Live or Die Essay - 672 Words

In William Shakespeare’s Hamlet, the ghost of Hamlet’s father appears very briefly. However, he provides the basis for the development and eventual downfall of Hamlet’s character. The play begins with a dismal Hamlet mourning his father’s death Recognizing this gloom, Queen Gertrude urges Hamlet to â€Å"cast thy nighted color off, and let thine eye look like a friend on Denmark† (I, ii, 68-69). Soon after, the ghost appears, insisting, â€Å"If thou didst ever thy father love, revenge his foul and most unnatural murder† (I, v, 24-25). As Hamlet decides to scourge the past and present evils in Denmark, the ghost unleashes death and malice onto the stage. The first and most obvious change which the ghost instills into Hamlet is a vengeful spirit.†¦show more content†¦In his first appearance to Hamlet, the ghost insults his brother saying, â€Å"Ay, that incestuous, that adulterate beast... O wicked wit and gifts, that have the power so to seduce!--won to his shameful lust the will of my most seeming-virtuous queen† (I, v, 42-45). Hamlet, adopting this malicious spirit, later responds to the ghost with a fervent, â€Å"O most pernicious woman! O villain, villain, smiling, damned villain† (I, v, 105-106). Hamlet now has a valid reason to be disgusted with both his uncle and his mother and proceeds to confront his mother on this incestual issue. He does this by comparing his father, a â€Å"combination and a form indeed which every god did seem to set his seal to give the world assurance of a man† (III, iv, 61-63), to his uncle, a â€Å"mildewed ear blasting his wholesome brother† (III, iv, 65). Hamlet focuses on a minute and inconsequential part of avenging his father’s murder; thus, he delays action even more. The ghost also induces Hamlet’s preoccupation with death and decay, seen through Hamlet’s many allusions to the subject. Hamlet makes puns involving death: â€Å"Your worm is your only emperor for diet. We fat all creatures else to fat us, and we fat ourselves for maggots. Your fat king and your lean beggar is but variable service-two dishes, but to one table† (IV, iii, 21-24). He ponders and foresees death: â€Å"I see the imminent death of twentyShow MoreRelatedThe Main Conventions of James Bond Movies Essay613 Words   |  3 Pagesuseless and incredibly passive however in Live and Let Die, the women are surprisingly more intelligent, important and useful. 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The chemical formula for photosynthesis is: CO2 + H2O → C6H12O6 + O2 + H2O Plants photosynthesise to sustain themselves, using chlorophyll and sunlight to convert carbon dioxide and water into glucoseRead MoreHealth Care : Helping Patients Live Better Lives And Die Better Deaths Essay1649 Words   |  7 PagesPalliative Care: Helping Patients Live Better Lives and Die Better Deaths Executive Summary People today are living longer than their forebears. By 2030, an estimated 72 million people of the U.S. population will be older than 65 years old and an estimated 9 million people will be older than 85 years old (Heinle, McNulty, Hebert, 2014). Most adults will live with at least one chronic illness until they die (Heinle et al., 2014). 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The Great Gatsby By F. Scott Fitzgerald - 1330 Words

The famously written book, The Great Gatsby by F. Scott Fitzgerald, provides many details, which help to provoke the meaning behind this narrative. The use of symbolic objects helps to connect the significance of the story on a deeper level and eventually reveal its literal meaning. Many symbols portrayed throughout The Great Gatsby, such as the green light, the eyes of Dr. T.J. Eckleburg, Gatsby’s Mansion and the weather help to uncover one of the main themes–the American Dream. First, the green light located at the end of Tom and Daisy Buchanan’s dock, in East egg, plays a considerable role in Gatsby’s life. In chapter 1, we first encounter Gatsby’s attraction with the green light. When Nick Carraway sees Gatsby for the first time, he†¦show more content†¦The color green maintains a more promising effect as opposed to the color red or yellow, therefore giving Gatsby hopefulness for the future. This color also signifies Gatsby’s mai n objective in life–money. With money come ambition and jealousy, which also implies societies appeal and the superficial hopelessness of achieving the common theme of the American Dream. Second, perhaps one of the most well known symbols of this book, as well as in literature, are the eyes of Dr. T.J. Eckleburg. The billboard, overlooking the Valley of Ashes, is up to promote the business of an eye doctor (Dr. T.J. Eckleburg). The eyes, which make up the advertisement, watch over the main characters as they pass underneath on their way into New York City. These eyes observe as Tom carries on his disloyal affair, as Gatsby drives Nick into town to meet Meyer Wolfshiem (man who fixed the world series), and also these eyes observe the yellow car and the individual who ran over and killed Myrtle Wilson. In chapter 8, Wilson affiliates Eckleburg’s eyes to the eyes of God. After discovering Myrtles affair with Tom Buchanan, Wilson articulates to Myrtle: â€Å"God knows wh at you’ve been doing, everything you’ve been doing. You may fool me, but you can’t fool God!† (Fitzgerald 159). This indicates how strongly Wilson feels about the â€Å"eyes† and the correlation between God’s judgment and Myrtle’s affair. Adultery is seen as a sin

Nursing Deep Vein Thrombosis

Question: Discuss about theNursing: Deep Vein Thrombosis. Answer: Introduction: John Grants case is discussed in this essay. It is evident that he is at risk of deep vein thrombosis (DVT) because he has to undergo knee replacement surgery for bilateral knee surgery. In addition to the bilateral knee injury, he is associated with metabolic, cardiovascular and psychological disorders. Johns current state is described by taking into consideration of his medical history and family background. As John is susceptible for deep vein thrombosis, its pathophysiology is discussed. Tests for the assessment of John condition are discussed. Planned interventions for the problems detected in the assessment are discussed. Discussion about the different professionals for providing care to John is also discussed in the essay. John Grant is 63 year old and he having age related disease like bilateral knee osteoarthritis. He is consuming Endone for pain management. However, due to less improvement with medicatiosn, he is advised to have knee replacement surgery for both the legs. He is having different disease like angina, hypertension (HTN), hyperlipidemia, type 2 diabetes (T2DM), and depression. Previouslu, he used to work for 6 days per week, however now he is working for 2 days per week because of knee pain. He is capable of doing his daily activities on own. Occasinaly, his family members are visiting him to assist him in daily activities. Main reason for the occurrence of deep vein thrombosis is reduced flow. In case of John, it may occur due to blood clotting post surgery. Decreased blood flow, vein dilatation and less contraction of skeletal muscle can lead to venous stasis. As a result intimal lining of the blood vessels get damaged. This damaged site is susceptible for clot and thrombus formation. After thrombus formation inflammation occurs and it is called as phlebitis. Aggregation of the platelets at the vein wall is responsible for the venous thrombi. Venous thrombi is having tail like structure consisting of fibrin, white and red blood cells (Houshmand et al., 2015). Assessment: Musculoskeletal system should be assessed for John as he is having osteoarthritis. Strength, balance and joint range of motion necessary for performing his daily activities should be assessed using functional assessment. Movement of John and his body posture along with body symmetry should be assessed by observation. It would be helpful in the evaluating power of muscles and joint. Visual observation of spine should be done to understand spine contour and tenderness. Gait assessment should be done in John by asking him to walk few steps like heel-to-toe walking and steps on tiptoe walking in the room. Romberg testing should be used for assessment of balance in John (Almoallim and Gelidan, 2012). Assessment of diabetes in John should be done by monitoring body weight changes, sweating, weakness, polydipsia, polyphagia and polyuria. Blood pressure and heart beat should also be assessed in John because in diabetes cardiovascular parameters can change significantly. Ophthalmoscopy should be used to evaluate vision problem in John. In neuropathic assessment, tendon hammer should be used to assess ankle and knee reflexes. Blood glucose level test using glucose oxidase method and HBA1C test using ELISA kit should be performed in John for assessment of diabetes. Clinical laboratory scientist and pathologist should be incorporated in the assessment of John for carrying gout required tests. His family members should take him to pathology lab for assessment (Pagana and Pagana, 2014). Risk Assessment: John is susceptible to risks like fall due to osteoarthritis and infection due to surgery. Evidence of fall for John in last 3 months would be helpful is assessing fall in John. Evidence should include information about number of falls per week and reason behind fall. Number of visits to toilet for urination and defecation also would be helpful in fall assessment because elderly patients fall in bathroom is very common. Gait and vision or hearing impairment would also be helpful in assessment of fall in John (Suman et al., 2013). John is more susceptible to infection due to surgery. Risk of infection can be assessed by observing secretions form the surgery site and carrying out culturing of fluid or tissue from surgery site. Physical characters like pain, swelling and redness are also useful in the assessment of infection (Cheng et al., 2015). Strategies to Meet the Johns Needs: Nurse should provide intervention for the improvement in mobilization for John. Warm water treatment and gentle massage can be useful in reducing stiffness of joints. Mobilization can be improved with this treatment. Mobility exercise like range of movement (ROM) and stretching exercise would be helpful in improving mobility (Musumeci et al., 2014). For control of blood glucose level in John, he should be administered with gliclazide and acarbose. Gliclazide and acarbose produce its action by acting on sulfonylurea receptors (SUR-1) on the pancreatic beta-cells and alpha-glucosidase in small intestine and alpha amylase in the pancreas respectively. Acarbose reduces HBAIC level by carrying out carbohydrate digestion (Singla et al., 2016; Singh and Singh, 2016). Blood flow in the DVT patient like John can be increased by providing suitable position, increasing motion of the leg and by providing compression therapy. Elevated position of leg and knee flexion in John can increase blood glow in the leg. Warm and moist compresses can also increase blood flow to leg in John. Superficial veins caliber can be reduced by using graduated compression stockings which increases blood flow. Short stretch elastic wraps and intermittent pneumatic compression devices should be used in John for increasing blood flow. It is evident from the literature that use of compression devices are helpful in blood clot formation and moreover possibility of bleeding is less in using these devices as compared to the medications use for preventing clot formation. However, it should considered that medications are more effective in preventing blood clot as compared to these devices (Blann, 2015). Evaluation of Care: Nurse should incorporate different professional like doctor, pharmacist, clinical pharmacologist, clinical laboratory scientist, physical trainer, dietician, psychologist and family members in providing intervention to John. Nurse should consult with doctor to maintain optimal perfusion in John. This would be helpful in reducing thickness of blood and decreasing chances of clot formation. Pharmacist and clinical pharmacologist should be incorporated in providing education about medication consumption to John. These professionals should educate him about accurate dose and timings of anticoagulant consumption because high dose of anticoagulant can result in bleeding. Clinical laboratory scientist should help John in carrying out tests. Family members should be educated about the medications and tests for John because they can help in completing these things in time. Physical trainer can assist John in performing stretching exercise for John to increase blood flow in the leg. It is evid ent that, john is associated with metabolic, diabetic and cardiovascular complications. In these disease conditions proper diet should be consumed. Dietician can help John in taking suitable diet for his health conditions. John becomes depressive due to his age and disease condition. Hence, psychologist should be incorporated in his care to improve his moral boost (Blann, 2015). I illustrated current status of John keeping in mind his medical history. I understood that John is having very complex health condition comprising of osteoarthritis, diabetes, cardiovascular complications and depression. I performed health assessment of John to know his significant health problems. I identified problems like immobilization for osteoarthritis and increased blood glucose level for diabetes. I provided nursing intervention to improve mobility and to reduce blood glucose level in John (Papathanasiou et al., 2014). Conclusion: John is having painful bilateral knee osteoarthritis and medications are not relieving him. Hence, knee replacement surgery is suggested for him. Patients with knee replacement surgery are more susceptible for DVT. As John is having diabetes, risk of DVT is more in John. Assessment should be performed in John for providing correct intervention to John. Assessment for osteoarthritis and diabetes should be performed in John. Diabetes and long duration bed rest are identified as the risk factors for DVT in John. Professionals from different disciplines should be incorporated for John for mediation administration, diet plan, physical exercise and tests for assessment. In summary, assessment of John by using specific tests for his complications and relevant intervention would be helpful in providing holistic care to John. References: Almoallim, Hani., and Gelidan, A. (2012). Musculoskeletal Examination Skills: Are We Still Interested? International Journal of Clinical Medicine, 3, 335-340. Blann, A. (2015). Deep Vein Thrombosis and Pulmonary Embolism: A guide for practitioners.MK Update Ltd. Cheng, K., Jiawei, L., Qingfang, K., Changxian, W., Nanyuan, Y., and Guohua, X. (2015). Risk factors for surgical site infection in a teaching hospital: a prospective study of 1,138 patients. Patient Preference and Adherence, 9, 11711177. Houshmand, S., Salavati, A., Hess, S., Ravina, M., Alavi, A. (2014). The role of molecular imaging in diagnosis of deep vein thrombosis. American Journal of Nuclear Medicine and Molecular Imaging, 4(5), 406425. Musumeci, G., Mobasheri, A., Trovato, F.M., Szychlinska, M.A., Imbesi, R., and Castrogiovanni, P. (2014). Post-operative rehabilitation and nutrition in osteoarthritis. doi: 10.12688/f1000research.4178.3. Pagana, K.D., and Paganam T.J. (2014). Blood studies. In: Pagana KD, Pagana TJ, eds.Mosby's Manual of Diagnostic and Laboratory Tests. 5th ed. St Louis, MO: Elsevier Mosby; 2014:chap 2. Papathanasiou, I.V., Kleisiaris, C. F., Fradelos, E. C., Kakou, K., Kourkouta, L. (2014). Critical Thinking: The Development of an Essential Skill for Nursing Students. Acta Informatica Medica, 22(4), 283286. Singla, R.K., Singh, R., and Dubey, A.K. (2016). Important Aspects of Post-Prandial Antidiabetic Drug, Acarbose. Current Topics in Medicinal Chemistry, 16(23), 2625-33. Singh, A.K., and Singh, R. (2016). Is gliclazide a sulfonylurea with difference? A review in 2016. Expert Review of Clinical Pharmacology, 9(6), 839-51. Suman, V.B., Khalid, P., Jeganathan, P.S., Subbalakshmi, N.K., Sheila, R. P., Shaila, M.D. (2013). Risk factors associated with Osteoporosis- A population based study using p-Dexa technique. International Journal of Scientific and Research Publications, 3(2), 1 5.