noticed a similarity between the two. People in higher power have ways of stabilizing populations. The government is customized to make people fail and the less fortunate are targeted. The inequalities of the government aren’t dealt with but they surely do exist. Law’s are strictly enforced to populations where mostly black males live and populations where crime rates are high. Not all people have to deal with the law the same way due to social class.The government has it’s own way of controlling people who are thought to be dangerous. How does the government control people? The government is able to put fear in the hearts of people. Governments have tried to take away programs which help people who are struggling. People worry about public assistance such as welfare because they need it and the govern ment uses the poor populations weakness to their advantage. The government has it’s own way of silencing people who they feel might be a threat to people in higher power like Socrates.Socrates from â€Å"Crito† had information that might have endangered the government. That is the main reason why he was sentenced to prison. Both Socrates and Martin Luther King served time in jail. Neither of them were a threat to their communities. They were wise men who both were the voice of their community’s. The government seen them as dangerous so they were killed. This is why I believe the governments selected method of keeping things stabilized is unfair to the thought to be dangerous population. Countries are unfair when it comes to giving everyone equal rights.There are people who are superior to the law. Did you notice not one sentence in â€Å"Drug Policy as Social Control† said anything about targeted rich or white people ? I wonder why no upper class people a re being arrested. No one is perfect and we know the poor and dangerous aren’t the only people who get their hands on drugs. Many people get away with illegal transactions but they fly under the radar because they are rich. The upper class people do the same things the less fortunate populations are doing by taking and selling drugs but are less likely to be imprisoned.In â€Å"Drug policy as Social Control its specifically says â€Å"none of this has anything to do with drugs†. The main purpose in the so called drug control is to criminalize dangerous black populations. Our country is known to give people equal rights and freedom. It isn’t as it appears as you can see our country has favorites and the poor are targeted. While the upper class seems more united the government makes the poor hate each other. The way the government works the less fortunate are setup to fail.Job opportunities are decreasing and so are job wages. There are less support systems for t he people who need them. The Percentage of poverty is increasing while the rich get all the attention as their wealth keeps growing. In â€Å"Drug Policy as Social Control† it says, â€Å" If we wanted to stop drug use in the United States there’s an easy way to do it†. This means that the government can prevent drugs from getting into the country but they don’t because it helps them control populations by using drugs to criminalize black men.Where is the justice in this method of controlling people ? In my opinion this is a setup. These problems continue occurring in our country but there is no change. The voices of dangerous populations will continue to be controlled by the government. Hopefully one day poor and thought to be dangerous communities will not be recognized as what they are thought to be. The voices of these communities have been silenced for thousands of years, so has Jesus Christ. All these leaders have died for what they believed in.