Chest Pain Case Study

Chest Pain Case Study Ebunoluwa Mikiie Chest Pain There are various Chest pains. Chest pain may be caused by gastrointestinal, respiratory, cardiac or musculoskeletal analysis. Chest pains may also be caused by anxiety, pericardium, myocardium, parietal pleural, aorta, esophagus, Chest wall, trachea and large bronchi, skin, and musculoskeletal system. As a nurse, I must carefully assess by asking questions, such as Location: where do you feel the pain in your chest? Onset: when did the pain begin? Duration: Does it happen with breathing? Is it nonstop or comes and goes? Associated manifestation: what else is experienced with the chest pain? Characteristics: describe your pain? Treatment: have you seen anyone or tried any medication? Relieving factors: does anything make it better (Nursing Guide)? Anxiety procedure is not clear. It is located below the left breast or across the anterior chest. The quality of pain is stabbing, sticking, dull or aching. Its severity is varying. It can be from hours to days. Symptoms are shallow breathing, anxiety, weakness and palpitations. Aggravating factor may be emotional stress. A relieving factor is unknown (Nursing Guide). Pulmonary: Tracheobronchitis is Inflammation of the trachea and bronchi, and is located at the on both sides of the sternum or at the sternal. The quality of pain is a burning sensation, severity, mild to moderate. The timing is variable. Aggravating factor is coughing, and relieving factor is lying on the affected side (Nursing guide). Pleuritis Pain: Inflammation of the parietal pleura as in pleurisy, pneumonia, pulmonary infarction or neoplasm, located at the chest wall. The quality of pain is sharp and can hurt like a knife with severe pain. Aggravating factors are inspiration, coughing and movements of the trunk, and relieving factors are medication and treatment. Its timing is persistent (Nursing Guide). Cardiovascular: Angina Pictoris: Temporary myocardial ischemia, usually secondary to coronary atherosclerosis, located at the anterior chest that sometimes radiates to the shoulder, arm, neck, lower jaw or upper abdomen. The quality of pain is pressing, squeezing, tight and heavy with occasional burning. The severity is mild to moderate; this is sometimes perceived as discomfort rather than pain. Its timing is usually 1-3 minutes but up to 10 minutes, prolonged episodes are up to 20 minutes. Association symptoms are dyspnea, nausea and sweating. Aggravating factors are exertion in the cold, meals, emotional stress, it sometimes occurs at rest. Relieving factors are rest and nitroglycerin (Nursing Guide) Myocardial Infarction: This is prolonged myocardial ischemia, and results in irreparable muscle damage and/or necrosis. It is located at the anterior chest that sometimes radiates to the shoulder, arm, lower jaw, neck or upper abdomen. The quality of pain is like angina. Myocardial Infarction is often but not always a severe pain, with a timing of 20 minutes to several hours. The relieving and aggravating factors are unknown (Nursing Guide). Pericarditis: Irritation of the parietal pleura, adjacent to the pericardium. It is located at the precordial space and could radiate to the tip of the shoulder and the neck. The quality of pain is also sharp and knife-like and also severe with persistent timing. Aggravating factors are breathing changing position, lying down, swallowing and coughing. A relieving factor is sitting forward (Nursing Guide). Gastrointestinal: Reflex Esophagitis: Inflammation of the esophageal mucosa by reflux of gastric acid. It is located retro sternal and may radiate to the back. Its severity is mild to severe with variable timing. The quality of pain is burning and squeezing sensation. Aggravating factors are eating large meals, lying down, and also bending over. Relieving factors are antacid and sometimes belching. Associated symptoms are regurgitation and dyspnea (Nursing Guide). Chest wall Pain: The progression is not always clear, it is frequently found along the costal cartilages or below the left breast. The quality of pain is aching, dull, stabbing, or sticking. Its timing can be from hours to days and has variable severity. An associated symptom is a local tenderness. An aggravating factor may be movement of arms, trunk and chest. Relieving factor is unknown (Nursing Guide). Assessment SOAP note on two individuals adults. The first individual has a history of high blood pressure; he is taking his blood pressure medication regularly. The second individual has a history of diabetes; he exercise regularly and eat healthily, but is concerned that his lifestyle change is not apparent in weight loss outcome. A general assessment was done on both patients, but focused area was done on the upper and lower extremities for skin turgor, color temperature and capillary refills. Patient one: Mr. J.M. is a 49-year-old white male, a car salesperson. He was born in Georgia. Subjective: Mr. J.M. has a history of High Blood Pressure. Mr. J.M. said that he has been taking atenolol 25mg once a day by mouth for one year, and has no negative effect from it. He rated his pain scale as 0/10 (0-10 pain scale). He said he was concern about having a heart failure form cardiac issues from stress due to the nature of his job. Objective: Vital Signs, temperature 98.4, pulse 77, respiration 18 and blood pressure 130/80. Head, eyes and nose appears normal no pallor noted. Skin turgor normal and elastic, no signs of dehydration or excessive dryness noted. Color fair, normal for race, no change or abnormal pigmentation observed. Skin is warm and dry to touch (using the back of my hands). Capillary refills in upper and lower extremities of nail beds less than 2 seconds. Respiration clear, no, wheezing or shortness of breath or noisy breathing noted. Lung sounds auscultated, clear bilaterally at anterior and posterior lower and upper lobes. Normal breath sounds, soft and low pitch over most of both lungs, equal expiratory and inspiratory sounds. Irregular breath sounds will necessitate instantaneous care. No adventitious breath sounds such as crackles, wheezes or rhonchi noted. Heart sounds auscultated, normal S1 and S2 noted. These areas were palpated, brachial pulse found at the inner aspect of the elbow; it i s also a regular site use to obtain blood pressure measurements. The radial pulse is located at the thumb site of the wrist, the popliteal pulse at the back of the knee, the femoral pulse is located in the groin region, the dorsalis pedis pulse at the top of the foot, the posterior tibial pulse at the lower side at the inner aspect of the ankle. It is to locating these sites are imperative because they are necessary pressure points in case of severe bleeding. The amplitude of the pulses compares equitably, when the pulses were palpated (www.nursing times.net). Abdomen is soft and non-tender, and the bowel sounds active in all four quadrants, with active range of motion (ROM) noted in bilateral upper and lower extremities. Diagnosis: Knowledge deficit related to signs and symptoms of heart failure as evidence by patient’s concern of stress and impending heart failure. Blood pressure within normal range. Plan: Encourage Patient to continue taking his medication, increase water intake to at least eight glasses per day, decrease additional salt intake to help maintain normal blood pressure. Patient to continue daily exercise. Encourage patient to keep physician appointment. Routine laboratory test include complete blood count (CBC), urinalysis, thyroid panel, chemistry panels, thyroid panel, blood urea nitrogen (BUN), glucose check, and white blood count (WBC). Patient 2: Mr. J.J. is a 40-year-old African America male, businessperson. He was born in Georgia. Subjective: Patient came into the clinic with concern of not able to see the resulting exercise with his weight, change in diet. Patient associated his not being able to loose with his history of being a diabetic for over three years. He said that currently he takes metformin 1000mg twice a day by mouth. Patient denies any pain at this time. Objective: Vital Signs, temperature 98.6, pulse 84, respiration 20 and blood pressure 127/76. Blood sugar 115 mg/dl. Weight 200 pounds. Head, eyes and nose appears normal. Skin turgor normal and elastic, no signs of dehydration or excessive dryness noted. Color appropriates to ethnicity, no pallor noted, no change or abnormal pigmentation noted. Temperature of the skin is warm to touch. Capillary refills in upper and lower extremities nail beds less than 2 seconds. Respiration clear, no shortness of breath, wheezing or noisy breathing noted. Lung sounds auscultated, clear bilaterally at anterior and posterior upper and lower lobes. Normal breath sounds noted. No crackles or wheezes or rhonchi. Heart sounds auscultated and normal. These areas were palpated; brachial pulse establish at the inner part [tm1]of the elbow. Radial pulse found at the wrist. Femoral pulse found in the groin area. Popliteal pulse found at the back of the knee, the dorsalis pedis pulse found at the top of the f oot, the posterior tibial pulse found at the lower side at the inner aspect of the ankle. The amplitude of the pulses compares equitably, when the pulses were palpated (www.nursing times.net). Abdomen soft and non-tender, bowel sound noted in all four quadrants, active range of motion noted in bilateral upper and lower extremities. Diagnosis: Non-reassuring weight loss related history of diabetes. GLucose 115mg/dl before food. Plan: The patient should be congratulated on taking steps to live a healthy life. I would encourage the patient to continue his exercise and include exercises to target specific areas he wants to loose. I would encourage him to continue with his medication regimen and continue with his healthy lifestyle change to help with his medication. Routine laboratory test: Glucose (hemoglobin A1C); thyroid panel; white blood count (WBC); blood urea nitrogen (BUN); complete blood count (CBC). [tm1]

Prosecuting Arguments

Prosecuting Arguments A prosecutor's duty is to defer and produce evidence of the crime at hand to the judge and jury so that they can decide an appropriate sentence. According to the case of State v. Stu Dents, there are several charges against the defendant which range from moderate to severe. These charges include homicide, assault of a police officer, kidnapping, burglary, and crimes related to drugs. The prosecution must attempt to provide accurate evidence to prove the charges against Stu Dents.During this trial, the prosecution will evaluate the laws and statutes of Hawaii, Virginia, Arkansas, North Carolina, and Pennsylvania to determine which state the case is the strongest. The prosecution will examine each of these states thoroughly to provide a better understanding of the charges, which will provide a guideline in determining the best sentencing alternatives. Facts and Elements The prosecution must establish the facts and elements of each crime to prove a defendant's guil t. The elements of crime are the basic components of the crime, and the essential features of that crime specified by law or statute.These elements include actus reus, mens rea, and a concurrence of the two. To convict the defendant of a particular crime, the prosecution must establish that each of the required elements are present in the facts to prove criminal liability (Schmalleger, Hall, & Dolatowski, 2010). In the case of State v. Stu Dents, the prosecution must establish the facts and elements of the charges for homicide, assault of a police officer, kidnapping, burglary, and crimes related to drugs. For the charge of homicide, all of the required elements are present in the facts of the case.The journal entries discussing the purchase of rope, rags, and a sharp hunting knife â€Å"to fulfill [his] destiny† prove mens rea. Actus reus is proven in the evidence that the victim was found with cloth stuffed in her mouth, arms and legs tied with rope restraints, and stabbed to death. The defendant's intent to commit the crime is proven by the journal entries, and the proof that he engaged in the criminal conduct is evident in the gagging, restraining, and stabbing death of the victim (University of Phoenix, n. d. ).For the charge of assault of a police officer, all of the required elements are present in the facts of the case. When police officers attempted to take him into custody, he was extremely agitated, irrational, combative, and screaming about the end of the world and aliens working in the police force, which proves mens rea. Actus reus is proven when the defendant punched the officer in the face while the officer attempted to handcuff him. The defendant's intent to cause bodily harm to the officer by punching him proves the presence of intent and conduct (University of Phoenix, n. . ). For the charge of kidnapping, all of the required elements are present in the facts of the case. Mens rea is proven from the evidence officers found in the defe ndant's home, which included a timeline of more than 300 photos of the victim in various locations and situations. It appears as if some photos were taken without the victim's knowledge. Actus reus is proven by the evidence of cuts and bruises found on the victim's body as well as skin particles under her fingernails, which signify a struggle prior to death.The DNA of the skin particles matched samples of the defendant's DNA. Therefore, the defendant's intent to seize unlawfully and carry away the victim by force, as indicated by the evidence of struggle, proves the presence of intent and conduct (University of Phoenix, n. d. ). For the charge of burglary, all of the required elements are present in the facts of the case. Mens rea is proven from witness testimony stating that the defendant entered the victim's apartment when she was not home, and there was no proof that he used a key.Actus reus is proven when a search of the defendant's home produced drugs and jewelry owned by the v ictim. The defendant's intent to enter the victim's residence unlawfully without permission for the purpose of committing a crime is proven by the theft of the victim's possessions (University of Phoenix, n. d. ). For the charge of crimes related to drugs, all of the elements are present in the facts of the case. Mens rea is proven when a search of the defendant's home produced various amounts of ecstasy, cocaine, and methamphetamines.Actus reus is proven by the presence of ecstasy, cocaine, and methamphetamines in the defendant's home, which is an act of possession. The defendant knowingly possessing the drugs coexists with the act of possessing the drugs (University of Phoenix, n. d. ). State Laws In Hawaii, homicide occurs when a person intentionally or knowingly causes the death of another person, and it is considered murder in the first degree. The crime of homicide with more than one victim or an inmate killing his or her cellmate is considered first degree murder, and homicid e of an officer of the law is considered a felony murder.Murder in the first degree is a serious felony, and the defendant could face life in prison without parole because Hawaii does not have the death penalty (FindLaw, 2012). In Pennsylvania, assault of a police officer occurs when a person intentionally causes harm to an officer while on duty, such as fighting the officer to avoid arrest. If this incident causes the officer bodily harm, the crime is a second-degree misdemeanor. This will result in a sentence of up to five years in prison, and a fine of up to $3,000.If a person shoots and kills an officer on duty, the charge is assault in the first degree. The defendant could face a minimum of 20 years in prison or death for first-degree assault of a police officer (Justia, n. d. ). In North Carolina, kidnapping occurs when a person unlawfully restrains or keeps another person at any place without his or her permission. It is considered first degree kidnapping if the victim is not released in a safe place or is seriously injured. This charge is considered a Class C felony, and it carries up to 15 years imprisonment (North Carolina General Assembly, n. d. ).In Arkansas, residential burglary occurs when a person unlawfully enters and remains in a residential structure, and commits any offense punishable by imprisonment. This crime is considered a Class B felony. A defendant who is charged with this crime faces five to 10 years imprisonment, and a fine of up to $15,000 (Justia, n. d. ). In Virginia, crimes related to drugs include manufacturing, distributing, or possessing controlled substances with the intent to manufacture or distribute. A first offense under this statute carries a sentence of five to 40 years imprisonment, and a fine of up to $500,000.Second and subsequent offenses carry a sentence of five years to life imprisonment, and a fine of up to $500,000. It is considered a felony if a person manufactures, distributes, or possesses certain large amou nts of controlled substances. A felony conviction carries a sentence of five years to life imprisonment, and a fine of up to $1 million (Laws. com, 2011). Strongest State Case According to the information on the state laws and statutes, Hawaii would yield the strongest prosecution in the case of State v. Stu Dents. InHawaii, a conviction of homicide carries a sentence of life imprisonment without parole, which would keep the defendant away from society, and keep society safe from possible future offenses by the defendant. A conviction for assault of a police officer carries up to five years imprisonment. A conviction for kidnapping and drug crimes is a Class A felony, and it carries a term of up to life imprisonment with a fine of up to $50,000. A conviction of burglary is a Class B felony, and it carries a term of two to 20 years imprisonment with a fine of up to $25,000 (Nolo, 2012).If the defendant is found guilty of all charges in the state of Hawaii, he will spend the rest of h is life in prison as well as pay a large amount in fines, which is absolute justice for the victim. Conclusion Each state has different laws for each crime that a person commits and how that person is charged for the crime. The prosecution for each crime is strong for each of the states examined. No matter what the case is for a crime committed in any state, there is a law or statute available to charge a person for that crime.Regardless of the state the criminal trial proceeds in, the prosecution will have a strong case in the case of State v. Stu Dents. References FindLaw. (2012). Haw. Rev. Stat.  § 707-701 : Hawaii Statutes – Section 707-701: Murder in the first degree. Retrieved from http://codes. lp. findlaw. com/histatutes/5/37/707/II/707-701 Justia. (n. d. ). 2010 Arkansas Code  § 5-39-201 – Residential burglary — Commercial burglary. Retrieved from http://law. justia. com/codes/arkansas/2010/title-5/subtitle-4/chapter-39/ subchapter-2/5-39-201/ Justi a. (n. d. . 2010 Pennsylvania Code  § 2702. 1 – Assault of law enforcement officer. Retrieved from http://law. justia. com/codes/pennsylvania/2010/title-18/chapter-27/2702-1/ Laws. com. (2011). 18. 2-248 – Manufacturing, selling, giving, distributing, or possessing with intent to manufacture, sell, give, or distribute a controlled substance or an imitation controlled substance prohibited; penalties. Retrieved from http://statutes. laws. com/ virginia/title-18-2/chapter-7/18-2-248 Nolo. (2012). Hawaii Charges for Crimes by Felony Class. Retrieved from ttp://www. criminaldefenselawyer. com/resources/criminal-defense/felony-offense/ hawaii-felony-class. htm North Carolina General Assembly. (n. d. ). Article 10 – Kidnapping and Abduction. Retrieved from http://www. ncga. state. nc. us/EnactedLegislation/Statutes/PDF/ByArticle/Chapter_ 14/Article_10. pdf Schmalleger, F. , Hall, D. E. , & Dolatowski, J. J. (2010). Criminal law Today. (4th ed. ). Upper Saddle River, NJ: Prentice Hall. University of Phoenix. (n. d. ). State v. Stu Dents. Retrieved from University of Phoenix, CJA354 website.

Classified Information About Animal Argumentative Essay Topics That Only the Pros Know About

Classified Information About Animal Argumentative Essay Topics That Only the Pros Know About It's important to not forget that the zoos are businesses which exist to generate a profit. The Columbia Plateau herd spans all 3 eastern regions in a place called the Columbia Basin. Although animals are being taken advantage of, they may be used to discover cures for various diseases that individuals might have. Also, they can make sure that all products are safe before being put on the market. There are just a few things that define whether an essay you're working on is going to be a good one. Understanding how to compose a strong argumentative paper will help you advance your very own argumentative thinking. At precisely the same time, you should make an effort not to persuade the reader into a particular opinion or side. The issue is that everybody's interpretation of what makes a great society differs. But What About Animal Argumentative Essay Topics? When students are writ ing their argumentative essays which must find, read and analyze plenty of material to do good. To write a strong argumentative essay, they should begin by familiarizing themselves with some of the common, and often conflicting, positions on the research topic so that they can write an informed paper. They are used to the fact that their professors give them the assignment's topic. They should be careful about posting on social media. Animal testing shouldn't be done because animals don't have a choice and it's wrong. Unfortunately, humans are frequently the most dangerous animal so far as zoo animals are involved. It's important to not forget that lots of animals reside in herds or packs in the wild. Animals shouldn't be used for testing. Animal Argumentative Essay Topics Secrets That No One Else Knows About Finding the cure for diseases can help everybody in the long run because people are going to have cure. Argumentative writings is a particular sort of a paper. An argumentative essay is a particular sort of essay which requires students to argue with the present points of view as a way to show the truth of their own position. You want to opt for something which is controversial since you can't really argue to refute facts. A conclusion is, without doubt, the most essential portion of the argumentative essay since you can either support the very good impression or destroy it entirely. Ultimately, you also have to have the ability to talk about either side of the argument to provide a rounded essay. At the conclusion of these list, you will discover links to a variety of argumentative paragraphs and essays. Otherwise, the info could possibly be too old to use. No warrant ought to be needed for search and seizures. You should back up your viewpoint with well-researched facts and data also. 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Choosing topics for argumentative essays is essential for your general success. On the opposite side, acquiring a list of good persuasive essay topics is inadequate. Thus, it's important to read corresponding formatting guide. As any guide on the best way to compose a persuasive essay will inform you, your essay has to be organized in paragraphs with a logical progression from 1 paragraph to the next. The One Thing to Do for Animal Argumentative Essay Topics Weave in your perspective to create your essay unique. Now, whenever you have a 1-hour essay or a 2-hour essay due and you're not sure you can cope with it on such a brief notice, consider asking our writers for assistance. It's important to understand that essay topics are just basic ideas that leave you pondering an idea that might be a huge deal to somebody else. Moral argumentative essay topics are a few of the simplest to get carried away with. Persuasive essays share a good deal of resemblance with argumentative essays. All argumentative essays must have a conclusion paragraph. Argumentative essay topics are so important since they are debatableand it's critical to at all times be critically considering the world around us. Good persuasive essay topics need to be persuasive. Schools should not have anything to do with ads. Since you can see, a number of the topics listed are new and handle the recent issues happening in the World today. Still, it's better to get a freedom of choice as far as it is possible to select the issue which interests you. Around the world, immigration is a popular topic as countries suffer from war and financial disasters. Life, Death and Animal Argumentative Essay Topics Bear in mind you may make funny argumentative essays if you do a few things. Your readers will need to observe the entire picture, and that's what you should concentrate on. It is crucial to begin with demonstrating the most important idea of the entire piece so you and your readers are going to be on the very same page. The picture of a number of the dresses has been displayed together with the color so that it will become simple for the buyer to produce the best alternative.

Feral Cats Essay - 1382 Words

Cats are one of the most beloved pets to humans beings. Though they provided a sense of comfort and love, there is a dark side to these soft, adorable, felines. Cats, both domestic and feral, poses a serious threat to native bird populations in the United States and health risk to both people and other animals. It is important that people realize the impact that feral cats have in the environment that they inhabit and how it not only effects other species, but us humans as well. Feral cats have no form of human interaction and therefore are difficult and or nearly impossible to assimilate as a regular house pet. There appears to be limited options on what can be done to help assist in the reduction of feral cat populations without sparking†¦show more content†¦It is important to note the difference between stray cats and feral cats. Stray cats are cats that were once owned and then later abandoned or lost. Feral cats are cats that grew up with no human contact. Cat colonies are not some big happy cat family like â€Å"Cat Warriors† According to this article, in the 1980’s, the population of Brown Pelican colonies decreased as the population of feral cats increased, â€Å"Feral cats could depress Brown Pelican productivity in local areas†¦Ã¢â‚¬  (Daniel, James, Gene, Franklin, Leopoldp). Brown Pelicans constructs their nests close to the ground. Their natural predators when it comes to eating their offspring’s have been black rats. However, this relationship between pelicans and rats have always existed before the introduction of cats. With cats interring the game, Brown Pelicans not only have to defend their eggs and hatchlings from rats, but also a new, and skilled predator; cats having the ability to attack and kill both parents and offspring will surely lead to the extinction of Brown Pelicans along the California coast. Piping Plover, California Clapper Rail, Florida Scrub-Jay, and Hawaiian Petre are example of rare spec ies of birds that find their existence threatened by cats. According to an article from abcbirds.org, â€Å"cats carry bacteria and viruses in their mouths, some of which can be transmitted to their victims. Even if treatment is administered immediately, only aboutShow MoreRelatedFeral Cat Mitigation Efforts : Tnr And More Essay2390 Words   |  10 PagesFeral Cat Mitigation Efforts: TNR and More With feral cats posing ecological and public health threats, many different techniques, reflecting a range of moral and ethical values, have been proposed and implemented. TNR is considered one of the most humane methods, but other methods that exist include euthanasia, trap and eradication, and more intensive versions of TNR that include vaccinations and rehabilitations. 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