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Classical Argument Outline Template
I. INTRODUCTION
a) Hook:
b) Background/context:
c) Thesis:
II. NARRATION
a) History/background of your topic (neutral)
b) Any key words/terms that need to be defined
III. PARTITION
a) Overview of your position on the issue (broad explanation of
your argument; might include support from sources):
IV. ARGUMENT PARAGRAPHS (Sub claims must be arguable)
a) Sub Claim #1:
a. Supporting evidence:
b) Sub Claim #2:
a. Supporting evidence:
c) Sub Claim #3:
a. Supporting evidence;
d) Additional sub claim(s) if needed:
V. COUNTER-ARGUMENT/REFUTATION
a) Major objection to your main claim/thesis:
a. Evidence to disprove/refute the objection:
b) Second objection to your main claim/thesis (if needed):
VI. CONCLUSION
a) Summary of argument, main points, call to action, etc.
Presented by
Margaret Smallwood
ALZHEIMER'S
Joseph Maximilien
Excellent presentation.
Joseph Maximilien
Always date your work.
Pathophysiology
Alzheimer's disease produces a steady and
gradual decline of a client's cognitive function.
Amyloid plaques containing fragments of
protein mix with neuron remnants, and other
nerve cell pieces. The neurofibrillary tangles,
found inside neurons, form a tau which clumps
together. Failure function and immobility of the
neurons leading to death. As the disease
progresses the client's ability to learn new
information and will eventually impair language,
judgment, and behavior (Ignatavicius &
Workman, 2021).
Etiology
Alzheimer's is caused by genetic and environmental factors
(viral). The amyloid plaques containing fragments of protein
mix with neuron remnants, and other nerve cell pieces. The
neurofibrillary tangles, found inside neurons, form a tau which
clumps together. Failure function and immobility of the neurons
leading to death. As the disease progresses the client's ability
to learn new information and will eventually impair language,
judgment, and behavior. Neurons cannot survive when their
connections to other neurons are lost. As neurons die
throughout the brain, the affected regions begin to atrophy or
shrink. The damage is widespread and brain tissue has shrunk
significantly (Story, 2017).
Many Alzheimer's clients have chronic
health problems such as diabetes mellitus,
strokes, and atherosclerosis.
Preventive methods such as smoking and
excessive alcohol consumption increase
the risk of stroke and cardiovascular
disease (Ignatavicius & Workman, 2021).
Health Promotion and Maintenance
Eating a well-balanced diet
Using soy products
Consuming sufficient amounts of folate and
vitamins B12, C, and E.
Walking and swimming
Other exercises not only increase tone and
muscle strength but also may decrease
cognitive decline. (Ignatavicius &
Workman, 2021).
Maintaining a healthy lifestyle such as:
Risk Factors / History
Female
Over 65 years of age
Down syndrome
Traumatic brain injury
chemical imbalances
Environmental agents
Immunologic changes
Excessive stress
Ethnicity/race.
Environmental agents such
as herpes zoster and
herpes simplex, and toxic
metals (zinc and copper)
increase the risk of AD.
Patients who have
experienced a traumatic
brain injury such as war
veterans or repeated head
trauma such as boxers may
experience AD at an early
age (Story, 2017)
Short-term memory impairment.
Alterations in communication such as apraxia, aphasia,
anomia, and agnosia.
Impaired judgment such as inability to make decisions,
decreased attention span, and decreased ability to
concentrate.
CHANGES IN COGNITION
Aggressiveness, especially verbal and physically abusive
tendencies.
Rapid mood swings
Increased confusion at night/sundowning or excessively
fatigued.
The client wanders and become lost / may go into other
rooms to rummage through anothers belonging.
CHANGES IN BEHAVIOR & PERSONALITY
Decreased interest in personal appearance.
Selection of clothing that is inappropriate for the weather
or event.
Loss of bowel and bladder control.
Decreased appetite or ability to eat (Ignatavicius &
Workman, 2021).
CHANGES IN SELF-MANAGEMENT SKILLS
Physical Signs and Symtoms
CT scan shows cerebral atrophy and
ventricular enlargement, wide sulci,
and shrunken gyri
MRI scan rule out other causes of the
neurological disease (Ignatavicius &
Workman, 2021).
Diagnostics
Genetic testing (apooliprotien E4 (APOE 4))
Amyloid beta-protein precursor (soluble)
(sBPP).
Laboratory Imaging assessment
Planning and Implementation
Interprofessional collaborative
Implement a structured and consistent plan of care and
environment.
Provide a complete evaluation and assistance in helping
the client become more independent.
Promote cognitive stimulation and memory training
such as interactive pet therapy.
Promoting bowel and bladder continence.
Promoting communication and self-management such
as communication board or digital handheld device for
scheduled activities.
Encourage the family to provide pictures of family and
friends that are labeled with the person's name on the
pictures.
Encourage family and staff to frequently reorient the
patient such as "what day is it" (Ignatavicius &
Workman, 2021).
Psychosocial Integrity
The client experience the
grieving process; the client
anticipates loss, experiencing
denial, anger, bargaining, and
depression at varying times.
After diagnosis one or more
family members may desire
genetic testing.
Support the client and family's
decisions regarding testing
Ensure the family finds credible
resources for testing and
professional genetics
counseling.
Help client with change in
routine and environment
since the client
experiences changes in
emotional and behavioral
affect.
The client experience
sexual disinhibition such as
masturbating publicly.
The client is unaware of
their behavior, therefore,
provide support to both
family and client
(Ignatavicius & Workman,
2021).
This drug blocks excess amount of
glutamate that can demage nreve
cells.
Helps maintain clients function for
few months longer.
Improve memory and thinking skills
For AD client who develop depression
SSRIs such as paroxetine and
sertraline
Memantine (Namenda):
Antidepressants :
Medications
This drug slows the onset of cognitive
decline.
These drugs are prescribed for clients
with mental/behavioral health
problems.
This drug should be used as a last
resort due to the decreasing mobility
and self management ability (Story,
2017)
Cholinesterase inhibitors: Aricept, Reminyl,
and Exelon
Psychotropic drugs such as antipsychotic
or neuroleptic
The client room should have adequate,
nonglare lighting and no potentially
lightening shadows.
A private room is needed if the client has
a history of agitation or wandering.
The television should remain off unless
the client turns it on or requests it on
When communicating with the client use
short sentences and one-step
instructions.
Never assume. that the client is totally
confused and can't understand what is
being communicated.
Safety Considerations
Keep the client away from stairs or
elevators.
Avoid physical or chemical restraints
and assess and treat pain.
Place the client in an area that
provides maximum observation but not
in the nurse's station.
Use family members, friends,
volunteers, and sitters as needed to
monitor the client.
Provide frequent toileting and
incontinence care as needed
(Ignatavicius & Workman, 2021).
Ignatavicius, D.D., & Workman, M.L.,
Rebar, C. & Heimgartner, N. M. (2021).
Medical-surgical nursing: Concepts for
interprofessional care (10th ed.). Elsevier.
Story, L. (20170301). Pathophysiology:
A Practical Approach, 3rd Edition.
[VitalSource Bookshelf 10.0.2].
Retrieved from vbk://9781284142983
References
Presented by
Margaret Smallwood
ALZHEIMER'S
Joseph Maximilien
Excellent presentation.
Joseph Maximilien
Always date your work.
Pathophysiology
Alzheimer's disease produces a steady and
gradual decline of a client's cognitive function.
Amyloid plaques containing fragments of
protein mix with neuron remnants, and other
nerve cell pieces. The neurofibrillary tangles,
found inside neurons, form a tau which clumps
together. Failure function and immobility of the
neurons leading to death. As the disease
progresses the client's ability to learn new
information and will eventually impair language,
judgment, and behavior (Ignatavicius &
Workman, 2021).
Etiology
Alzheimer's is caused by genetic and environmental factors
(viral). The amyloid plaques containing fragments of protein
mix with neuron remnants, and other nerve cell pieces. The
neurofibrillary tangles, found inside neurons, form a tau which
clumps together. Failure function and immobility of the neurons
leading to death. As the disease progresses the client's ability
to learn new information and will eventually impair language,
judgment, and behavior. Neurons cannot survive when their
connections to other neurons are lost. As neurons die
throughout the brain, the affected regions begin to atrophy or
shrink. The damage is widespread and brain tissue has shrunk
significantly (Story, 2017).
Many Alzheimer's clients have chronic
health problems such as diabetes mellitus,
strokes, and atherosclerosis.
Preventive methods such as smoking and
excessive alcohol consumption increase
the risk of stroke and cardiovascular
disease (Ignatavicius & Workman, 2021).
Health Promotion and Maintenance
Eating a well-balanced diet
Using soy products
Consuming sufficient amounts of folate and
vitamins B12, C, and E.
Walking and swimming
Other exercises not only increase tone and
muscle strength but also may decrease
cognitive decline. (Ignatavicius &
Workman, 2021).
Maintaining a healthy lifestyle such as:
Risk Factors / History
Female
Over 65 years of age
Down syndrome
Traumatic brain injury
chemical imbalances
Environmental agents
Immunologic changes
Excessive stress
Ethnicity/race.
Environmental agents such
as herpes zoster and
herpes simplex, and toxic
metals (zinc and copper)
increase the risk of AD.
Patients who have
experienced a traumatic
brain injury such as war
veterans or repeated head
trauma such as boxers may
experience AD at an early
age (Story, 2017)
Short-term memory impairment.
Alterations in communication such as apraxia, aphasia,
anomia, and agnosia.
Impaired judgment such as inability to make decisions,
decreased attention span, and decreased ability to
concentrate.
CHANGES IN COGNITION
Aggressiveness, especially verbal and physically abusive
tendencies.
Rapid mood swings
Increased confusion at night/sundowning or excessively
fatigued.
The client wanders and become lost / may go into other
rooms to rummage through anothers belonging.
CHANGES IN BEHAVIOR & PERSONALITY
Decreased interest in personal appearance.
Selection of clothing that is inappropriate for the weather
or event.
Loss of bowel and bladder control.
Decreased appetite or ability to eat (Ignatavicius &
Workman, 2021).
CHANGES IN SELF-MANAGEMENT SKILLS
Physical Signs and Symtoms
CT scan shows cerebral atrophy and
ventricular enlargement, wide sulci,
and shrunken gyri
MRI scan rule out other causes of the
neurological disease (Ignatavicius &
Workman, 2021).
Diagnostics
Genetic testing (apooliprotien E4 (APOE 4))
Amyloid beta-protein precursor (soluble)
(sBPP).
Laboratory Imaging assessment
Planning and Implementation
Interprofessional collaborative
Implement a structured and consistent plan of care and
environment.
Provide a complete evaluation and assistance in helping
the client become more independent.
Promote cognitive stimulation and memory training
such as interactive pet therapy.
Promoting bowel and bladder continence.
Promoting communication and self-management such
as communication board or digital handheld device for
scheduled activities.
Encourage the family to provide pictures of family and
friends that are labeled with the person's name on the
pictures.
Encourage family and staff to frequently reorient the
patient such as "what day is it" (Ignatavicius &
Workman, 2021).
Psychosocial Integrity
The client experience the
grieving process; the client
anticipates loss, experiencing
denial, anger, bargaining, and
depression at varying times.
After diagnosis one or more
family members may desire
genetic testing.
Support the client and family's
decisions regarding testing
Ensure the family finds credible
resources for testing and
professional genetics
counseling.
Help client with change in
routine and environment
since the client
experiences changes in
emotional and behavioral
affect.
The client experience
sexual disinhibition such as
masturbating publicly.
The client is unaware of
their behavior, therefore,
provide support to both
family and client
(Ignatavicius & Workman,
2021).
This drug blocks excess amount of
glutamate that can demage nreve
cells.
Helps maintain clients function for
few months longer.
Improve memory and thinking skills
For AD client who develop depression
SSRIs such as paroxetine and
sertraline
Memantine (Namenda):
Antidepressants :
Medications
This drug slows the onset of cognitive
decline.
These drugs are prescribed for clients
with mental/behavioral health
problems.
This drug should be used as a last
resort due to the decreasing mobility
and self management ability (Story,
2017)
Cholinesterase inhibitors: Aricept, Reminyl,
and Exelon
Psychotropic drugs such as antipsychotic
or neuroleptic
The client room should have adequate,
nonglare lighting and no potentially
lightening shadows.
A private room is needed if the client has
a history of agitation or wandering.
The television should remain off unless
the client turns it on or requests it on
When communicating with the client use
short sentences and one-step
instructions.
Never assume. that the client is totally
confused and can't understand what is
being communicated.
Safety Considerations
Keep the client away from stairs or
elevators.
Avoid physical or chemical restraints
and assess and treat pain.
Place the client in an area that
provides maximum observation but not
in the nurse's station.
Use family members, friends,
volunteers, and sitters as needed to
monitor the client.
Provide frequent toileting and
incontinence care as needed
(Ignatavicius & Workman, 2021).
Ignatavicius, D.D., & Workman, M.L.,
Rebar, C. & Heimgartner, N. M. (2021).
Medical-surgical nursing: Concepts for
interprofessional care (10th ed.). Elsevier.
Story, L. (20170301). Pathophysiology:
A Practical Approach, 3rd Edition.
[VitalSource Bookshelf 10.0.2].
Retrieved from vbk://9781284142983
References
Classical Argument Outline
RHETORICAL SITUATION:
Purpose: Compose a Classical Argument essay that aims to
persuade your audience by using evidence and research to back
up your thesis.
Audience: Peers with an opposite or indifferent viewpoint to
yours
Subject: Issue that is debatable and arguable
Thesis: Arguable, Specific (problem), Feasible (solution). See
pages 110-113 in Let’s Get Writing!
INTRODUCTION: The introduction will provide a very brief
overview of the issue, capture the reader’s interest, and state the
arguable thesis. Consider the following questions to gather the
information needed for this paragraph:
• Consider using a quote, statistic, or an interesting fact to catch
reader’s attention and establish context of persuasion (appeal to
pathos)
• Briefly describe the problem with the issue that you are going
to address (background and context)
• Why is this issue important? (engage the audience)
• If your argument proposes a solution, you may want to hint at
it here.
• Usually, the thesis statement comes at the end of the
introduction. Remember, the thesis must be arguable (readers
can agree or disagree with it), describe a specific problem, and
offer a feasible (workable) solution.
BODY SECTIONS:
NARRATION/BACKGROUND:
What is the history of your topic/issue/claim? Give the audience
essential background information. Provide research sources for
anything that isn’t common knowledge, especially when
providing statistics.
• Begin maybe 5-10 years ago with your topic. What are some
key events, topics, ideas (or people) that have happened to make
your issue debatable and something to argue?
1.
2.
3.
• Define key words in your position statement that will help
convince your audience to believe the way you do. Think about
defining at least two words in your claim/position statement.
1. Do you need to redefine or clarify any terms that have
specific meaning in this context? For example, what does
“institutional racism” mean, and what does it mean in the
context of higher education?
PARTITION:
The partition is like an expansion of your thesis statement
before you begin your detailed argument. It is typically one to
two paragraphs.
• Provide a larger overview about your position on the issue,
the exact problem you see and your proposed solution.
• Give specifics and provide support from outside sources as
needed.
ARGUMENT:
Develop your argument by creating a list of specific reasons
(subclaims) that prove your position. Before you write this
section, consider the following:
• As you develop your subclaims, consider the warrants
(principles/laws of society) and assumptions (shared
values/beliefs) of your audience. Make sure your subclaims
appeal to what you have in common with your audience. This
will make your argument much more convincing.
• Each reason will become a paragraph with a clear topic
sentence; each paragraph will need outside sources to support
the subclaim (data, statistics, expert opinion, etc.)
• Aim to provide a balance of ethos (objective and fair support),
logos (factual information), and pathos (human
interest/emotion).
• Be careful to avoid unsupported assertions: opinions without
outside support to validate their truth. Ex: “Most people don’t
like to spend a lot of money” is an assertion that will need
outside support in order to be accepted by readers.
Quick Brainstorm Activity: What warrants and assumptions
does my audience share with me? Try to identify at least two
and use them to help develop your subclaims.
1.
2.
3.
Argument Section Body Paragraphs:
Think back to your brainstormi ng list above and develop
paragraph topics that are subclaims for your thesis. Try to
create subclaims that appeal to the commonly shared values you
considered in the brainstorming list you just created.
Use as many subclaims as needed to thoroughly argue your
position. Each subclaim will become the focus of a paragraph
and should be reflected in the paragraph topic sentence.
1.
2.
3.
4.
REFUTATION OR COUNTEREVIDENCE:
What are some major objections to your claim? In other words,
what are some reasons your audience might disagree with your
thesis? Explain why your audience could be wrong, and how
you are right. Maybe they just need more information; maybe
you need to remind them of shared warrants/values. Maybe an
objection contains a logical fallacy that you can reveal.
Remember to keep your tone neutral. Don’t confront or
condescend to your audience. Consider using logos and ethos
more heavily in this section.
• Objection 1:
§ Explain why this is wrong/your suggestion is better:
• Objection 2:
§ Explain why this is wrong/your suggestion is better:
• Objection 3:
§ Explain why this is wrong/your suggestion is better:
Conclusion:
• Briefly, and without repeating yourself, restate the specific
problem and your claim.
• Summarize your main points, being careful to not add any
new subclaims
• You may consider ending with an emotional appeal such as a
call to action, asking readers to consider what may happen if
your solution isn’t accepted, or providing a humorous
observation to lighten the mood.
NOTE! This assignment is for an outline only).
Intro: Do you have some information to establish the context of
your argument? For example, if your essay is about gun control,
is there a reference to recent news reports or an establishment
of a need for gun control? Does your thesis appear at or near the
end of the intro paragraph? Is your thesis arguable?
Narrative: Does your narrative provide background information
on your topic? Is the information within the past 10 years or
less? Do you have source material for this section? Is this
section neutral, as it should be?
Partition: Does your partition provide context for your issue?
Does it provide an overview of why there is a disagreement
concerning your topic? Do you have source material for this
section? Does this section begin to provide a broad overview of
your argument?
Argument Section Paragraphs: Do you have at least three
arguable sub-claims to provide the basis of the argument section
paragraphs? Does each paragraph list a sub claim as a topic
sentence at or very near the beginning? Does each paragraph
have evidence to prove the sub claim it is presenting?
Refutation: Is there at least one counter-claim listed? Do you
have source material to accurately describe the counterpoint(s)?
Do you have a refutation listed for the counter-claim? Do you
have source material to support your refutation?
Conclusion: Is there a clear re-establishment of your overall
thesis? Did you avoid repeating sentences that appeared
elsewhere in your essay? Is there a reiteration of all of your
main points?

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Classical Argument Outline TemplateI. INTRODUCTIONa) Hook

  • 1. Classical Argument Outline Template I. INTRODUCTION a) Hook: b) Background/context: c) Thesis: II. NARRATION a) History/background of your topic (neutral) b) Any key words/terms that need to be defined III. PARTITION a) Overview of your position on the issue (broad explanation of your argument; might include support from sources): IV. ARGUMENT PARAGRAPHS (Sub claims must be arguable) a) Sub Claim #1: a. Supporting evidence: b) Sub Claim #2: a. Supporting evidence: c) Sub Claim #3: a. Supporting evidence; d) Additional sub claim(s) if needed: V. COUNTER-ARGUMENT/REFUTATION a) Major objection to your main claim/thesis: a. Evidence to disprove/refute the objection:
  • 2. b) Second objection to your main claim/thesis (if needed): VI. CONCLUSION a) Summary of argument, main points, call to action, etc. Presented by Margaret Smallwood ALZHEIMER'S Joseph Maximilien Excellent presentation. Joseph Maximilien Always date your work. Pathophysiology Alzheimer's disease produces a steady and gradual decline of a client's cognitive function. Amyloid plaques containing fragments of protein mix with neuron remnants, and other nerve cell pieces. The neurofibrillary tangles, found inside neurons, form a tau which clumps together. Failure function and immobility of the neurons leading to death. As the disease progresses the client's ability to learn new information and will eventually impair language, judgment, and behavior (Ignatavicius & Workman, 2021).
  • 3. Etiology Alzheimer's is caused by genetic and environmental factors (viral). The amyloid plaques containing fragments of protein mix with neuron remnants, and other nerve cell pieces. The neurofibrillary tangles, found inside neurons, form a tau which clumps together. Failure function and immobility of the neurons leading to death. As the disease progresses the client's ability to learn new information and will eventually impair language, judgment, and behavior. Neurons cannot survive when their connections to other neurons are lost. As neurons die throughout the brain, the affected regions begin to atrophy or shrink. The damage is widespread and brain tissue has shrunk significantly (Story, 2017). Many Alzheimer's clients have chronic health problems such as diabetes mellitus, strokes, and atherosclerosis. Preventive methods such as smoking and excessive alcohol consumption increase the risk of stroke and cardiovascular disease (Ignatavicius & Workman, 2021). Health Promotion and Maintenance Eating a well-balanced diet Using soy products Consuming sufficient amounts of folate and vitamins B12, C, and E. Walking and swimming Other exercises not only increase tone and muscle strength but also may decrease
  • 4. cognitive decline. (Ignatavicius & Workman, 2021). Maintaining a healthy lifestyle such as: Risk Factors / History Female Over 65 years of age Down syndrome Traumatic brain injury chemical imbalances Environmental agents Immunologic changes Excessive stress Ethnicity/race. Environmental agents such as herpes zoster and herpes simplex, and toxic metals (zinc and copper) increase the risk of AD. Patients who have experienced a traumatic brain injury such as war veterans or repeated head trauma such as boxers may experience AD at an early age (Story, 2017) Short-term memory impairment. Alterations in communication such as apraxia, aphasia,
  • 5. anomia, and agnosia. Impaired judgment such as inability to make decisions, decreased attention span, and decreased ability to concentrate. CHANGES IN COGNITION Aggressiveness, especially verbal and physically abusive tendencies. Rapid mood swings Increased confusion at night/sundowning or excessively fatigued. The client wanders and become lost / may go into other rooms to rummage through anothers belonging. CHANGES IN BEHAVIOR & PERSONALITY Decreased interest in personal appearance. Selection of clothing that is inappropriate for the weather or event. Loss of bowel and bladder control. Decreased appetite or ability to eat (Ignatavicius & Workman, 2021). CHANGES IN SELF-MANAGEMENT SKILLS Physical Signs and Symtoms CT scan shows cerebral atrophy and ventricular enlargement, wide sulci, and shrunken gyri MRI scan rule out other causes of the neurological disease (Ignatavicius & Workman, 2021).
  • 6. Diagnostics Genetic testing (apooliprotien E4 (APOE 4)) Amyloid beta-protein precursor (soluble) (sBPP). Laboratory Imaging assessment Planning and Implementation Interprofessional collaborative Implement a structured and consistent plan of care and environment. Provide a complete evaluation and assistance in helping the client become more independent. Promote cognitive stimulation and memory training such as interactive pet therapy. Promoting bowel and bladder continence. Promoting communication and self-management such as communication board or digital handheld device for scheduled activities. Encourage the family to provide pictures of family and friends that are labeled with the person's name on the pictures. Encourage family and staff to frequently reorient the patient such as "what day is it" (Ignatavicius & Workman, 2021). Psychosocial Integrity The client experience the
  • 7. grieving process; the client anticipates loss, experiencing denial, anger, bargaining, and depression at varying times. After diagnosis one or more family members may desire genetic testing. Support the client and family's decisions regarding testing Ensure the family finds credible resources for testing and professional genetics counseling. Help client with change in routine and environment since the client experiences changes in emotional and behavioral affect. The client experience sexual disinhibition such as masturbating publicly. The client is unaware of their behavior, therefore, provide support to both family and client (Ignatavicius & Workman, 2021). This drug blocks excess amount of glutamate that can demage nreve cells. Helps maintain clients function for
  • 8. few months longer. Improve memory and thinking skills For AD client who develop depression SSRIs such as paroxetine and sertraline Memantine (Namenda): Antidepressants : Medications This drug slows the onset of cognitive decline. These drugs are prescribed for clients with mental/behavioral health problems. This drug should be used as a last resort due to the decreasing mobility and self management ability (Story, 2017) Cholinesterase inhibitors: Aricept, Reminyl, and Exelon Psychotropic drugs such as antipsychotic or neuroleptic The client room should have adequate, nonglare lighting and no potentially lightening shadows. A private room is needed if the client has
  • 9. a history of agitation or wandering. The television should remain off unless the client turns it on or requests it on When communicating with the client use short sentences and one-step instructions. Never assume. that the client is totally confused and can't understand what is being communicated. Safety Considerations Keep the client away from stairs or elevators. Avoid physical or chemical restraints and assess and treat pain. Place the client in an area that provides maximum observation but not in the nurse's station. Use family members, friends, volunteers, and sitters as needed to monitor the client. Provide frequent toileting and incontinence care as needed (Ignatavicius & Workman, 2021). Ignatavicius, D.D., & Workman, M.L., Rebar, C. & Heimgartner, N. M. (2021). Medical-surgical nursing: Concepts for interprofessional care (10th ed.). Elsevier. Story, L. (20170301). Pathophysiology: A Practical Approach, 3rd Edition. [VitalSource Bookshelf 10.0.2]. Retrieved from vbk://9781284142983
  • 10. References Presented by Margaret Smallwood ALZHEIMER'S Joseph Maximilien Excellent presentation. Joseph Maximilien Always date your work. Pathophysiology Alzheimer's disease produces a steady and gradual decline of a client's cognitive function. Amyloid plaques containing fragments of protein mix with neuron remnants, and other nerve cell pieces. The neurofibrillary tangles, found inside neurons, form a tau which clumps together. Failure function and immobility of the neurons leading to death. As the disease progresses the client's ability to learn new information and will eventually impair language, judgment, and behavior (Ignatavicius & Workman, 2021).
  • 11. Etiology Alzheimer's is caused by genetic and environmental factors (viral). The amyloid plaques containing fragments of protein mix with neuron remnants, and other nerve cell pieces. The neurofibrillary tangles, found inside neurons, form a tau which clumps together. Failure function and immobility of the neurons leading to death. As the disease progresses the client's ability to learn new information and will eventually impair language, judgment, and behavior. Neurons cannot survive when their connections to other neurons are lost. As neurons die throughout the brain, the affected regions begin to atrophy or shrink. The damage is widespread and brain tissue has shrunk significantly (Story, 2017). Many Alzheimer's clients have chronic health problems such as diabetes mellitus, strokes, and atherosclerosis. Preventive methods such as smoking and excessive alcohol consumption increase the risk of stroke and cardiovascular disease (Ignatavicius & Workman, 2021). Health Promotion and Maintenance Eating a well-balanced diet Using soy products Consuming sufficient amounts of folate and vitamins B12, C, and E. Walking and swimming Other exercises not only increase tone and muscle strength but also may decrease cognitive decline. (Ignatavicius & Workman, 2021).
  • 12. Maintaining a healthy lifestyle such as: Risk Factors / History Female Over 65 years of age Down syndrome Traumatic brain injury chemical imbalances Environmental agents Immunologic changes Excessive stress Ethnicity/race. Environmental agents such as herpes zoster and herpes simplex, and toxic metals (zinc and copper) increase the risk of AD. Patients who have experienced a traumatic brain injury such as war veterans or repeated head trauma such as boxers may experience AD at an early age (Story, 2017) Short-term memory impairment. Alterations in communication such as apraxia, aphasia, anomia, and agnosia. Impaired judgment such as inability to make decisions,
  • 13. decreased attention span, and decreased ability to concentrate. CHANGES IN COGNITION Aggressiveness, especially verbal and physically abusive tendencies. Rapid mood swings Increased confusion at night/sundowning or excessively fatigued. The client wanders and become lost / may go into other rooms to rummage through anothers belonging. CHANGES IN BEHAVIOR & PERSONALITY Decreased interest in personal appearance. Selection of clothing that is inappropriate for the weather or event. Loss of bowel and bladder control. Decreased appetite or ability to eat (Ignatavicius & Workman, 2021). CHANGES IN SELF-MANAGEMENT SKILLS Physical Signs and Symtoms CT scan shows cerebral atrophy and ventricular enlargement, wide sulci, and shrunken gyri MRI scan rule out other causes of the neurological disease (Ignatavicius & Workman, 2021). Diagnostics
  • 14. Genetic testing (apooliprotien E4 (APOE 4)) Amyloid beta-protein precursor (soluble) (sBPP). Laboratory Imaging assessment Planning and Implementation Interprofessional collaborative Implement a structured and consistent plan of care and environment. Provide a complete evaluation and assistance in helping the client become more independent. Promote cognitive stimulation and memory training such as interactive pet therapy. Promoting bowel and bladder continence. Promoting communication and self-management such as communication board or digital handheld device for scheduled activities. Encourage the family to provide pictures of family and friends that are labeled with the person's name on the pictures. Encourage family and staff to frequently reorient the patient such as "what day is it" (Ignatavicius & Workman, 2021). Psychosocial Integrity The client experience the grieving process; the client anticipates loss, experiencing
  • 15. denial, anger, bargaining, and depression at varying times. After diagnosis one or more family members may desire genetic testing. Support the client and family's decisions regarding testing Ensure the family finds credible resources for testing and professional genetics counseling. Help client with change in routine and environment since the client experiences changes in emotional and behavioral affect. The client experience sexual disinhibition such as masturbating publicly. The client is unaware of their behavior, therefore, provide support to both family and client (Ignatavicius & Workman, 2021). This drug blocks excess amount of glutamate that can demage nreve cells. Helps maintain clients function for few months longer. Improve memory and thinking skills
  • 16. For AD client who develop depression SSRIs such as paroxetine and sertraline Memantine (Namenda): Antidepressants : Medications This drug slows the onset of cognitive decline. These drugs are prescribed for clients with mental/behavioral health problems. This drug should be used as a last resort due to the decreasing mobility and self management ability (Story, 2017) Cholinesterase inhibitors: Aricept, Reminyl, and Exelon Psychotropic drugs such as antipsychotic or neuroleptic The client room should have adequate, nonglare lighting and no potentially lightening shadows. A private room is needed if the client has a history of agitation or wandering. The television should remain off unless
  • 17. the client turns it on or requests it on When communicating with the client use short sentences and one-step instructions. Never assume. that the client is totally confused and can't understand what is being communicated. Safety Considerations Keep the client away from stairs or elevators. Avoid physical or chemical restraints and assess and treat pain. Place the client in an area that provides maximum observation but not in the nurse's station. Use family members, friends, volunteers, and sitters as needed to monitor the client. Provide frequent toileting and incontinence care as needed (Ignatavicius & Workman, 2021). Ignatavicius, D.D., & Workman, M.L., Rebar, C. & Heimgartner, N. M. (2021). Medical-surgical nursing: Concepts for interprofessional care (10th ed.). Elsevier. Story, L. (20170301). Pathophysiology: A Practical Approach, 3rd Edition. [VitalSource Bookshelf 10.0.2]. Retrieved from vbk://9781284142983 References
  • 18. Classical Argument Outline RHETORICAL SITUATION: Purpose: Compose a Classical Argument essay that aims to persuade your audience by using evidence and research to back up your thesis. Audience: Peers with an opposite or indifferent viewpoint to yours Subject: Issue that is debatable and arguable Thesis: Arguable, Specific (problem), Feasible (solution). See pages 110-113 in Let’s Get Writing! INTRODUCTION: The introduction will provide a very brief overview of the issue, capture the reader’s interest, and state the arguable thesis. Consider the following questions to gather the information needed for this paragraph: • Consider using a quote, statistic, or an interesting fact to catch reader’s attention and establish context of persuasion (appeal to pathos) • Briefly describe the problem with the issue that you are going to address (background and context) • Why is this issue important? (engage the audience) • If your argument proposes a solution, you may want to hint at it here. • Usually, the thesis statement comes at the end of the introduction. Remember, the thesis must be arguable (readers can agree or disagree with it), describe a specific problem, and offer a feasible (workable) solution. BODY SECTIONS: NARRATION/BACKGROUND: What is the history of your topic/issue/claim? Give the audience essential background information. Provide research sources for anything that isn’t common knowledge, especially when providing statistics.
  • 19. • Begin maybe 5-10 years ago with your topic. What are some key events, topics, ideas (or people) that have happened to make your issue debatable and something to argue? 1. 2. 3. • Define key words in your position statement that will help convince your audience to believe the way you do. Think about defining at least two words in your claim/position statement. 1. Do you need to redefine or clarify any terms that have specific meaning in this context? For example, what does “institutional racism” mean, and what does it mean in the context of higher education? PARTITION: The partition is like an expansion of your thesis statement before you begin your detailed argument. It is typically one to two paragraphs. • Provide a larger overview about your position on the issue, the exact problem you see and your proposed solution. • Give specifics and provide support from outside sources as needed. ARGUMENT: Develop your argument by creating a list of specific reasons (subclaims) that prove your position. Before you write this section, consider the following: • As you develop your subclaims, consider the warrants (principles/laws of society) and assumptions (shared values/beliefs) of your audience. Make sure your subclaims appeal to what you have in common with your audience. This will make your argument much more convincing. • Each reason will become a paragraph with a clear topic sentence; each paragraph will need outside sources to support
  • 20. the subclaim (data, statistics, expert opinion, etc.) • Aim to provide a balance of ethos (objective and fair support), logos (factual information), and pathos (human interest/emotion). • Be careful to avoid unsupported assertions: opinions without outside support to validate their truth. Ex: “Most people don’t like to spend a lot of money” is an assertion that will need outside support in order to be accepted by readers. Quick Brainstorm Activity: What warrants and assumptions does my audience share with me? Try to identify at least two and use them to help develop your subclaims. 1. 2. 3. Argument Section Body Paragraphs: Think back to your brainstormi ng list above and develop paragraph topics that are subclaims for your thesis. Try to create subclaims that appeal to the commonly shared values you considered in the brainstorming list you just created. Use as many subclaims as needed to thoroughly argue your position. Each subclaim will become the focus of a paragraph and should be reflected in the paragraph topic sentence. 1. 2. 3. 4. REFUTATION OR COUNTEREVIDENCE: What are some major objections to your claim? In other words, what are some reasons your audience might disagree with your thesis? Explain why your audience could be wrong, and how you are right. Maybe they just need more information; maybe you need to remind them of shared warrants/values. Maybe an objection contains a logical fallacy that you can reveal. Remember to keep your tone neutral. Don’t confront or condescend to your audience. Consider using logos and ethos more heavily in this section.
  • 21. • Objection 1: § Explain why this is wrong/your suggestion is better: • Objection 2: § Explain why this is wrong/your suggestion is better: • Objection 3: § Explain why this is wrong/your suggestion is better: Conclusion: • Briefly, and without repeating yourself, restate the specific problem and your claim. • Summarize your main points, being careful to not add any new subclaims • You may consider ending with an emotional appeal such as a call to action, asking readers to consider what may happen if your solution isn’t accepted, or providing a humorous observation to lighten the mood. NOTE! This assignment is for an outline only). Intro: Do you have some information to establish the context of your argument? For example, if your essay is about gun control, is there a reference to recent news reports or an establishment of a need for gun control? Does your thesis appear at or near the end of the intro paragraph? Is your thesis arguable? Narrative: Does your narrative provide background information on your topic? Is the information within the past 10 years or less? Do you have source material for this section? Is this section neutral, as it should be? Partition: Does your partition provide context for your issue? Does it provide an overview of why there is a disagreement concerning your topic? Do you have source material for this section? Does this section begin to provide a broad overview of your argument? Argument Section Paragraphs: Do you have at least three arguable sub-claims to provide the basis of the argument section paragraphs? Does each paragraph list a sub claim as a topic sentence at or very near the beginning? Does each paragraph
  • 22. have evidence to prove the sub claim it is presenting? Refutation: Is there at least one counter-claim listed? Do you have source material to accurately describe the counterpoint(s)? Do you have a refutation listed for the counter-claim? Do you have source material to support your refutation? Conclusion: Is there a clear re-establishment of your overall thesis? Did you avoid repeating sentences that appeared elsewhere in your essay? Is there a reiteration of all of your main points?