...ETHIC 445N: Principle of Ethics DeVry Universit GOUP B, DILEMMA 1 The case study is about a certain office worker who is fond of missing work as he pleases. His excuse is that he is entitled to all the time off that he takes, regardless of it being a working day or a weekend. Consequences of the behavior of this officer have had dire effects on his co-workers who have not more than once complained to the management about his absenteeism. In my opinion, I consider what this officer does as reckless and inconsiderate. It is even odd that he is the only person doing such a thing in the office and he does not seem to care about it. Different companies usually have differing policies that outline days when a worker should take his offs or shifts. For most companies, this strategy is employed in order to reduce fatigue among its workers and to reduce feelings of monotonous activity that could result to laziness and low work productivity. Adhering to these company policies creates an atmosphere of equality among the workers, which is not the same case as those in this case study. The workers feel wronged since they have to shoulder the burden of having to do extra work which could have been allocated to this worker. To make matters worse they are not paid thus making them feel misused. It is not right that this worker should exploit the opportunity of taking off from work. It is even surprising that the management has not done anything so far to make him stop this behavior....
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...Arrhythmias * Are common and often benign, but can indicate underlying heart disease. They often occur intermittently and so can be difficult to diagnose. * Can present with palpitations, chest pain, presyncope/syncope, hypotension, pulmonary oedema. Some are asymptomatic e.g. AF. * History taking make sure include: * Precipitating factors, onset, nature (fast/slow, regular/irregular), duration, associated symptoms (chest pain, dyspnoea, collapse). * Causes: * CARDIAC: * MI. * CAD. * LV aneurysm. * Mitral valve disease. * Cardiomyopathy. * Pericarditis. * Myocarditis. * Aberrant conduction pathways. * NON-CARDIAC: * Caffeine. * Smoking. * Alcohol. * Pneumonia. * Drugs (β2 agonist, digoxin, L-dopa, tricyclics). * Metabolic imbalance (K, Ca, Mg, hypoxia, hypercapnia, acidosis, thyroid disease, phaeochromocytoma). * Tests: * Bloods: FBC, U&E, glucose, Ca, Mg, TSH. * ECG: look for signs of IHD, AF, short P-R interval, long QT interval, U waves. * If ECG normal consider doing 24 hour tape. * Echo: look for structural heart disease. * Others: exercise ECG, cardiac catheterisation etc. * Types of Arrhythmias: * Bradycardias: * If asymptomatic and rate >40bpm then no treatment. * Look for cause and stop any drugs that may be the...
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...sharp/ dull (more tongue depressors) **Tuning forks: 128 Hz and 512 Hz **Penlight **Triangular reflex hammer **Centimeter ruler *please read below before purchasing **Pocket Snellen eye chart **PA class sells packets that contains all these CARDIOLOGY-GRADE STETHOSCOPE: ~$ 140-160 Get at least a cardiology-grade stethoscope: has a diaphragm, bell, and dual lumen. Plan to spend at least $140. Examples: 1. Littman: Cardiology III: pediatric side can be a bell or can adjust pressure on diaphragm ~$140160, Master Cardiology ~$185 (is single sided and NOT necessary) 2. Heine: Gamma C3 Cardiology ~$140 3. Welch Allyn: Tycos Elite ~$140 4. MDF: Procardial C3 ~$162 Your stethoscope will be used to hear heart murmurs, lung sounds, bruits--- things not always so easy to hear. You will not be working in sound proof environments. DO NOT skimp in this area or you’ll just buy another one because you can’t hear anything. Chest piece can be two sided: bell (low pitch) and diaphragm (high pitch) or single sided. We suggest for ease of use that you purchase a scope with a two-sided chest piece Should have replaceable, multi-size ear tips, esp if you have small ear canals! Multiple tube colors and different chest piece finishes available; get whatever color you desire. Get a name tag piece to identify yours or you can get it engraved. SPHYGMOMANOMETER (Blood Pressure cuff) $20-200 Prices vary according to calibration warranty, valves, and...
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...is a sign that her body is trying to compensate for the lack of oxygenated blood and is trying to bring her body back to homeostasis. Here are some possible diagnosis for Brianna. Congenital heart defect symptoms include heart murmur, breathing problems, cyanosis, and fatigue. Cyanotic congenital heart disease symptoms are low birth weight, cyanosis, rapid breathing rapid heart rate, abnormal heart rhythms, and fatigue. Transposition of the greater vessels some symptoms may include cyanosis, shortness of breath, poor feeding, and rapid breathing. Truncus arteriosus is another possible diagnosis symptoms are cyanosis, dyspnea, poor feeding, lethargy, and...
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...Kayla Martinez 5/16/15 HW6 1. (3 pts) What are intercalated discs in cardiac muscle? What is the functional importance of these in the heart? Intercalated discs are important because they have desmosomes that hold the cell together, and also gap junctions that allow ions to pass through. These all currents to travel through cardiac muscle. 2. (2 pts) Define systole and diastole. Which heart chambers are usually referenced when these terms are used? Systole is the contraction while Diastole is the relax state of the muscle. They are referenced with the ventricles. Systole is the amount of blood after contraction and diastole is the amount of blood after relaxation inside the ventricles. 3. (4 pts) In an infant, what is ductus arteriosus? What...
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...that he has developed a heart murmur. The pilot only has a month to go before he is eligible for retirement. The doctor knows this and wonders whether, under these unusual circumstances, she is justified in withholding the information about the pilot's condition. I think in this situation, with it being medical issues, the doctor should do their job and help the person with what they can do to control the heart murmur with medicine and whatever else there is to do. Is the doctor in the wrong for not following her procedure when it comes to issues such as these? As a nursing student, if I was in this position as a doctor and something happened to the patient before his retirement, I would have a reminder every day that I could’ve done something to prevent the patient from being more ill or death. I think she would be in the wrong because if something happened to him, she could be liable for not following through what she is supposed to do as a doctor. She shouldn’t think of his retirement, she should think of how to fix this heart murmur. While it may be unfortunate for him, he should also think of his health too. He is in the hands of a professional and if she does not do her job then he could be in big trouble. Now another issue I think that can play into this is her beliefs and morals. What if she believes the heat murmur is not that serious? Then what happens if she does not treat because of her morals and then he dies the next day from his murmur not being treated? If she documents...
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...Study Mr. Smith is a 56-year-old Caucasian man who is being evaluated in the emergency room with progressively worsening chest pain that began 2 hours ago. The patient describes the pain as pressure in the center of his chest. He rates his pain 7/10. He reports the pain is now radiating down his left arm and through to his back, he is diaphoretic, and complaining of shortness of breath. He denies nausea or vomiting. Mr. Smith reports no previous history of chest pain or pressure. He smoked one pack of cigarettes daily for 13 years but quit smoking last year. He denies a family history of heart disease. Upon initial examination he did not have jugular venous distension, no carotid bruits, normal S1 and S2 with an S3 present. No S4 or murmurs auscultated. Lung sounds clear to auscultation bilaterally, bowel sounds normal, all pulses palpable 2+/4, no edema present. Diagnostic data: BP: 165/98 mmHG HR: 96 bpm RR: 30 breaths/min Temp: 37 C SaO2: 96% with 2L/min O2 per nasal cannula Wt:100 kg A 12-lead ECG was performed in the emergency room showed: Normal Sinus Rhythm (NSR) with frequent premature ventricular contractions. ST segment elevation in Leads 1, aVL, and V2 through V6 (3mm). ST segment depression in Leads III and aVF. Q waves in V2 through V4. The chest X-ray revealed slight cardiomegaly with mild congestive heart failure. An echocardiogram reveals an ejection fraction of 30% and mild mitral valve regurgitation. Mr. Smith’s cardiac enzyme lab...
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...February 1, 2014 Head and Face • Scalp: Inspection and palpation findings of no lesions, lumps, tenderness, or protrusions. • Hair: No thinning or dryness. • Cranium: Normocephalic. • Facial expression: Relaxed and a little nervous. • Symmetry: Eyes, expressions and mouth are symmetrical. • Temporomandibular joint: Palpated non tender and no clicking noted. • Maxillary sinuses: Palpated and non-tender. • Frontal sinuses: Palpated and non-tender. Eyes • Visual fields: Near vision with in normal with using a magazine about 14 inches from eyes. • Corneal light reflex: Symmetric bilaterally. • Cardinal positions of gaze: Eye movement is parallel with tracking of each eye. • External structures: Eyebrows are symmetrical, no redness, discharge, lesions or swelling. • Conjunctivae: Clear. • Sclera: Pink. • Cornea: Clear no cloudiness noted. • Iris: round, 3mm, and equal in both eyes. • Pupils: PERRLA (pupils are equal, round, react to light and accommodations. Ears • Position: Ears are symmetrical in alignment. • Skin: Intact with no lumps or lesions. • Auditory meats: No redness, or discharge observed. • Auricle: Non-tender, no redness or swelling. • Tragus: Non-tender. • Voice test: Whispered voice test patient was able to repeat the words whispered. Nose, Mouth, Throat • External nose: Non-tender, no redness or swelling. ...
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...but I was somewhat amazed because it has taller buildings rather than that of my school before. I heard also many murmurs about this institution before I stepped in. Murmurs that made me confident in entering this one of a kind institution. Some parents say that LUCI has two curriculums, the Chinese curriculum and the English curriculum. Having two curriculums was a unique one because you’ll not just learn Mathematics, English, Science and many more but you’ll also learn a different culture that is the Chinese Culture. In every school year, the students of LUCI acquire the knowledge of the Chinese culture and their own culture. They also say that this institution had produced many students who compete globally in terms of academics and sports. I never knew that this institution is really big. When I entered at this school, I was very shy, because I thought all of the students in this school are Chinese but to my surprise there are so many Filipinos and that I started to gain confidence because of the friendship that the students gave to me as a welcome. They say that if a LUCIan stepped out of their school gate, they feel higher than that of other students. I don’t know about these murmurs until I found out all from it. I noticed before that when I enter the gate, I saw these banners full of names and congratulations. In that scene alone, it answers all these murmurs I heard, that many of the students of this...
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...This closure of valves sets up vibrations in valves, in adjacent blood, in walls of heart and in major vessels around heart. Main components present in normal heart sound are: first prominent peak of heart sound (S1) and second peak present in heart sound (S2) that occur in sequence with each heartbeat. The first heart sound (S1) originates when mitral and tricuspid valve close and it occurs at beginning of systole. The second heart sound (S2) originates at end of systole by the closing of aortic and pulmonary valves. Besides these two normal sounds, some other sound components may be present in heart sound including thrill, gallop rhythms (S3, S4) and heart murmurs. The third heart sound (S3) is produced by vibration of blood backward and forward between walls of ventricles due to inrush of blood from atria and it may occur near mid of diastole. The fourth heart sound (S4) is produced by inrush of blood into ventricles and it occurs when atria contract, S4 is also called atrial...
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...Cardiovascular The cardiovascular system is consists of the heart and network of arteries, veins, and capillaries that transport blood throughout the body. There are two primary circulatory loops in the human body: the pulmonary circulation loop and the systemic circulation loop. The heart is a muscular organ about the size of a closed fist that functions as the body’s circulatory pump. It takes in deoxygenated blood through the veins and delivers it to the lungs for oxygenation before pumping it into the various arteries. The condition marked by the heart’s inability to pump enough blood to the rest of the body is called a heart failure, although it is generally long term or chronic, it may have a sudden onset. In the case study presented here the client complains: “I have shortness of breath, fatigue, cough, and swelling in feet”. Based on the above information during the initial interview the examiner will collect an additional subjective data in order to gain in depth understanding of what is the cause of the exhibited symptoms, and to rule out certain issues. Subjective data: 1) Dyspnea. (Shortness of breath) What kind of activities and amounts bring on shortness of breath. Did these activities bring the shortness of breath 6 months ago? Does shortness of breath come on suddenly? Is it constant or comes and goes? Is it changed by the position change, for example lying down? Does it wake you up at night? Does the shortness of breath interfere with ADLs? 2) Fatigue...
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...thickening and loss of elasticity in the arterial wall causing the heart to continually pumps against greater resistance((Potter, Perry, Hall, & Stockert, 2013). The classification for adults to be considered hypertensive is to have a systolic reading 140 or greater and a diastolic reading 90 or greater. Modifiable risk factors that contribute to hypertension are obesity, cigarette smoking, heavy alcohol consumption, high sodium intake, sedentary lifestyles, and continued exposure to stress. Incidences of hypertension are greater in patients with diabetes, older adults, and African Americans and contributing factors for heart attacks ((Potter, Perry, Hall, & Stockert, 2013). Mitral value prolapse could be another indicator of a heart murmur. The mitral value is located between the left atrium and left ventricle. . Mitral valve prolapse occurs when the two leaves of the mitral valve...
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...Advanced Nursing Practice I NSG6001 Genitourinary Care Plan Case Genitourinary Care Plan Patient Initials: H.M Age: 60 years old Sex: Male Subjective Data: Client Complaints: Decreased Urinary flow, dysuria, nocturia, urinary frequency, low grade fever. HPI (History of Present Illness): This 60 year old Hispanic male presents at the clinic today with a chief complaint of urinary frequency, decreased urine flow, increased nocturia, slight terminal dysuria and low grade fever. The patient was experiencing these symptoms for the past two years, but they had increased a whole lot more during the last two weeks. Upon assessment, it is noted that the patient has a systolic murmur that is more audible at the right sternal border. Five years ago, patient was in the hospital with suspected angina. At the moment, the patient presented with a PSA level of 6.0. In the past patient did not seek medical advice or treatment for his symptoms which have worsening now and forced him to look for medical assistance. PMH (Past Medical History—include current medications, any known allergies, any history of surgery or hospitalizations): Patient has history of urinary frequency, decreased urine flow, nocturia and dysuria which he did not seek medical help for. Patient was hospitalized five years ago, where he was treated for chest wall syndrome. Patient is currently under treatment for high cholesterol and hypertension. No...
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...are a paramedic and will walk him to your car where you have your medical equipment. He reports that he has had a headache off and on since he had a tooth extracted four days ago. This evening he is feeling very weak. His blood pressure is normal. When you listen to his heart you note that he has a pronounced murmur. He reports having had rheumatic fever 15 years ago. You examine his fingernails and find one that has tiny petechial hemorrhages under it. 1. Name the most likely causative agent of this man's signs and symptoms. 2. Name the most likely infection this man has. 3. What type of culture would a physician most likely order, and why? 4. What is the treatment? 5. What is rheumatic fever? What causes it. Can it be prevented? 1) Streptococcus viridans transmitted through the wound to the bloodstream as a result of the tooth extraction. 2) subacute bacterial endocarditis (endocarditis- inflammation of the endocardium) 3) a blood culture looking for alpha hemolysis because Streptococcus viridans is alpha hemolytic and this would detect the presence of the bacteria in the blood. 5) Rheumatic fever was the cause of the man's heart murmur because the endocardium (lining of heart muscle that covers heart valve) was damaged. A damaged heart valve makes a person more susceptible to bacterial endocarditis because the bacteria easily lodges onto the heart valve. http://jan.ucc.nau.edu/~fpm/bio205/sp-05/cardiovascsyst3=1-8.pdf http://en.wikipedia...
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...E L James Fifty Shades Freed First published by The Writer’s Coffee Shop, 2012 Copyright © E L James, 2012 The right of E L James to be identified as the author of this work has been asserted by him under the Copyright Amendment (Moral Rights) Act 2000 This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be reproduced, copied, scanned, stored in a retrieval system, recorded or transmitted, in any form or by any means, without the prior written permission of the publisher. This book is a work of fiction. Names, characters, places and incidents are either a product of the author’s imagination or are used fictitiously. Any resemblance to actual people living or dead, events or locales is entirely coincidental. The Writer’s Coffee Shop (Australia) PO Box 2013 Hornsby Westfield NSW 1635 (USA) PO Box 2116 Waxahachie TX 75168 Craig, W.J., ed. “King Lear.” The Complete Works of William Shakespeare. Scene 1, Act 1. New York: Random House Value Publishing: 1997. www.thewriterscoffeeshop.com/publishinghouse About the Author E L James is a TV executive, wife, and mother of two, based in West London. Since early childhood, she dreamt of writing stories that readers would fall in love with, but put those dreams on hold to focus on her family and her career. She finally plucked up the courage to put pen to paper with her first novel, Fifty Shades of Grey. E L James is currently working on a new romantic thriller with...
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