Monday, December 30, 2019
Oscar Wildeââ¬â¢S The Importance Of Being Earnest Was Written
Oscar Wildeââ¬â¢s The Importance of Being Earnest was written during the Modernism movement. Modernism was a literary movement that pushed back against the movement previously: Victorian/Realism. Wilde suggests that keeping up appearances was so significant during the Victorian ages that men engaged in bunburying: the idea that people take on a different persona, whether real or imagined, as an escape from their current life or in order to portray themselves in a better light. Wilde uses satirical humor in The Importance of Being Earnest to reveal his disdain at the hypocritical customs and shallow lives of the Victorian people; in particular, Wilde uses the concept of bunburying to reveal their own hypocrisy to themselves.â⬠¦show more contentâ⬠¦Both theories suggest that Bunbury represents actual people rather than a concept. The theory of attributively naming Bunbury stems from Wildeââ¬â¢s own double life. According to Greenââ¬â¢s article, ââ¬Å"an unidentified book reviewer for Time magazine states that ââ¬Å"Bunburying was shorthand for a visit to a fashionable London male whorehouseâ⬠and suggested that the word bunburying is related to berging ââ¬â ââ¬Å"the disguise of homosexual material in literatureâ⬠(Green 70). Green also suggests that this definition ââ¬Å"has its origin in details brought out at the trials about Wildeââ¬â¢s own double life in which he shuttled between Alfred Taylorââ¬â¢s male whorehouse and the brilliant world of Victorian high societyâ⬠(Green 70). Seemingly, Bunbury may actually be an imaginary manifestation of Wilde himself, who struggled with his own homosexuality while attempting to maintain his status in society. The other theory that may explain Bunburyââ¬â¢s existence is the fact that he was named after a direct individual: Henry Shirley Bunbury, who went to school with Wilde (Green 73). The theory of Bunbury being named after Henry Shirley Bunbury makes sense here: Green states that Henry Shirley Bunbury ââ¬Å"did have elements of a double life in him, for while he earned his living as a government tax official, he was quite interested inShow MoreRelatedThe Misunderstood Legacy of Oscar Wilde Essay1663 Words à |à 7 PagesThe Misunderstood Legacy of Oscar Wilde Surrounded by scandal caused by his own deception, Oscar Wilde left this world with a legacy of often misunderstood wit, a brilliant collection of writing, and sordid tales of an extramarital homosexual affair. The playwright progressed from a fashionable, flippant fop immersed in London society to a man broken by the public discovery of his relationship with Lord Alfred Douglas. In his prime, Oscar Wilde was a social butterfly, admired and acceptedRead MoreContextual Essay: the Importance of Being Earnest769 Words à |à 4 PagesIt is clear to me that throughout Oscar Wildes life there was a degree of personal uncertainty he bestowed upon himself. This was very much reflected in his social lifestyle, personality and dress sense; but above all through his many dramatic works that reflect his often contrasting attitudes toward himself in his extravagant and highly esteemed approach to his writing of classic English literature. This is true for drama: the playwrights who write plays often incorporate aspects of their ownRead MoreThe Importance Of Being Earnest1041 Words à |à 5 PagesFeminist Perspective As seen in The Importance of Being Earnest by Oscar Wilde, men and women live in a society of inequality between the two sexes as conveyed through double standards. For instance, there is a double standard regarding men and women flirting as seen when Algernon says ââ¬Å"She will place me next to Mary Farquhar, who always flirts with her own husband across the dinner-table. That is not very pleasant.â⬠While women are shamed for talking to men whom they are married to, men such asRead MoreThe Effects Of Victorian Society s Unrealistic Expectations Of The Individual887 Words à |à 4 Pagessource is an essay examining how Wilde shows ââ¬Å"the impact of Victorian societyââ¬â¢s unrealistic expectations of the individualâ⬠in both The Importance of Being Earnest and The Picture of Dorian Gray. In the article, she talks about gender roles and societal expectations along with the ways characters in the play conform to or reject them. Although the essay is written by a stu dent at McKendree University, the writing is not difficult to understand. This essay is well-documented and seems unbiased. I canRead More The Importance of Being More Than Earnest Essay1715 Words à |à 7 PagesEvery line, every character, and every stage direction in The Importance of Being Earnest is set on supporting Oscar Wildeââ¬â¢s want for social change. The Importance of Being Earnest was written during the late period of the Victorian era. During this period social classification was taken very seriously. It could affect working and living conditions, education, religion, and marriage. Wilde explores the issues of social class and turns it into a comedic play. He humorously criticizes Victorian mannersRead MoreWilde as Parodist: a Second Look at the Importance of Being Earnest : a Review877 Words à |à 4 PagesAlthough many of the early critics found Oscar Wildeââ¬â¢s final play strictly humorous, it clearly conveys social hypocrisies of the upper-classes of the p eriod (late-Victorian). Wilde was being satirical and paradoxical in his play to show the hypocrisy and entertain the viewers in a play that is still being repeated till today. It is a witty and amusing comedy which conveys real life everyday themes such as real love as opposed to selfish love, religion, marriage, being truthful and country life as opposedRead MoreThe Influence Of Victorian Society On Relationships And Marriage1642 Words à |à 7 PagesInfluence of Victorian Society on Relationships and Marriage Marriage was of utmost importance during the 1830ââ¬â¢s to the 1900ââ¬â¢s. The ââ¬Å"idealâ⬠relationship had been searched for by both men and women using the standards that the commonwealth had created. When reading Oscar Wildeââ¬â¢s ââ¬Å"The Importance of Being Earnestâ⬠and associating it to societyââ¬â¢s expectations for both genders throughout the Victorian era, people are depicted as being very effected and influenced by the set rules and boundaries. Using theRead MoreWildes Use of Binary Opposites Is the Key Comedic Element in the Impoprtance of Being Earnest. to What Extent Do You Agree with This View?1615 Words à |à 7 PagesWildeââ¬â¢s use of binary oppositions is the key comedic element in the Importance of Being Earnest. To what extent do you agree with this view? Throughout the play, Oscar Wilde portrays several binary opposites using the characters and themes of the play, such as the town and country, class, age, gender and morals. However I donââ¬â¢t think that the binary opposites are the main source of comedy in the play. The reason I find it comical is from the fact that the play is a comedy of manners as well as Wildeââ¬â¢sRead MoreThe Importance Of Being A Doll s House1627 Words à |à 7 PagesThe Importance of being a Doll. ââ¬Å"She s only a bird in a gilded cage. A beautiful sight to see. You may think she is happy and free from care sheââ¬â¢s not, though she seems to beâ⬠. (Lamb) The Importance of Being Earnest and A Dolls House have been subjects of controversy since their creation. How the plays characterize the parodies of society as a gilded cage are directly related to the writers and how they were treated in their real lives. From the standpoint of the importance of being earnest theRead More Oscar Wilde Art Essay1488 Words à |à 6 PagesOscar Wilde Art We begin another chapter in the life of Oscar Wilde, the year 1888, many things have taken place, Oscar has been married and bore two children, Vyvyan and Cyril and his touring of the United States and other countries have brought forth success to the literary giant. Some of his successful writings are The Picture of Dorian Gray(1891), A Woman of No Importance(1894) and his most resent essay known The Decay of Lying. Is it true that lying has fallen to its deepest shadow
Sunday, December 22, 2019
Dehumanization Of Racial And Religious Groups - 1348 Words
As the great American writer Audre Lorde had voiced, ââ¬Å"unless one lives and loves in the trenches, it is difficult to remember that the war against dehumanization is ceaseless.â⬠This demonstrates that the hierarchical standard of an admirable human is not someone who is seen within darkness or dissociation from a social state. People are naturally imposed on wanting to gain an infiltrated categorization of themselves. Dehumanization is inflicted upon people due to forced beliefs and instincts that are presented in our society. Universally, any form of government or class structure has a form of media base and the constant cycle of the sociological depiction of its surrounds. This projection about political wrath ultimately influences a person s consciousness. The institutionalized systems that are created produce desensitized global citizens to the negativity and restraint to a targeted group. When Nour Kteily, Emile Bruneau, Adam Wayt, and Sarah Cotterill conducted exper imental research on the dehumanization of racial/religious groups based on differentiating biases. They compared and contrasted the responses of two hundred and one Americans to that of a numerical correspondence to thirteen different nationalities, ethnicities or religious groups. The research was construed by the topic of evolution. For defining this rhetoric, it brings in the ideologies over the course of years in foreign affairs, furthermore accelerated the amount of propaganda and politicalShow MoreRelatedHistory, Gender, Racial, And Cultural Heritage Of The American Nation State During The Holocaust1332 Words à |à 6 Pagesduring the Holocaust, both display patterns of racialized identity, formed by analyzing the meaning of reification through dehumanization and demonization. On April 6, 1994, Hutus began a mass slaughtering of the Tutsis in the African country of Rwanda. 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Hitler created a new political theory ââ¬ËNational Socialismââ¬â¢. The population was viewed as a ââ¬Ëvolkââ¬â¢ (people) consisting of Bavarians, Thuringians, Prussians, Rhinelanders, Sudetens and Austrians all of German racial stock and Hitler their Fueher. The political slogan Hitler created, ââ¬ËEin Volk, Ein Reich, Ein Fuhrer (One people, one empire, one leader) sums up his leadership as the head of the leader cult. Hitlerââ¬â¢s success as the figurehead of the National SocialistRead MoreEvaluation Of An Immersive Video Environment910 Words à |à 4 Pagesstudy indicated a scheme of racial dehumanization, racial barbarity, and slaughter or mass killing, which contributed to such result in the experiment. Thus, the result of Dambrun and Vatinà © (2010) experiment indicates humansââ¬â¢ behavioral dynamics that views other racial group as inferiority to them. 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Friday, December 13, 2019
Nursing Pressure Sore Free Essays
string(56) " is important because it helps your body heal the sore\." What are pressure sores? Pressure sores are areas of injured skin and tissue. They are usually caused by sitting or lying in one position for too long. This puts pressure on certain areas of the body. We will write a custom essay sample on Nursing Pressure Sore or any similar topic only for you Order Now The pressure can reduce the blood supply to the skin and the tissues under the skin. When a change in position doesnââ¬â¢t occur often enough and the blood supply gets too low, a sore may form. Pressure sores are also called bedsores, pressure ulcers and decubitus ulcers. What are the symptoms of a pressure sore? There are 4 stages of pressure sores. Symptoms at each stage include the following: Stage 1. The affected skin looks red and may feel warm to the touch. The area may also burn, hurt or itch. In people who have dark skin, the pressure sore may have a blue or purple tint. Stage 2. The affected skin is more damaged in a stage 2 pressure sore, which can result in an open sore that looks like an abrasion or a blister. The skin around the wound may discolored. The area is very painful. Stage 3. These types of pressure sores usually have a crater-like appearance due to increased damage to the tissue below the skinââ¬â¢s surface. This makes the wound deeper. Stage 4. This is most serious type of pressure sore. The skin and tissue is severely damaged, causing a large wound. Infection can occur at this stage. Muscles, bones, tendons and joints can be affected by stage 4 pressure sores. Who gets pressure sores? Anyone who sits or lies in one position for a long time might get pressure sores. You are more likely to get pressure sores if you are paralyzed, use a wheelchair or spend most of your time in bed. However, even people who are able to walk can develop pressure sores when they must stay in bed because of an illness or an injury. Some chronic diseases, such as diabetes and hardening of the arteries, make it hard for pressure sores to heal because of poor blood circulation. Peripheral vascular disease,MI, Stroke,Multiple trauma,Musculoskeletal disorders/fractures/contractures,Gibleed , Spinal cord injury (e. g. , decreased sensory perception, muscle spasms),Neurological disorders (e. g. , Guillain-Barreââ¬â¢, multiple sclerosis),Unstable and/or chronic medical conditions (e. g. , diabetes, renal disease, cancer, chronic obstructive pulmonary disease, congestive heart failure),History of previous ressure ulcer,Preterm neonates, Dementia, Recent surgical patient. Where on the body can you get pressure sores? Pressure sores usually develop over bony parts of the body that donââ¬â¢t have much fat to pad them. Pressure sores are most common on the heels and on the hips. Other areas at risk for pressure sores include the base of the spine (tail bone), the shoulder blades, the backs and sides of the knees, and the back of the head. How are pressure sores treated? There are several things you can do to help pressure sores heal: * Relieving the pressure that caused the sore * Treating the sore itself Improving nutrition and other conditions to help the sore heal What can be done to reduce pressure on the sore? Donââ¬â¢t lie on pressure sores. Use foam pads or pillows to take pressure off the sore. Special mattresses, mattress covers, foam wedges or seat cushions can help support you in bed or in a chair to reduce or relieve pressure. Try to avoid resting directly on your hip bone when youââ¬â¢re lying on your side. Use pillows under one side so that your weight rests on the fleshy part of your buttock instead of on your hip bone. Also, use pillows to keep your knees and ankles apart. When lying on your back, place a pillow under your lower calves to lift your ankles slightly off the bed. When lying in bed, change your position at least every 2 hours. When sitting in a chair or wheelchair, sit upright and straight. An upright, straight position will allow you to move more easily and help prevent new sores. You should change positions every 15 minutes when sitting in a chair or wheelchair. If you cannot move by yourself, have your caregiver help you shift your position. How should the pressure sore be kept clean? In order to heal, pressure sores must be kept clean and free of dead tissue. Stage 1 sores can be cleaned with mild soap and water. You can clean stage 3 sores by rinsing the area with a salt and water solution. The saltwater removes extra fluid and loose material. Your doctor or nurse can show you how to clean your pressure sore. Pressure sores should be kept covered with a bandage or dressing. Sometimes gauze is used. The gauze is kept moist and must be changed at least once a day. Newer kinds of dressings include a see-through film and a hydrocolloid dressing. A hydrocolloid dressing is a bandage made of a gel that molds to the pressure sore and helps promote healing and skin growth. These dressings can stay on for several days at a time. Dead tissue (which may look like a scab) in the sore can interfere with healing and lead to infection. There are many ways to remove dead tissue from the pressure sore. Rinsing the sore every time you change the bandage is helpful. Special dressings that help your body dissolve the dead tissue can also be used. They are left in place for several days. Another way to remove dead tissue is to put wet gauze bandages on the sore and allow them to dry. The dead tissue sticks to the gauze and is removed when the gauze is pulled off. For more severe pressure sores, dead tissue must be removed surgically. Removing dead tissue and cleaning the sore can hurt. Your doctor can suggest a pain reliever for you to take 30 to 60 minutes before your dressing is changed to help reduce pain. Why is good nutrition important for healing sores? Good nutrition is important because it helps your body heal the sore. You read "Nursing Pressure Sore" in category "Papers" If you donââ¬â¢t get enough calories, protein and other nutrients (especially vitamin C and zinc, which can help heal wounds like pressure sores), your body wonââ¬â¢t be able to heal, no matter how well you care for the pressure sore. Your doctor, nurse or a dietitian can give you advice about a healthy diet. Be sure to tell your doctor if you have lost or gained weight recently. What if the sore gets infected? Pressure sores that become infected heal more slowly and can spread a dangerous infection to the rest of your body. If you notice any of the signs of infection listed below, call your doctor right away. Signs of an infected pressure sore include the following: * Thick yellow or green pus * A bad smell from the sore * Redness or warmth around the sore * Swelling around the sore * Tenderness around the sore Signs that the infection may have spread include the following: * Fever * Chills * Mental confusion or difficulty concentrating * Rapid heartbeat * Weakness How are infected pressure sores treated? The treatment of an infected pressure sore depends on how bad the infection is. If only the sore itself is infected, an antibiotic ointment can be put on the sore. When bone or deeper tissue is infected, antibiotics are often required. They can be given intravenously (through a needle put in a vein) or orally (by mouth). How can I tell if the sore is getting better? As a pressure sore heals, it slowly gets smaller. Less fluid drains from it. New, healthy tissue starts growing at the bottom of the sore. This new tissue is light red or pink and looks lumpy and shiny. It may take 2 to 4 weeks of treatment before you see these signs of healing. How can pressure sores be prevented? The most important step to prevent pressure sores is to avoid prolonged pressure on one part of your body, especially the pressure points mentioned previously. Itââ¬â¢s also important to keep your skin healthy. Keep your skin clean and dry. Use a mild soap and warm (not hot) water. Apply moisturizers so your skin doesnââ¬â¢t get too dry. If you must spend a lot of time in bed or in a wheelchair, check your whole body every day for spots, color changes or other signs of sores. Pay special attention to the pressure points where sores are most likely to occur. If you smoke, you should quit. People who smoke are more likely to develop pressure sores. Exercise can help improve blood flow, strengthen your muscles and improve your overall health. Talk to your doctor if physical activity is hard for you. He or she can suggest exercises that can work for you, or refer you to physical therapist that can help. Pressure Sore Prevention Relieving pressure: Position must be changed on a regular basis, at least every two hours, and in the very frail at least every hour. Good Diet: A good and balanced diet contributes to healing, as well as avoiding severe nutritional and weight loss Skin Care: Keep the skin clean. Moisture should be minimized. Skin care products should be used that moisturize the skin but do not make it wet or soggy. Use continence aids if a person is unable to control their bladder or bowels. Pads, diapers, convenes or catheterizing. Inspect the skin to see if any redness or breaks in the skin are developing. Use products to relieve and treat pressure sores; airbeds, foam bed, bed and chair protectors, chair products, continence aids can all contribute to avoiding of bed sores. Clean skin with warm water and minimal friction. Apply lotion often. ââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬â- Avoid direct pressure to bony areas such as ankles and hips. Use pillows and padded protectors to support arms, legs and vulnerable areas. Change the position of a bed-bound person every two hours. Handle and move carefully to avoid skin tears and scrapes. Change the position of a chair-bound person hourly. Discourage the bed-bound or chair-bound person from sitting with the head elevated more than 30 degrees, except for short periods of time. Check and change bed linens as often as necessary Use continence management products if necessary to reduce exposure to moisture. Padded supports, such as doughnut cushions may, themselves, become a source of pressure. Do not massage bony areas of the body. Do not massage pressure sores. Do not use remedies such as iodine, peroxide and cornstarch that may further irritate the skin. Pressure sores (bedsores, decubitus ulcers, pressure ulcers) are areas of skin damage resulting from a lack of blood flow due to pressure. â⬠¢ Sores often result from pressure but may also result from pulling on the skin or friction, particularly over bony areas. â⬠¢ The diagnosis is usually based on a physical examination. â⬠¢ Treatment includes cleansing, removal of pressure from the affected area, special dressings, and, sometimes, surgery. Pressure sores can occur in people of any age who are bedbound, chairbound, or unable to reposition themselves. They are more common among older people. They tend to occur over bony projections where pressure on skin can be concentrated, such as over the hip bones, tailbone, heels, ankles, and elbows. They occur where there is pressure on the skin from a bed, wheelchair, cast, splint, or other hard object . Pressure sores lengthen the time spent in hospitals or nursing homes and increase the cost of care. Pressure sores can be life threatening if they are untreated or if underlying health conditions prevent them from healing. Causes Causes that contribute to the development of pressure sores include: â⬠¢ Pressure Traction â⬠¢ Friction â⬠¢ Moisture â⬠¢ Inadequate nutrition Pressure on skin, especially when over bony areas, reduces or cuts off blood flow to the skin. If blood flow is cut off for more than 1 or 2 hours, the skin dies, beginning with its outer layer (epidermis). The dead skin breaks down and forms an open sore (ulcer). Most people do not develop pressure sores because they constantly shift position withou t thinking, even when they are asleep. However, some people cannot move normally and are therefore at greater risk of developing pressure sores. They include people who are paralyzed, comatose, very weak, sedated, or restrained. Paralyzed and comatose people are at particular risk because they also may be unable to move or feel pain (pain normally motivates people to move or to ask to be moved). Traction also reduces blood flow to the skin. Traction occurs when the skin is stretched by being wedged against something or when it sticks to something, often bed linens. When the skin is stretched, the effect is much like pressure. Friction can lead to or worsen pressure sores. Repeated friction may wear away the top layers of skin. Such skin friction may occur if people are pulled repeatedly across a bed. Moisture can increase skin friction and weaken or damage the protective outer layer of skin if the skin is exposed to it a long time. For example, the skin may be in prolonged contact with perspiration, urine, or feces. Inadequate nutrition increases the risk of developing pressure sores and slows the healing process of sores that do develop. Malnourished people may not have enough body fat to pad the skin and bones or to keep the blood vessels from being squeezed shut. Also, skin repair is impaired in people whose diets are deficient in protein, vitamin C, or zinc. Did You Knowâ⬠¦? â⬠¢ Inadequate nutrition increases the chances of developing pressure sores and slows the healing of sores that do develop. â⬠¢ Repositioning people who cannot move themselves at least every 1 to 2 hours can help prevent pressure sores. Symptoms For most people, pressure sores cause some pain and itching. However, in people whose senses are dulled, even severe sores may be painless. Pressure sores are categorized into four stages according to the severity of damage: â⬠¢ Stage I: Redness and inflammation Stage II: Some shallow skin loss, including abrasions, blisters or both â⬠¢ Stage III: Full-thickness skin loss down to the layer of fat. â⬠¢ Stage IV: Full-thickness skin loss with exposure of underlying muscle, tendon, or bone Pressure sores do not always progress from mild to severe stages. Sometimes the first noticeable sign is a late-stage sor e. If pressure sores become infected, they may have an unpleasant odor. Pus may be visible in or around the sore. The area around the pressure sore may become red or feel warm, and pain may worsen if the infection spreads to the surrounding skin (causing cellulitis). Infection delays healing of shallow sores and can be life threatening in deeper sores. Infection can even penetrate the bone (osteomyelitis), requiring weeks of treatment with antibiotics. In the most severe cases, infection can spread into the bloodstream (sepsis), causing fever or shaking chills. Spotlight on Aging Aging itself does not cause pressure sores. But it causes changes in tissues that make pressure sores more likely to develop. As people age, the outer layers of the skin thin. Many older people have less fat and muscle, which helps absorb pressure. The number of blood vessels decreases and blood vessels rupture more easily. All wounds, including pressure sores, heal more slowly. Certain conditions make pressure sores more likely to develop: â⬠¢ Being unable to move normally because of a disorder such as stroke â⬠¢ Having to stay in bed for a long time, for example, because of surgery â⬠¢ Being excessively sleepy (such people are less likely to change position or ask someone to reposition them) â⬠¢ Losing sensation because of nerve damage (such people do not feel discomfort or pain, which would prompt them to change ositions) â⬠¢ Becoming less responsive to what is happening in and around them, including their own discomfort or pain, because of a disorder such as dementia Diagnosis Doctors can usually diagnose pressure sores by doing a physical examination. A doctor or nurse usually measures the size and depth of a sore to determine its stage and plan treatment. If the damage is severe, radionuclide bone scan ning or gadolinium-enhanced MRI (magnetic resonance imaging) may be done to check whether infection has spread from the sore to boneââ¬âa disorder called osteomyelitis. To diagnose osteomyelitis, doctors may need to take a small sample (biopsy) of bone to see if bacteria grow from it (culture). Prevention Prevention is the best strategy for dealing with pressure sores. In most cases, pressure sores can be prevented by meticulous attention from all caregivers, including nurses, nursesââ¬â¢ aides, and family members. Close daily inspection of a bedridden or chairbound personââ¬â¢s skin can detect early redness or discoloration. Any sign of redness or discoloration at pressure areas is a signal that the person needs to be repositioned and kept from lying or sitting on the discolored area until it returns to normal. Because shifting position is necessary to keep the blood flowing to the skin, oversedation should be avoided and activity encouraged. People who cannot move themselves should be repositioned every 2 hours if they are in bed and every hour if they are in a chairââ¬âmore often if possible. The skin must be kept clean and dry because moisture increases the risk of developing pressure sores. Dry skin is less likely to stick to fabrics and cause friction or traction. For people confined to bed, sheets should be changed frequently to make sure they are clean and dry. Applying noncaking body powder to skin in areas where two parts of the body press against each other (such as the buttocks and groin) can help keep the skin in these areas dry. Bony projections (such as heels and elbows) can be protected with soft materials, such as foam wedges and heel protectors. Donut-shaped devices and sheepskins should be avoided as they only shift pressure or friction from one vulnerable site to another. Special beds, mattresses, and seat cushions can be used to reduce pressure in people who are wheelchair-bound or bedridden. These products can reduce pressure and offer extra relief. A doctor or nurse can recommend the most appropriate mattress surface or seat cushion. It is important to remember that none of these devices eliminate pressure completely or are a substitute for frequent repositioning. Treatment Treating a pressure sore is much more difficult than preventing one. The main goals of treatment are to relieve pressure on the sores, keep them clean and free of infection, and provide adequate nutrition. Adequate nutrition is important in helping pressure sores heal and in preventing new sores from forming. A well-balanced, high-protein diet is recommended as well as a daily high-potency vitamin and mineral supplement. Supplemental vitamin C and zinc may help with healing as well. Electrical stimulation, heat therapy, massage therapy, and hyperbaric O2 therapy have not proven helpful. In the earliest stage, pressure sores usually heal by themselves once pressure is removed. When the skin is broken, a doctor or nurse considers the location and condition of the pressure sore when recommending a dressing. Film (see-through) dressings help protect early-stage pressure sores and allow them to heal more quickly. Hydrocolloid (oxygen- and moisture-retaining) patches protect, keep the skin appropriately moist, and provide a healthy environment for deep sores. Other types of dressings may be used for deeper sores, those that ooze a lot of fluids, and those that are infected. If the sore appears infected or oozes, rinsing with saline and dabbing gently with a gauze pad are helpful. A doctor may need to remove (debride) dead tissue with a scalpel or a chemical solution. Removal of dead tissue is usually painless, because pain is not felt in dead tissue. Some pain may be felt because healthy tissue is nearby. Health care practitioners may flood (irrigate) the sore, particularly its deep crevices, with a sterile solution to help clean away hidden debris. Sometimes a bed that circulates air (an air-fluidized bed) is used in hospitals and nursing homes. This special bed helps reduce or redistribute pressure on the body. ââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬â- Deep pressure sores are difficult to treat. Sometimes they require skin and muscle flaps, in which healthy, thicker tissue with a good blood supply is surgically repositioned to cover the damaged area. This type of surgery is not always successful, however, especially for frail older people who are malnourished. Often, when infections develop deep within a sore, antibiotics are given. When bones beneath a sore become infected, the bone infection (osteomyelitis) is extremely difficult to cure and may spread through the bloodstream, requiring many weeks of treatment with an antibiotic (see Bone and Joint Infections: Osteomyelitis). ââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬â- The terms decubitus ulcer and pressure sore often are used interchangeably in the medical community. Decubitus, from the Latin decumbere, means ââ¬Å"to lie down. â⬠Decubitus ulcer, therefore, does not adequately describe ulceration that occurs in other positions, such as prolonged sitting (eg, the commonly encountered ischial tuberosity ulcer). Because the common denominator of all such ulcerations is pressure, pressure sore is the better term to describe this condition. Pressure is exerted on the skin, soft tissue, muscle, and bone by the weight of an individual against a surface beneath. These pressures are often in excess of capillary filling pressure, approximately 32 mm Hg. In patients with normal sensitivity, mobility, and mental faculty, pressure sores do not occur. Feedback, conscious and unconscious, from the areas of compression leads inIndividuals who are unable to avoid long periods of uninterrupted pressure over bony prominencesââ¬âa group of patients that typically includes elderly individuals, persons who are neurologically impaired, and patients who are acutely hospitalizedââ¬âare at increased risk for the development of necrosis and ulceration. These individuals cannot protect themselves from the pressure exerted on their body unless they consciously change position or have assistance in doing so. Even the most conscientious patient with an extensive support group and unlimited financial resources may develop ulceration resulting from a brief lapse in avoidance of the ill effects of pressure. [2, 3] dividuals to change body position. These changes shift the pressure prior to any irreversible tissue damage. The inciting event for a pressure sore is compression of the tissues by an external force, such as a mattress, wheelchair pad, or bed rail. Other traumatic forces that may be present include shear forces and friction. These forces cause microcirculatory occlusion as pressures rise above capillary filling pressure, resulting in ischemia. Ischemia leads to inflammation and tissue anoxia. Tissue anoxia leads to cell death, necrosis, and ulceration. ââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬â- Irreversible changes may occur after as little as 2 hours of uninterrupted preSpecialized support surfaces are available for bedding and wheelchairs, which can maintain tissues at pressures below 30 mm Hgssure. urning and repositioning the patient remain the cornerstones of prevention and treatment. The wound and surrounding skin must be kept clean and free A new international guideline with regard to the prevention of pressure ulcers was released in 2009. [11] A collaboration between the National Pressure Ulcer Advisory Panel and the European Pressure Ulcer Advisory Panel, the guideline covers the latest evidence-based recommendations for all patients in all healthcare settings. Clinical practice recommendations in regard to prevention will include: * Current definitions and classification of pressure ulcers; * Risk assessment, including the role of nutrition; * Skin inspection and skin care; * Positioning and repositioning patients; * Evidence for use of various support surfaces (air-fluidized beds; alternating air mattresses and cushions; foam-, gel-, or fluid-filled mattresses; overlays for operating tables; turning beds; and other aids for pressure redistribution); * Protective devices used for pressure ulcer prevention; and * Education and training for healthcare providers. How to cite Nursing Pressure Sore, Papers
Thursday, December 5, 2019
Project Charter for development of Melbourne City Free Samples
Question: Prepare a Project Charter for development of Melbourne City 2026. Answer: Project summary It provides a summary description of the project. Project title Development of Melbourne to be a sustainable, inclusive, innovative vibrant flourishing city by the end of 2016 Project managers Melbourne 2026 Ambassadors Project sponsor Melbourne city council Project duration June 2016 to June 2026 Project high value budget AUD 207, 500 Project aim/purpose: The purpose of the project is to ensure that Melbourne city is developed to be a sustainable, invention and inclusive city that is vibrant and flourishing by the end of 2026. In accomplishing the purpose the project will be guided by the following specific areas of priority: To create a city that cares for its environment a balance between flora and fauna To develop a city for people that is welcoming, accessible, affordable, inclusive and safe To foster a creative initiatives in the city To create a prosperous city for local and international entrepreneurs and business to thrive upon. To facilitate knowledge based city that will produce skilled intellectual workforce. To have a connected city for easy movement of its citizens To promote a deliberative city that uses participatory democratic approaches in decision making To be a leading city in managing change and ensuring technological advancements To develop a city that can acknowledge, educate and enhance Aboriginal culture Project justification: The choice of the project was due to several reasons (Leach, L. 2014, 34). The project sponsors (Melbourne city council) established that the previous plan was constructed in 2008 it was valuable and they saw the need to refresh it to guide the future. Cities are complex ecosystems and shared places which are dynamic in that regard they need to be continuously planned for that was the case of Melbourne city. The city is known for its livability the project sponsors are wishing to maintain that and ensure that citizens future aspirations are met (Snyder, C. 2014, 36). Project objectives: The project objectives will define the scope, customer expectations, time, and budget. The project objectives will be: To focus on transforming Melbourne city by the end of 2016 To ensure that Melbourne city citizens aspirations and ideas are catered during the planning process To ensure that the project will cover all Melbourne city aspects of life To build Melbourne to be a world class city within the budget constraints To ensure that various project deliverables are competitive, standard and acceptable worldwide. Project success criteria: The success criteria defines the end results expectations (Heagney, J. 2016, 67).To ensure that the project meets customer aspirations it will need to be attractive city, inclusive, competitive, and sustainable. Project assumptions and constraints The constraints include: slow decision making due to the consultation process, frequent changes in life aspects can affect the project, and budget constraints The project will assume that all citizens will be willing participate, and the project will not be affected much by the changes in the environment. Project deliverables: Deliverables are items that project will be intending to achieve (Petronila, A. 2014, 34). They will include: Writing of the project plan proposal To carry out needs assessments/stakeholder involvement for project initiation Collection of data, information and statistics Ideas are analyzed and synthesized A review and rewriting of future Melbourne plan Project communication and closure The deliverables will help to come up with a bottom-up budget approach. Project risks: There are certain risks that will affect the project this was ranked based on impact/likelihood of occurrence (De Roo, G. Hillier, J. 2016, 34). The risks are summarized in table 1. Table 1 Project risk plan Rank Type of risk Impact/occurrence Effect Mitigation 1. Conflicting interests Impact =high Occurrence=high It may delay decision making process Proper consultations and stakeholder analysis will be done 2. Changes in environmental factors Impact=high Occurrence=high It may affect the scope, time, and budget Contingency planning will be done 3. Non-participation Impact=High Occurrence=low Project will lack inclusiveness Consultations will be done Project budget and estimates: the budget estimates was created using bottom up approach. The bottom up approach is based on estimates of work packages obtaining the total project budget (Martinelli, R. Milosevic, D. 2016, 56). Table2 shows a summary of the estimates. It is a budget period of 10 years. Table 2 Project estimate Items Approximate value in AUD Stationery (assorted) 2,000.00 Research and development 50,000.00 Events related costs 10,000.00 Allowances remunerations 36,000.00 Ambassadors wages 24,000.00 Refreshments entertainments 8,000.00 Documentary processing costs 5000.00 Legal facilitation costs 1200.00 Airtime charges 1,500.00 Internet charges 9,500.00 Salaries 42,000.00 Miscellaneous expenses 12,000.00 Totals 207, 500.00 Stakeholders management: Stakeholders are those affected directly or indirectly by the project (Kerzner, H. 2013, 34). Melbourne project team will do stakeholder analysis to be able to manage them. Table 3 shows list of stakeholders, their stakes and way they will be managed. Table 3 stakeholder management Stakeholder Type of stakeholder Interest/influence Management Melbourne city council Primary They will directly sponsor the project They will be involved in any decision making and approvals Citizens representatives Primary Their opinions/ideas will need to be considered Their opinions will be sought Members of citizens jury Secondary Help in evaluation and analysis The will be consulted Lord major Secondary Need to be informed Communicated or informed Councilors Secondary Need to be informed Be informed Ambassadors Primary They help project execution Involved in decision making Project acceptance/approval: At any project stage and acceptance it will be approved by: Project Melbourne council representative.sign Date Project ambassador representativesign Date.. Project manager role: The ambassadors project roles will include: Technical operative role ensuring project deliverables are achieved, specifications and requirements are met. Budget management-ensuring budget constraint needs are met. The team will be responsible in ensuring budget is created, followed and evaluated. Conflict resolution management role- take part in resolving conflicts emanating from the project stakeholders. The will be tasked with the job of creating a conflict management plan. Communication role- ensure a communication plan is created to cater for informational roles in the project Monitoring, evaluation and control role- That will be important in ensuring standards are followed and improvements are done. Sponsor commitment: The project sponsors are committed to ensure that project is successful. They will demonstrate this commitment by budgetary support, making approvals on time, and participation in decision making. The commitment will be documented by sourcing the sponsors signature at each project stage (Verzuh, E. 2015, 56). References De Roo, G. and Hillier, J., 2016. Complexity and planning: Systems, assemblages and simulations. Routledge. 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. Leach, L.P., 2014. Critical chain project management. Artech House. Martinelli, R.J. and Milosevic, D.Z., 2016. Project management toolbox: tools and techniques for the practicing project manager. John Wiley Sons. Petronila, A., 2014. Project Management Plan. Docs. School Publications. Snyder, C.S., 2014. A Guide to the Project Management Body of Knowledge: PMBOK () Guide. Project Management Institute. Verzuh, E., 2015. The fast forward MBA in project management. John Wiley Sons.
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