Clinical Manifestation Of Osteomyelitis Nursing Essay

Clinical Manifestation Of Osteomyelitis Nursing Essay Osteomyelitis is the inflammation of the bone. This can be due to bacteria, fungi and germs PubMed Health 2012. Bone destruction, necrosis and formation of new bone or also called as involucrum are all features of chronic osteomyelitis. Osteomyelitis are characterised into two types depending where the infection originates. Homogenous osteomyelitis where the culprit of the infection such as bacteria, fungi or germs enters the bone through the lymphatic and circulatory systems and lodged in the small vessels, causing blockage in the bone. The bone will deprived of oxygen supply that causes thrombosis, ischaemia and eventually the bone will die, known as sequestrum (Marek 2007). The characteristic of bone inflammation is the accumulation of fluid, increased vasculature and leukocytes in the area. Bones caniculi will be sealed by exudates through the metaphysis, bone marrow cavity and into the cortex. As a result, this will lead to the formation of new bone by osteoblast, known, as invo lucrum. The infected materials escape through the opening of the involucrum into the soft tissues. The infectious materials will weaken the cortex of bone making it more prone to fracture (Marek 2007). Exogenous osteomyelitis is the infection starts at the soft tissues affecting the muscles and connective tissues that lead to the formation of abscesses oedema or this is known as Brodies abscesses (Marek 2007). Clinical Manifestation of Osteomyelitis The clinical manifestation of osteomyelitis generally includes general malaise or weakness, headache, anorexia and fever. The site of infection will exhibit redness, swelling, warm to touch, tender and usually contains purulent material (Marek 2007). The high dose intravenous antibiotic treatment for Mr. Andrews of three to eight weeks is necessary to kill the causative agents of the infection and prevent its reoccurrence (Marek 2007). What is PICC and the complications associated with the device? Peripherally inserted central catheter or PICC is a soft, long plastic tube inserted into the superficial vein proximal to the basilic or cephalic vein. The PICC is place for medication treatment such as antibiotic, chemotherapy and total parenteral nutrition (TPN) (California Pacific Medical Center 2012). Complications of the PICC are includes infection, occlusion, thrombosis and air embolism. Infection usually occurs either inside or on the insertion site. The area becomes swollen/tender, red and fever. The PICC line should be plush before and after the procedure to ensure patency of the line thus, preventing blood clot or thrombosis. The line should remained clamped and close after being used to prevent air from entering into the system (Erickson Field 2007). What information should be included in the nurses documentation of the dressing change? When changing the dressing the nurses should observe for signs and symptoms of systemic infection such as redness and swelling or any abnormalities on the surrounding area (Monahan et al 2007, p 1592). The documentation should include the date and time of dressing change, appearance of the wound or infection site, may take a photo of the infection or trace the wound using tracing paper. The location of the infection should be documented, any signs of granulating tissue or presence of slough material, purulent discharge and its amount and ask for patient of any pain around the site. What observations should be noted related to the exudates collected in the haemovac? The exudates collected in the haemovac should be noted. The amount or volume, color, odour and consistency should all be documented on the wound chart. The new data collected should be compared from the previous data to ensure that the wound discharge is decreasing. If not, the wound is not probably healing and infection is still going on. In this case, this should be reported to the doctor. Each of the medication below is prescribed for Mr. Andrews. For each provide the therapeutic drug classification and discuss the purpose of the medication for Mr. Andrews and potential adverse effect(s) that the nurse should monitor. Linezolid (Zyvox) oral is an antibacterial agent that inhibits the protein synthesis of the bacteria. This drug is use to treat infection on Mr. Andrews hip (Tiziani 2010, p 129). Some of the adverse reaction includes lactic acidosis, nausea and vomiting and low level of bicarbonate. If patient experience recurrent nausea and vomiting this should be reported to the doctor immediately (McKinnell, Jr. nd). Enoxaparin (Clexane) sub-cut is an anticoagulant medication use to prevent the formation of clot. This is usually given to patient after surgery and bedridden patient (Tiziani 2010, p 137). Patient should be monitor for any sign and symptoms of bruising or pain on the site, bleeding, haematoma, difficulty breathing or anything that is unusual (Tiziani 2010, p 138). Docusate Sodium (Coloxyl with Senna) oral is a laxative drugs use to prevent constipation. Mr. Andrews may experience constipation as a side effect to pain medication. This drug is given to alleviate restraining during defaecation . Some of the common side effects of the drugs includes: nausea, abdominal bloating and flatulence (Tiziani 2010, p 612). Tramadol hydrochloride (Tramal) oral- is a synthetic opioid analgesic for the treatment of pain. The adverse effects of the drug include nausea, anorexia, constipation, vomiting, dry mouth and many others. Important nursing consideration to consider if given to patient is to ensure that the patient will not develop dependency on the drugs Tiziani 2010, p 655). This drug will help alleviate Mr. Andrews pain due to surgical incision from his hip infection. Paracetamol (Panadol) oral is an analgesic and anti-pyretic medication. It is a short acting pain relief drug that is usually given in conjunction with slow release pain medication such as Tramadol. Avoid using with other Paracetamol drugs to prevent overdose and liver problems. Monitor patient for sign of overdose like nausea, lethargy, abdominal pain, hypotension, sweating and hypoglycaemia (Tiziani 2010, p 11-12). Conclusion If a wound is not looked after it can become a serious illness and even cause death. Osteomyelitis is one of the serious complication related to surgery, it is really a nasty disease that could paralysed or killed someone if left untreated. A proper monitoring and right treatment of the disease is the key to managing and controlling the adverse possible complication osteomyelitis can bring. The drugs used to treat the infection, surgery to the removed the dead tissues, maintaining aseptic technique during wound dressing and proper monitoring and documentation of the wound are essentials to keep the wound healed. There are also some important things to consider in giving the drugs to the patient to ensure that the drugs effectively does its intended job and there should be no major side effects to the patient.

Brrokstone’s business Essay

Brookstone is a nationwide specialty retailer that sells a variety of consumer products with distinctive function, excellent quality and design, which are not available in other retailers. The company develops strong positioning as a specialty retailer selling the â€Å"hard-to-find tools† in Popular Mechanics Magazine in 1965. The main concerns of Brookstone is to provide customers with the quality of products and quality of services, which served by the quality of people. The company first catalog is printed in black-and-white in the 24 pages that present the detailed and no-nonsense information regarding the product features, materials, measurements, capabilities, and any other useful information to guide customers in buying the suitable products for them (Brookstone, 2009). The successful catalog-type company has encouraged Brookstone to open their first retail store in Peterborough, New Hampshire. Right now, the company is headquartered in Merrimack, New Hampshire, which backed up by vast distribution center and customer service department that handle mail and telephone orders that located in Mexico, Missouri (Brookstone, 2009). The company also has over 305 retail stores within the United States and Puerto Rico. Mostly, the retail stores are located in leading shopping malls, the nation’s busiest airport, and lifestyle center. In order to cope with the demands, the company, on average, opens 10 to 15 new stores each year (Brookstone, 2009). As a catalog company, Brookstone employ a multifaceted Direct-Marketing approach by using two catalogs and Internet operation (www. brookstone. com) to help boosting the orders. The two catalogs are Brookstone catalog and the Hard-to-Find Tools catalog. The Brookstone catalog presents the branded products that available at stores and merchandise from key vendors of Brookstone. Meanwhile, the Hard to Find Tools catalog features customers with high-quality and unique solutions for the home. In addition, the corporate website (www. brookstone. com) acts as the combine catalogs that features all offering that placed in the two printed catalogs. Figure 1 shows the current offering in the corporate website. Figure 1 Brookstone corporate website Source: www. brookstone. com 1. Market Attractiveness Assessment 1. 1. Environment Overview Qatar is actually the country who has the highest per-capita income in 2007. This however, was effect of its overwhelming petroleum resources. Its high level of income nevertheless, has been influencing other aspects of people’s lives also. In this chapter, I will display short elaboration on several aspects of Qatar’s environment. 1. 1. 1. Political Environment Qatar is a politically active nation. The country is home to many Islamic activist and pro-Islamic views. Country officials however, refused to the confirmed of any connections with terrorist groups. Nevertheless, the country maintained very good relationship with the US government. The country is home to the largest US airbase in Middle East, outside of Iraq and it also support a US Naval base. The country has a large magnitude of gas projects, converging with Exxon Mobil and Royal Dutch/Shell. These businesses significantly enhanced Qatar’s importance to the vital Western Political interests and also economic interests. Many have said that Qatar’s ‘balancing’ political and economic programs are actually quite difficult to understand. However, analysts have also understood that this willingness to court both sides aggressively has given the country such a high political and economic profile compared to other nations in the Middle East. Despite the bomb attack that happened in 2005, Qatar’s political atmosphere is actually conducive for business. It is revealed that there are no ruling families holding control of the political activities, even though conservative elements of the society are still unease with recent foreign policy changes which have brought thousands of foreigners into the country. We should hold in our understanding however, that Qatar is still a eforming country. One of the good signs of positive developments is that the ruler of the country has been actively encouraging education and open political debates as key elements of his reform strategy. The latest banking environment also reveals that the country in overall, enjoy stable political conditions.

Negative And Negative Impacts Of Bullying Essay - 951 Words

Prevalence The nature of bullying presents some challenges to accurately determining either its prevalence or severity. Both the positive and negative social interactions of school aged children may be misinterpreted by peers or by education professionals. Additionally, victims and perpetrators of bullying may be less likely to provide truthful responses to research inquiries out of fear of retaliation from peers or school personnel. In spite of these challenges, numerous recent studies on bullying have produced fairly consistent results that may point to an accurate baseline of bullying activity. Several studies demonstrate that bullying continues to be a significant issue for both primary and secondary schools (Casebeer, 2012; Low et al., 2014; and Veenstra, Lindenberg, Huitsing, Sainio, Salmivalli, 2014). 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Love in The Yellow Wallpaper, Hlls Like White Elephants,...

Love in The Yellow Wallpaper, Hlls Like White Elephants, and A Dolls House True love is the love that everyone fantasizes about. It is the love that is unconditional and everlasting. Love is very hard to define since everybodys concept of love is different. However, in order to achieve a good relationship, people must have a well balanced power structure in their relationship, and good understanding and communication between them. In the stories, The Yellow Wallpaper,; Hills Like White Elephants,; and A Dolls House,; one could see the lopsided relationship between the males and females. In these stories the males predominates the females, and the characters seem to lack understanding, and communication toward another,†¦show more content†¦She is just trying to do what he wants to do, to please him, even though she does not like it. He says that, Its really an awfully simple operation#8230;not really an operation at all.; He does not know the feelings and pressure that the girl is under, and not being the person who has to have the operation, he cou ld say that easily. However, if he really cared about her, he should listen to her inner thoughts. There should be a more serious and honest conversation between these people. The girl should not compromise if it bothers her, and she should clearly state what she thinks. What the girl wants is not the sweet words such as, I love you now,; or I care about you,; but real action where he shows his caring and loving by truly understanding her. We also see a misunderstanding and unbalanced relationship in the story The Yellow Wallpaper,; by Charlotte Perkins Gilman. In this case, the main characters are husband and wife. The wife has a temporary nervous depression and is repressed by her whole surroundings. First of all the room she has to stay is very confined having bars, and has little funiture and ugly wallpaper. She is left in the room by herself during the day, while her husband is at work. Her husband and her brother are physicians who are highly educated, and whatever they say seem right. The housekeeper also, who is her sister-in-law is a perfect housekeeper which gives comparison with the wife who is