...Sally, a 22 year-old woman has been suffering from anorexia nervosa for six years. The recent weeks have seen her condition worsen to the extent that the Medical Officer has resulted to prescribing her artificial nutrition, PEG feeds, administration. Sally has however refused the artificial feeding, let alone the insertion of the PEG tube. Essentially, Sally is just an exemplar of the numerous cases that nurses’ encounter when patients refuse treatments that could save their lives. Hendrick (2000) indicates that in such cases, nurses, with patients’ best interest at heart question the possibility of employing coercion or other means to make the patient undergo the treatment. Veitch (2007) warns nurses or any medical practitioner on making patients comply with treatment citing that in healthcare, best practices, in reference to legal rights and ethical practices should act as effective tools that should make nurses and other medical practitioners decide on patients that refuse treatment. In addition, every case should be examined individually to decide the best course of action that nurses and the medical practitioners should take. Hence, in deciding on Sally’s case, the key question lies on whether Sally has a legal basis or right, as well as the ethical right of refusing treatment. Respect for autonomy, granted under the individual legal right to refuse or consent treatment automatically grants Sally the legal right to refuse treatment. However, the complexity, in reference to...
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...Antidepressants: I) Tricyclic Antidepressents:TCA: Drugs: - 3ry amines; old generation more selective to 5HT reuptake inhibition are: imipramine, trimipramine, clomipramine, amitriptyline, and doxepin( potent H1 blocking agent). - 2ry amines; new generation more selective to NE reuptake inhibition are: nortriptyline, protriptyline, maprotiline, desipramine, and amoxapine(can block DA receptor causing Park-like effect). MOA: they block NE and 5HT reuptake, thus increase their levels. Plus they inhibit histaminergic, cholinergic, alpha adrenergic receptors. It requires weeks to give antidepressent effect. And alpha blocking effect will subside withing few weeks. It is used in; enursis, tics, neuropathic pain, ADHD, and depression. Avoid adrupt D/C, taper down 25% of dose every week. Side effects: Must monitor since NTR Anticholinergic, CV due to NE reuptake inhibition, sedation due to H1 blocking effect thuse give at bed time, OH and reflex tachycardia due to alpha inhibition, Wt gain, skin rashes and leukopenia. II) SSRI: Drugs; citalopram-escitalopram(least DDI), paroxetine(sedative give at bed time), fluoxetine(wt loss &only approved for pediatrics)-fluvoxamine(most DDI), and sertraline. MOA: it inhibits 5HT reuptake and stimulate 5HT1-2A for antidepressent effect. It needs 80% of receptor to be bound for effect. Used in OCD, panic, and depression. We need a washout period btw SSRI and TCA about 2 weeks, and between SSRI-MAOI about 4-6 weeks to avoid Serotonin...
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...An analysis of Victoria's Secret Lingerie Marketing Today, Victoria Secret models have by and large become a benchmark of female beauty. They posses what society deems beautiful: mesmerizing eyes, sexy lips, flawless skin, big voluminous hair, and perfect bodies, complete with unusually long and toned legs to complement their beautiful faces. While on the one hand, Victoria Secret’s primary purpose is certainly to utilize these army of girls to sell their products, it is important to look beyond this and recognize that they inevitably sell values, images, and concepts (eg: sexuality). The overpowering presence of these models in the in the media provides a benchmark telling us who we are and who we should be. It also tells us how to look and how to be beautiful. It tells us in order to be acceptable we have to be unnaturally thin.They promote a very unrealistic idea of body image, which are inadvertently translated into "normalcy"- providing audiences with a sense of what is supposedly normal. Either consciously or subconsciously we internalize these values, which then fuels us to strive to become exactly what we see. For instance, we feel ashamed and even guilty if we fail to have stick thin bodies akin to these statuesque models. This "thin inspiration" is clearly apparent when almost immediately after the Victoria’s Secret Fashion Show 2011 aired, many girls set their Facebook statuses to lines such as: “Better go to the gym! Just watched the Victoria’s Secret Fashion show...
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