...will be applied to the essay to facilitate critical thought, relating theory to practice where the model allows. Discussion will include the knowledge underpinning practice and the evidence base for the clinical skill. A conclusion to the essay will then be given which will discuss my reflection skills, acknowledge my competence and show my personal and professional development. The clinical skill I have chosen to reflect on within this essay is the administration of Intramuscular (IM) injections. I have chosen this as within my first clinical placement this was a widely used method of drug administration and I became involved in the process of IM injections. I therefore researched the topic of IM injections and my knowledge within this area developed. The first stage of Gibbs (1988) model of reflection requires a description of events. I was asked to administer a drug to a patient via IM injection. I had observed this clinical skill on a variety of occasions and had previously administered an IM injection under supervision. On this occasion I was being observed by two qualified nurses, one of which was my mentor. The drug had been drawn up and was ready to be administered and the patient consented to have a student administer the injection. My mentor was talking me through the procedure step by step and informed me that I should use an alcohol wipe to cleanse the injection site, when the other nurse interrupted and said that this...
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...Diese Arbeit ist unter Zugrundelegung der konventionellen deutschen Rechtschreibung erstellt. Alle Zitate aus Büchern, Zeitschriften, Zeitungen, elektronischen Medien wurden orthographisch und grammatikalisch unverändert übernommen. Alle Teile dieser Arbeit sind urheberrechtlich geschützt, alle Rechte liegen beim Autor, sofern (z.B. bei Abbildungen) nicht ein anderer Rechteinhaber genannt ist. Jede (Teil)Veröffentlichung, Speicherung in elektronischen Datenverarbeitungseinrichtungen oder ähnliche Verarbeitung darf nur nach schriftlicher Genehmigung des Autors erfolgen. Dies beinhaltet ausdrücklich auch die Verbreitung über das Internet. Verwendete Produktnamen, Warenzeichen und geschützte Warenzeichen sind im Besitz ihrer jeweiligen Eigentümer; sie werden ohne Gewährleistung der freien Verfügbarkeit benutzt. produktionserweiternde Hilfsmittel Musik: Bronski Beat: „Why“; Georgette Dee & Terry Truck: „Nochmal mit Gefühl“; Sono: „Keep Control“, Technasia: „Force“, Andeas F.: „Science Fiction“, Daft Punk: „Discovery“ sowie die mp3-Livestreams ska*anarchy und philosomatika.net Drogen: frische Erdbeeren, Currywurst ohne Darm mit Pommes/Mayo, Oi-Zigaretten hoch oben auf dem Kreuzberg, der Blick über den Hamburger Hafen, Kaffee, Bailey’s, der Himmel über Berlin und 1275 mg Johanniskraut täglich spezieller Dank an: Klaus Farin und das „Archiv für Jugendkulturen“, Frank aus Guben (Es sollte nicht sollen sein!), Markus aus FFM, Frank und Max aus Kreuzberg 36 für ganz viel Zuversicht...
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...good example of an intradermal injection is a PPD test. 3. Drugs applied directly on the skin are administered via the topical route. 4. Drugs applied topically to the skin or mucous membranes exert a local effect 5. Drugs that distribute throughout the body exert a systemic effect. 6. Drugs that come as an emulsion must be shaken well before administration. 7. An enteric coating resists the acid environment of the stomach. 8. A solid drug dispersed within a liquid is called a suspension. 9. Administration of a drug into the cerebrospinal fluid (CSF) uses the intrathecal route. 10. Sublingual tablets are placed under the tongue. 11. A tablet placed between the cheek and gum in the mouth is an example of buccal administration. 12. A drug compressed or molded into a specific shape is called a tablet. 13. An intravenous drug is administered directly into the bloodstream. 14. A sustained release tablet is formulated to release a drug slowly over an extended period. 15. A drug encased in a hard or soft gelatin container is known as a capsule 16. A syrup is a concentrated solution of sugar in water. 17. The technique of instilling drugs into a muscle uses the intramuscular route. 18. An IV push medication is administered over a few minutes, whereas a/an IV piggyback medication is administered over 20 to 60 minutes. 19. Subcutaneous drugs are administered under the skin into the fat and connective tissues. 20. Drugs administered into a joint space are called...
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...That means I’m an angel doomed to this earth You can trap my body, but I will free this verse Beat Drop Verse 1 I will rip you apart with my fucking heart I mean my fucking art, call it hip hop, It makes my heart stop and do a flip flop When I hear that verse that gives me chills Like AB soulo when he spitting that real Look our government on some other shit Like exploit the poor and get rich off the shit I got this beat from King Tip, call me Queen Bri Born in the south, disguised in poverty That mean we run our mouth, no more slavery You can trap me physically, but my mind been free I put a knife in your gut just to shut you up Your rhymes are obese, my rhymes are super fit My lines win the race and you just need to quit Im Eating vegetables so my wallet don’t get sick That mean my money green and its really long You can Call me daddy long legs cz I’m 5’9, And look I’m fine without 9n’s Stepped on the scene looking like top model Body slim, shaped like a diet coke bottle That means I’m a size three, like my three eyes see My mind is 360, you can’t fuck with me All these fake emcees spitting they debris Making my nerves itch, call is nervous fleas The knowledge I spit will need a decree And after my thesis you will earn a degree Now your soul has been set free, by Queen Bri And You been educated by one of the greatest And I’m still an underdog, haven’t even made it But I’m on some other shit like Kendrick said Fuck the government Verse 2 ...
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...The first type of parenteral route of drug administration involves subcutaneous injection, which is given in the fatty layer of tissue under the skin where the hypodermis lies (Bethesda, 2015). The equipment required for this particular method of injection includes gloves, alcohol pads, sterile 2 x 2-inch gauze pads, container for syringe disposal, medication log, syringes, and 25-gauge needles (Bethesda, 2015). 27-gauge needles may be used depending on the amount of medication to be administered and the weight of the patient while 31-gauge needles may be necessitated for those who are visually impaired or for those who only require a relatively small dosage (Bethesda, 2015). Before preparing to administer the injection, health professionals...
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...“Safety is our number 1 priority” Director “Okay, okay, lets go over a few rules. Listen and be very careful. This is a great lake and you will definitely have a good time. Some important things to remember are: to keep out of direct sun as much as possible. Everyone must use sunscreen. Sunscreen lotion not only aids our sebaceous glands by providing moisture to the skin and hair, this also prevents you from being overexposed to sun which can burn your skin if not protected. Also, make sure you are drinking plenty of fluids, especially water. This prevents you from overheating yourselves. Last but not least, while we are all here to have fun, when you are in the canoes, whatever you do… Do not fall into Canoe Lake, there are harmful bacterias that live in there. 8th grade kids “Okay, okay, we will be careful!” Scene#2 Lake Narrator Boy and girl run and grab their canoes. They are having small talk while in their canoes. They begin to play around splashing water and 8th grade girl trips 8th grade boy’s canoe over.... Director "Hurry and get out of there!" 8th grade boy "I cut my foot! Oh my gosh...Im gonna die!" Director "Lets get you to the nurse" 8th grade boy (Crying)...
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...sense to me and yet society loves to live with stereotypes, She writes about how White society seems to think we didn't exist before the big Latin explosion on the pop culture in the 90s, and since then they just sees us with stereotypes that oppressed the Latino population for example, She talks about how, Debrahlee Lorenzana, was fired because her male colleagues and supervisors believed she was too distracting at the office. this is one of many Latinas women that have been negatively affected by their imagined sex appeal that the media gives to Latinas women. As a Mexican women I can say Im nothing like the media would portrait a 20 year old Latina, Im the definition of petite, small body small boobs and a not that bad bump but Im definitely not a curvaisouse women, I have light skin Im almost pale, and have green eyes, I do have an accent ( I mean I was raised speaking Spanish how Im supposed not to) but I defiantly not have a thick sexy accents like Latinas on tv...
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...Clinical guidelines Diagnosis and treatment manual for curative programmes in hospitals and dispensaries guidance for prescribing 2010 EDITION © Médecins Sans Frontières – January 2010 All rights reserved for all countries. No reproduction, translation and adaptation may be done without the prior permission of the Copyright owner. ISBN 2-906498-81-5 Clinical guidelines Diagnosis and treatment manual Editorial Committee: I. Broek (MD), N. Harris (MD), M. Henkens (MD), H. Mekaoui (MD), P.P. Palma (MD), E. Szumilin (MD) and V. Grouzard (N, general editor) Contributors: P. Albajar (MD), S. Balkan (MD), P. Barel (MD), E. Baron (MD), M. Biot (MD), F. Boillot (S), L. Bonte (L), M.C. Bottineau (MD), M.E. Burny (N), M. Cereceda (MD), F. Charles (MD), M.J de Chazelles (MD), D. Chédorge (N), A.S. Coutin (MD), C. Danet (MD), B. Dehaye (S), K. Dilworth (MD), F. Fermon (N), B. Graz (MD), B. Guyard-Boileau (MD), G. Hanquet (MD), G. Harczi (N), M. van Herp (MD), C. Hook (MD), K. de Jong (P), S. Lagrange (MD), X. Lassalle (AA), D. Laureillard (MD), M. Lekkerkerker (MD), J. Maritoux (Ph), J. Menschik (MD), D. Mesia (MD), A. Minetti (MD), R. Murphy (MD), J. Pinel (Ph), J. Rigal (MD), M. de Smet (MD), S. Seyfert (MD), F. Varaine (MD), B. Vasset (MD) (S) Surgeon, (L) Laboratory technician, (MD) Medical Doctor, (N) Nurse, (AA) Anaesthetist-assistant, (Ph) Pharmacist, (P) Psychologist We would like to thank the following doctors for their invaluable help:...
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... Unit/Room No. A735 Age 64 years old Gender F Ethnicity Black Religion Baptist Marital Status Widowed Occupation Unemployed Date of Admission March 31, 2011 Admitting Problem/Diagnosis Unstable Angina Chief Complaint (Why did the patient come to the hospital – in patient’s own words) “My chest was constantly hurting and I couldn’t figure out what was causing it and now my back is killing me.” Past Health History Asthma ________ Emphysema _______ Bronchitis ________ Pneumonia ________TB________ Angina ______ MI ______ Anemia ______ Hypertension _______ Rheumatic Fever _______ Pacemaker _______ Peripheral Vascular Disease _________ Blood Disorders _________ Stroke _________ Skin Disease ______ Bladder Infections _Kidney Disease ___________ Ulcers ________ DM _________ Dental Problems _________ Fractures _________Congenital Heart Defects Surgeries Family Health History Condition Family Members Condition Family Members Heart Disease Mom died of heart attack Tuberculosis Hypertension Asthma Stroke Mental Illness Diabetes Alcoholism Cancer Aunt died of mylethoma Kidney Disease Other Health Problems in Family: _________________________________________________________________ Medications Prior to Admission: (List) Prescription: She only takes aspirin and pain medications, but...
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...When Jefferson wrote “Good by mr wigin tell them im strong tell them im a man” (Gaines 234), this was the point when Jefferson finally believed that he was a man again and got his manhood back. This quote also proves my thesis by showing how much it took for Jefferson to get to that point. It took several visits and an abundance of encouragement and advice just to get Jefferson to be comfortable and confident in his body again. All of the harsh discrimination and racism that black people had to endure was not easy to shake off—it creates an emotional toll. The fact that Jefferson was able to overcome this emotional toll exemplifies that it is possible to regain self-confidence, even in times of turmoil, but it also displays how long it can take to regain...
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...Bruno Mars Watching Her Move lyrics She Got It She Looking Good Im Just Watching Her Move She Walks On In With Her Retros On Her Lips As Bright As The Sun Her Curves Goes Every Which Way Got Skin Like Porcelien The Way Her Hair Falls Down Her Back Billy Accents Her Tattoo? (Are You Talking To Me?) The Way Her Hair Falls Down Her Back Billy Accents Her Tattoo? (Are You Talking To Me?) Her Legs like A Supermodel She Worn For Them High Heel Boots She Got Every Single Guy In The Club Just Watching Her Move And She Dont Wanna Dance With Anyone Let Her Do What She Do She Got Every Single Guy In The Club Just Watching Her Move And She Dont Wanna Dance With Anyone Let Her Do What She Do Just Watch Her Get It (Get It...) Just Watch Her Move She Pulls Me To The Side Tells Me She Wants To Go I Say Girl Im Yours Tonight After This Im Taking You Home First And For Most I Dance With You Get You In The Mood Maybe Later Baby Girl Ill Show You Exactly How I Do She Got Every Single Guy In The Club Just Watching Her Move And She Dont Wanna Dance With Anyone Let Her Do What She Do She Got Every Single Guy In The Club Just Watching Her Move And She Dont Wanna Dance With Anyone Let Her Do What She Do Just Watch Her Get It (Get It...) Just Watch Her Get It (Get It...) God Baby You look Goood You Sexy Watch Her Move Watch Her Move She Got Every Single Guy In The Club Just Watching Her Move And She Dont Wanna Dance With Anyone Let Her Do What She...
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...potential tissue damage, or described in terms of such damage * NOCICEPTIVE: activation of normal pain fibres in response to a noxious stimulus (e.g. injury, disease, inflammation); may be somatic (e.g. involving superficial structures such as skin and muscle) or visceral (e.g. involving deeper organs such as liver, pancreas) * NEUROPATHIC: injury or disease affecting the peripheral (e.g. diabetic neuropathy, phantom limb) or central (e.g. spinal cord injury, post stroke) nervous system or both (e.g. postherpetic neuralgia) * MIXED NOCICEPTIVE/NEUROPATHIC: e.g. cancer some cancer-related pain * BREAKTHROUGH PAIN: occurs between regular doses of an analgesic and reflects an increase in the pain level beyond the control of the baseline analgesia. This may just be an occasional natural fluctuation in pain or, if frequent, reflect inadequate baseline analgesia or management * INCIDENT PAIN: occurs with, or is exacerbated by, physical activity or an event such as a wound dressing. Inadequate stabilisation of a fracture or cough can also cause incident pain Classification of pain: | Nociceptive - superficial somatic | Nociceptive – deep somatic | Nociceptive – visceral | Neuropathic | Origin of stimulus | Skin, subcutaneous tissue, mucous of mouth, nose, sinuses, urethra, anus | Bones, joints, muscles, tendons, ligaments, superficial lymph nodes, organ capsules an mesothelial membranes (pleura and peritoneum) | Solid or hollow organs, deep tumour masses...
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...School nurse – kirsty Student -Jessica J : hi miss im here to ask a few questions about a balanced diet , I think I don’t have the correct diet needed K: that’s fine just sit down and I will explain everything about a balanced diet , firstly a balanced diet is having all the right amounts of food from the food groups Do you know the food groups ? J : yeh but I don’t really know the benfits of having them . K: that’s okay , the benefits of having carbohydrates is that is provides energy , prevents, controls your weight , carbs are whole grains , some sugars and starch and fibre , you should have 33( in your meal . J: oh so carbohydrates are good what food will I get carbs from ? K: bread , pasta , limited amount of sugars , cereal , flour , potatoes if oyu decide to eat the naughty foods like fizzy drinks , dougnuts these are the ones which don’t have good carbs ,if you don’t have enough carbs your energy will be very low s carbs keep you fuller for longer which means no snacking . J: that information is helping , whats vitamins ?. K: vitamins is in fruit and veg , the vitamins are vitamin K, vitamin A and vitamin C. J: what are the benefits of having vitamins ? K: the benefits of having vitamin C is that it maintains healthy gums , vitamin K is essential for blood clotting while vitamin A maintains healthy skin , we get our vitamin C from citrus fruit like lemons , we get vitamin K from our leafy green vegetables while we get vitamin A...
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...lives with his daughter Claudia in her home. Claudia and her two brothers visit Mr. Gordon daily since he has been hospitalized. Mr. Gordon has not been eating well since the surgery and has lost 3 pounds. Mr. Gordon has type 2 diabetes and is on oral antihyperglycemic medication. Before he came to the hospital, Mr. Gordon was able to only ambulate for short distances. He has orders to get up in a chair twice a day. Joan, a student nurse, is caring for Mr. Gordon this morning. She has reviewed his medical record and is now ready to start caring for him. Joan assesses Mr. Gordon using the Braden Scale and determines that his score is 12. What does this score indicate about Mr. Gordon’s pressure ulcer risk? Joan is assessing Mr. Gordon’s skin and notices that he has a 3 cm blister and a shallow crater on his buttock. Mr. Gordon winces when Joan palpates the area. How should Joan stage this area? A. Stage I pressure ulcer B. Stage II pressure ulcer C. Stage III pressure ulcer D. Stage IV pressure ulcer Rationale: Mr. Gordon has drainage coming from his surgical incision, and his dressing needs to be changed. What assessments of the incision should Joan perform while changing? Answer: Rationale: Claudia asks Joan what she can do when she takes him home to help prevent more pressure ulcers. How should she answer? Answer: Rationale: Elvis Baker, a 65-year-old black male, is being admitted to the preoperative suite for a colon resection for removal of...
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... INTRO:C G Am F (PLUCKING) C G No Im never gonna leave you darling Am No Im never gonna go regardless F Everything inside of me is leaving in your heartbeat C G Even when all the lights are fading Even then if your hope was shaking Am F Im here holding on [Chorus:] C Am Dm I will always be yours for ever and more F G For the push and the pull C Am I still drown in your love Dm And drink till Im drunk F And all that Ive done is it ever enough C F VERSE 2 C G Im hanging on a line here baby I need more than ifs and maybes Am ...
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