Sickle Cell Plan of Care

Then, provide a brief description of the pathologically of sickle cell anemia and complete the nursing care plan by filling in the goals, outcomes, and nursing orders for the diagnoses provided in the table. SITUATION: Lavabo is a 30 year old, single African American who was diagnosed with sickle cell anemia when he was 4 years old. He works for a computer company and has been working 12 hour days to meet the deadline for a special project.Lavabo is complaining f fatigue and decided to relax by playing golf on a warm Saturday morning. After the seventh hole he experienced odyssey, tingling, and numbness in his legs. After the next hole, he experienced severe pain in his right ankle and knee. He was taken to the local medical center, where he was admitted. Lavabo rates his pain at 8 on a scale of 1-10. The physician ordered oxygen, IV fluids, and a PICA pump with morphine sulfate. Describe the pathologically that occurs in sickle cell anemia (4 points).Sickle cell anemia is the most c ommon form of sickle cell disease which is an inherited, autocross recessive disorder that causes an abnormal hemoglobin cell. The person with this specific disorder inherited hemoglobin S from both parents, also known as homozygous (Lewis, Drinkers, Hitchhiker, & Boucher, 2014, up. 644-647). This hemoglobin S results from the substitution of valise for glutamine acid on the B- globing chain of hemoglobin, and this ultimately causes the erythrocyte to stiffen and elongate taking a sickle shape in response to low oxygen levels (Lewis et al. 2014, up. 644-647). Due to the sickle cells elongated shape, and its stiff and sticky consistency it tends to get stuck in capillaries and vessels, and blocks blood flow to limbs and organs (Lewis et al. , 2014, up. 644-647). The major problems with sickle cell anemia is due to their sickles shape, reduced life expectancy and their ability to carry enough hemoglobin or transport it properly to the body to provide adequate oxygenation.Therefore a p erson who has sickle cell anemia has a lower number of red blood cells related to the shortened cell life that dies after only 10-20 days, compared to a normal red blood cell which lives about 120 days (Lewis et al. , 2014, up. 644-647). Bone marrow is unable to keep up with the demand for new red blood cells to replace the dying ones, making a person with sickle cell anemia left in a state of constant inadequate oxygenation (Lewis et al. , 2014, up. 644-647). Occlusion of capillaries and small vessels lead to acute or chronic tissue injury.This leads to further problems related to homeostasis which continues to perpetuate a cycle of local hypoxia, degeneration of more erythrocytes, and more suckling which continue to cause irreversible cell membrane damage (Lewis et al. , 2014, up. 644-647). Unless you're directly quoting you only need to address the authors once According to Lewis et al. , ASS is xx or write your summary and add to the end of the paragraph (Lewis et al. , 2014 up. 644-647) since all your information is from 1 source. If your quoting directly from the source you need to enclose in †Nursing Diagnoses Pain related to occlusion of small vessel by sickle cells as evidenced by severe pain in art. Knee and ankle. Altered tissue perfusion related to a decreased number of Orb's and decreased oxygenation as manifested by odyssey, tingling/numbness in ankle and knees. Activity Intolerance related to imbalance between oxygen supply and demand, as manifested by fatigue, odyssey,

The Realism Theory in Relationships of State and Non

The Realism Theory in Relationships of State and Non The three main theories used in international political economy are constructivism, realism and idealism or liberalism. Scholars commonly use the theories to explain economical events in the international political economy. Liberalists are concerned about private enterprise while constructivists are much concerned about wealth, political and material interactions of actors in the system.Advertising We will write a custom essay sample on The Realism Theory in Relationships of State and Non-state Actors specifically for you for only $16.05 $11/page Learn More This paper uses realism theory to explain relationships among state and non-state actors in the international system. Realism is based on the idea that the international system exists according to the Hobbestian state of nature, which is anarchic and brutal. There is no centralized authority in the system. The influential states have powers that they use to subjugate the poor and powerless in the system. The paper evaluates three supranational regimes in order to understand the theory in detail. States agree to form governments that control internal affairs. It is not surprising that any sovereign state has the power to enforce and prescribe laws. These powers are limited in the international system because there is no Leviathan that controls the activities of all members. The first argument is that the US and other major powers use supranational organizations to further their interests ((Wolf 87). WTO is a world body that is charged with the responsibility of overseeing how countries conduct trade globally. Liberalists argue that the body is beneficial to all states that subscribe to it because they benefit from free markets and business opportunities. In the liberalists’ view, the world organization in charge of trade is supposed to arbitrate on conflicts emerging from trade and commerce. Nearly all states in Africa, Europe, South and North America are members. Member state s are required to follow the laid down rules and regulations if they are to benefit from the organization. In this regard, the organization ensures that the interests of all states are catered for. Managers are answerable to states whereby they are called to explain inconsistencies during hard economic times. In the realists’ perspective, the organization is the property of the rich nations, which is used to enforce compliance. The headquarters of the organization is in the United States meaning that everything is operated from there. States are usually forced to come into terms with unfavorable policies in order to be members. The Chinese case would serve as an example. China was requested to adopt some policies that would favor the West in order to be incorporated in the system.Advertising Looking for essay on international relations? Let's see if we can help you! Get your first paper with 15% OFF Learn More Less developed countries do not actually b enefit from the organization. The organization allows US manufacturers to exploit markets in the third world but not vice versa. The third world is incorporated in the system as underdogs meaning that they assist the rich nations in producing goods. This is why the gap between the rich and the poor is widening day after another. The organization ensures that the poor states do not pursue interests that seem to contradict with those of the US. The organization is quick to slap economic sanctions to states that do not conform to the set rules. In the late 1980s to early 1990s, Libya was barred from exporting fuel to Europe, US and other friendly countries (Wolf 90). Oil trade nearly collapsed in Libya, which had caused sufferings due to lack of basic needs. This proves that states are usually in pursuit of their selfish interests not universal ideas. The US could have allowed Libya to sell its fuel to other states because citizens were suffering. This was never an issue to the US and WTO because Libya was non-compliant. Economic sanctions have been slapped to nations not because of misconduct but because of going against the wishes of the US and other major world powers. The second argument is that the US uses donor agencies to enforce compliance. IMF is a world organization that was established after the Second World War mainly to reconstruct Europe. This was an attempt to restructure European financial system after it was worst hit by the war. The organization offered assistance to European states that cooperated. After completion of its mission, the organization was turned into political tool that would subjugate and dominate developing countries. The US used the organization to restructure institutions of developing countries for its own interests (Milner 845). The organization forced many developing countries to restructure their governments in order to qualify for loans and other monetary assistances. For instance, the organization was effectively utilized in Kenya to boost American investment. The government, under Daniel Moi as president, was urged to privatize key national industries such as Kenya Airways, Rift Valley Railways and Kenya Ports Authority. Furthermore, the state was not supposed to interfere with the market meaning that prices of commodities could be determined by market logics (Milner 851). The Kenyan government suffered a lot because it had to retrench some of its employees in order to qualify for the IMF loan. The IMF program introduced in many countries was referred to as structural adjustment program (SAP). Liberalization of the economy benefited the US and other developed nations because they exploited the poor with cheap goods.Advertising We will write a custom essay sample on The Realism Theory in Relationships of State and Non-state Actors specifically for you for only $16.05 $11/page Learn More Finished goods were imported from developed countries while raw materials were exported to the US and other developed nations. This was seen as unbalanced trade because Kenyan citizens could not afford processed goods, which were originally Kenyan. To ensure political compliance, the US used IMF to request third world leaders to accept multiparty politics (Stone 346). Accountability was demanded from leaders before they could qualify for monetary assistance. This ensured that US joint ventures were managed well. The US entered into contracts with governments of the third in order to construct expensive projects such as Geo-thermal power plants and ports. Such projects could not yield needed profits without proper management. This is why accountability became a pre-requisite of assistance. The organization was effectively used to further the interests of Americans because US firms took over major investments in Kenya and the whole of East African region after the introduction of SAPs (Stone 349). The third argument claims that developed nations relate with developing co untries in terms of natural resources. It is true that the US and other major powers in the international system are led by their selfish interests not world ideas. The US and other powers have been reluctant to intervene in Somalia militarily because national interests would not be achieved. Somalia does not have oil and gas that may attract foreign powers. This can be compared to the Middle East where each world power is camping there mainly because of oil and gas (Gholz and Daryl 465). The US has been planning to sell military radar to Saudi Arabia mainly to strengthen diplomatic ties. The US would reap maximally from the deal meaning that national interests drive a country to participate in world affairs actively. The US could not intervene militarily in El Salvador to save the lives of many people who were undergoing brutal treatment from an autocratic regime because national interests would not be achieved. The European gas crisis also proves that a state cannot participate in world politics without an interest. In Europe, there are two competing pipelines that is, Nabbuco and Nord. Nabbuco is owned by the Russian government and has a backing of the EU. Britain and the US have been supporting the construction of Nord pipeline because it would benefit them in future.Advertising Looking for essay on international relations? Let's see if we can help you! Get your first paper with 15% OFF Learn More Nabbuco cannot be wrestled from Russia because it is also a major power (Rosato 54). The British government and the US have justified the erection of Nord conduit claiming that Nabbuco cannot effectively supply gas to Europe. Such arguments are based on the Turkish gas conflict where Russia delayed supply because of diplomatic reasons. Critics of realism theory argue that states offer assistance to the needy out of goodwill. This could be witnessed in times of catastrophes where countries in conflicts help each other (Rosato 53). For instance, the US offers humanitarian assistance to some Middle East and Asian states during earthquakes but gets nothing in return. This could be witnessed during the Japanese nuclear accident. The US was in frontline offering technical assistance to Japan. This argument could be valid but the reality is that the US intervenes to further its interests. In the Japanese case, the US intervened to gain political mileage in the world political arena. Hegemo nic powers are strengthened by participating in important events. It can be concluded that national interests drive a state to act in the international system. Constructivists and idealists are misplaced by believing that states act to restore order and justice in trouble regions. Somalia case would act as an example, where major powers are silent because they would not get anything by intervening. Kenya has been forced to intervene militarily because its national security is in danger. Tourists have been abducted more than once, which has greatly affected the tourism industry. It should not be forgotten that Kenya generates more than 20% of the total revenue from tourism. Al shabaab militiamen are therefore a threat to Kenyan interests. Gholz, Eugene and Daryl, Press. Protecting the Prize: Oil and the U.S. National Interest†. Security Studies, 19.3, 2010, 453-485. Milner, Helen. â€Å"Globalization, development, and international institutions: Normative and Positive Perspec tives†. Review Essay, 3.4, 2005, 833-854. Rosato, Sebastian. Europes Troubles: Power Politics and the State of the European Project.† International Security, 35.4, 2011, 45-86. Stone, Randall. How to Reform the IMF†. Current History, 109.730, 2010, 342-348. Wolf, Martin. Why Globalization Works. 1st ed. Sydney: Yale University Press, 2004.

Cairo Capital of Egypt Geography and Facts

Cairo Capital of Egypt Geography and Facts Cairo is the capital of the north African country of Egypt. It is one of the largest cities in the world and it is the largest in Africa. Cairo is known as being a very densely populated city as well as being the center of Egypts culture and politics. It is also located near some of the most famous remnants of Ancient Egypt like the Pyramids of Giza.Cairo, as well as other large Egyptian cities, has been in the news due to protests and civil unrest that began in late January 2011. On January 25, over 20,000 protesters entered the streets of Cairo. They were likely inspired by the recent revolts in Tunisia and were protesting Egypts government. The protests continued for several weeks and hundreds were killed and/or wounded as both anti and pro-government demonstrators clashed. Eventually, in mid-February 2011 Egypts president, Hosni Mubarak, stepped down from office as a result of the protests. 10 Facts About Cairo 1) Because present-day Cairo is located near the Nile River, it has long been settled. In the 4th century,  for example, Romans built a fortress down on the banks of the river called Babylon. In 641, Muslims took control of the area and moved its capital from Alexandria to the new, growing city of Cairo. At this time it was called Fustat and the region became a center of Islam. In 750,  though, the capital was moved slightly north of Fustat but by the 9th century, it was moved back. 2) In 969, the Egypt-area was taken from Tunisia and a new city was built north of Fustat to serve as its capital. The city was called Al-Qahira, which translates to Cairo. Shortly after its construction, Cairo was to become the center of education for the area. Despite Cairos growth,  however, most of Egypts governmental functions were in Fustat. In 1168, though the Crusaders entered Egypt and Fustat was intentionally burned down to prevent the destruction of Cairo. At that time, Egypts capital was then moved to Cairo and by 1340 its population had grown to nearly 500,000 and it was a growing trading center. 3) Cairos growth began to slow beginning in 1348 and lasting into the early 1500s due to the outbreak of numerous plagues and the discovery of a sea route around the Cape of Good Hope, which allowed European spice traders to avoid Cairo on their routes east. In addition in 1517, the Ottomans took control of Egypt and Cairos political power diminished as government functions were mainly conducted in Istanbul. In the 16th and 17th centuries,  however, Cairo grew geographically as the Ottomans worked to expand the citys borders out from Citadel that was constructed near the citys center. 4) In the mid-to late 1800s, Cairo began to modernize and in 1882 the British entered the region and economic center of Cairo moved closer to the Nile. Also at that time, 5% of Cairos population was European and from 1882 to 1937, its total population grew to over one million. In 1952 however, much of Cairo was burned in a series of riots and anti-government protests. Shortly thereafter, Cairo began to again grow rapidly and today its city population is over six million, while its metropolitan population is over 19 million. In addition, several new developments have been built nearby as satellite cities of Cairo. 5) As of 2006 Cairos population density was 44,522 people per square mile (17,190 people per sq km). This makes it one of the most densely populated cities in the world. Cairo suffers from traffic and high levels of air and water pollution. However, its metro is one of the busiest in the world and it is the only one in Africa. 6) Today Cairo is the economic center of Egypt and much of the Egypts industrial products are either created in the city or pass through it on the Nile River. Despite its economic success, its rapid growth has meant that city services and infrastructure cannot keep up with demand. As a result, many of the buildings and roads in Cairo are very new. 7) Today, Cairo the center of the Egyptian education system and there are a large number of universities in or near the city. Some of the largest are Cairo University, the American University in Cairo and Ain Shams University. 8) Cairo is located in the northern part of Egypt about 100 miles (165 km) from the Mediterranean Sea. It is also about 75 miles (120 km) from the Suez Canal. Cairo is also located along the Nile River and the citys total area is 175 square miles (453 sq km). Its metropolitan area, which includes nearby satellite cities, extends to 33,347 square miles (86,369 sq km). 9) Because the Nile, like all rivers, has shifted its path over the years, there are parts of the city that are very close to the water, while others are farther away. Those closest to the river are Garden City, Downtown Cairo,  and Zamalek. In addition, prior to the 19th century, Cairo was highly susceptible to annual flooding. At that time, dams and levees were constructed to protect the city. Today the Nile is shifting westward and portions of the city are actually getting farther from the river. 10) The climate of Cairo is desert but it can also get very humid due to the proximity of the Nile River. Wind storms are also common and dust from the Sahara Desert can pollute the air in March and April. Precipitation from rainfall is sparse but when it does occur, flash flooding is not uncommon. The average July high temperature for Cairo is 94.5ËšF (35ËšC) and the average January low is 48ËšF (9ËšC). Sources: CNN Wire Staff. Egypts Tumult, Day-by-Day. CNN.com. Retrieved from: http://edition.cnn.com/2011/WORLD/africa/02/05/egypt.protests.timeline/index.htmlWikipedia.org.  Cairo - Wikipedia, the Free Encyclopedia. Retrieved from: http://en.wikipedia.org/wiki/Cairo

Manchester City - Management Success Essay Example | Topics and Well Written Essays - 750 words

Manchester City - Management Success - Essay Example As a player, Mancini lifted four Italian Cups, the Serie A (1991 and 2000), the Cup Winners' Cup (1990 and 1999), the Italian Supercup, and the UEFA Supercup and was voted the Serie A Player of the Year and Italian Footballer of the Year in 1997. These achievements clearly manifest his talent and capabilities. However, it was the oddly immense powers that he wielded as a key player at Sampdoria that indicated early that he would get to be an excellent manager. Here Mancini, a 27 year old, often delivered the team-talk, sat on the interview panel for selecting the next manager and was also consulted when selecting the teams’ new kit. In addition to that, he was invited to board meetings and had a say in which players where to be bought by his club during the transfer market (Taylor 2012). This early foray into team management roles gave him a head start as well as helped him build the skills needed to succeed as a football club manager. Working with top clubs requires a manag er who can handle the pressure from the board, fans, journalists and even managers from the opposing teams. Kuper (n.d.) argues that one proven attribute of successful managers is their ability to, in some way for example via the media (Jackson 2012), lower the tension that players feel in each match so that they can be relaxed enough to enjoy the game. His argument was that successful teams are those whose players enjoy the game (Kuper n.d.). The fact that Mancini played at the highest level in football gives assurance to his players that he fully understands what they are going through. Another important trait of Mancini is his ability to not only work with but also bring out the best from his troublesome players such as Carlos Tevez and Mario Balotelli at Manchester City (Walker 2012). Here it would be best to remember that as a player, Mancini was also not the easiest to work with. Taylor (2012) argues that this could have been because he was so repulsed by failure and desperate to the point of having an obsession for winning. Like Mario Balotelli, Mancini was as skillful as he was hot tempered in his playing days. This could be the reason why he is able to work with the talented but difficult soccer players who join the teams that he is coaching. Finally, we believe that the greatest reason why Robert Mancini was selected to manage Manchester City is his track record as a coach. He has brought cup glory for all the clubs where he has coached namely: Fiorentina, Lazio and Inter Milan. In fact, with Lazio and Fiorentina, Mancini managed to create winning teams in spite of the financial constraints that forced him to lose several key players. At Fiorentina he lost Rui Costa and Francesco Toldo at their prime while at Lazio he had to work without the services of Hernan Crespo and Alessandro Nesta. Nevertheless, it was at Internazionale where he proved capable of handling the pressure that come with managing a top club. When the Abu Dhabi United Grou p purchased Manchester City in 2008 there agenda was to raise the club to the status of the other top clubs in Europe. Their strategy was first to attract top talent using their immense wealth, then a top coach and finally win the big trophies locally and abroad. Mancini was an attractive option because at Fiorentina and Lazio he had demonstrated his team-building skills and at Internazionale he proved that he could equally work well with a star-studded team. Furthermore the owners must