Nursing Awareness Case Study

Nursing Awareness Case Study
1. What developmental, gender–related and cultural issues should nurses be aware of when
promoting elimination?
Respecting patient's privacy.
Providing necessary comfort and hygiene measures.
Attending to his/her emotional needs.
Modifying nursing interventions to meet client needs (client centered care).
Providing culturally sensitive hygiene needs.
When client speaks other language use interpreter.
Provide gender–congruent care for patients from other cultures.
Accommodate pattern while client is in the health care facility.
Consider developmental changes that affect bowel functioning e.g. older adults that are less active
will experience constipation or diarrhoea.
Also high fibre promotes normal peristaltic movement. ... Show more content on Helpwriting.net ...
The nature of the intervention must be client–centered and individualized.
Health educate the client for the need of lifestyle modification, dietary recommendation and to
promote physical activity.
Promote comfort when patient uses bed–pan.
Answer call light promptly to prevent a patient from attempting to get out of bed without assistance
thereby having accidents.
3. What behaviours may indicate to the nurse that the client is having alterations in body image?
When patients refuses to discuss or have conversation with nurse or care giver.
When patient is in state of denial and refused to adjust to changes in body and lifestyle.
When patient refused to see the ostomy or participate in his own care.
When patient criticises self and not happy with caregiver.
When client is not discussing or participating in care plan and accept inadequacies.
When client is not accepting care from significant others.
When client refuses to discuss interpersonal and social conflict.
4. What are the ABC's of stoma assessment and pouching?
Observe existing skin barrier and pouch for leakage and length of time in
... Get more on HelpWriting.net ...

Collostomy: Colostomy Home Guide, Adult
Colostomy Home Guide, Adult
A colostomy is a surgical procedure to make an opening (stoma or ostomy) for stool to leave your
body. This surgery is done when a medical condition prevents stool from leaving your body through
the end of the large intestine (rectum).
During the surgery, a section of the large intestine (colon) is attached to the stoma made in the front
of your abdomen. A bag or pouch is fitted over the stoma. Stool and gas will collect in the bag.
After having this surgery, you will need to empty and change your colostomy bag as needed. You
will also need to take steps to care for the stoma.
HOW DO I CARE FOR MY STOMA?
Your stoma should look pink, red, and moist, like the inside of your cheek. At first, the stoma may
be swollen, but this swelling ... Show more content on Helpwriting.net ...
5 Unroll the tail and empty stool into the toilet.
6 Clean the tail with toilet paper.
7 Reroll the tail, and clip or velcro it closed.
8 Wash your hands again.
HOW DO I CHANGE MY COLOSTOMY BAG?
You will be taught how to change the bag before you leave the hospital. Basic steps include:
1 Wash your hands with soap and water. Have paper towels or tissues near you to clean any
discharge.
2 Pre–cut the skin barrier using a template. Smooth any rough edges.
3 If using a two–piece bag, attach the bag and the skin barrier to each other. Add the barrier ring, if
you use one.
4 If your stools are watery, add a few cotton balls to the new bag to absorb the liquid.
5 Remove the old bag and skin barrier. Gently push the skin away from the barrier with your fingers
or a warm cloth.
6 Wash your hands again. Then clean the stoma area as directed with water or with mild soap and
water. Use water to rinse away any soap.
7 Dry the skin. You may use the cool setting on a hair dryer to do this.
8 If directed, apply stoma powder or skin barrier gel to the skin.
9 Dry the skin again.
10 Warm the skin barrier with your hands or a warm

Exploratory Laparotomy: A Case Study
This is a 43–year–old male who came in ER with complain of weight loss, about 50 pounds in last 4
months, intermittent vomiting, abdominal pain. Patient has been admitted to hospital as an inpatient
as his CT scan showed severe bowel perforation and peritonitis. Patient underwent for exploratory
laparotomy followed by sigmoidectomy with colostomy. His previous CT scan (02/2016) revealed
multiple liver lesions, largest measuring left hepatic lobe 4 x 5.5 cm and the right hepatic lobe as
well as multiple periportal and peripancreatic adenopathy in the stomach and pancreas measuring ,
and periportal node and prominent epigastric notes. He had a CT–guided biopsy of the liver on
03/02/2016 which revealed carcinoma consistent with Stage IV squamous cell carcinoma of
stomach and esophagus with metastasized to the liver. The patient has been on chemotherapy,
recently completed 3rd cycle on chemotherapy. ... Show more content on Helpwriting.net ...
He does not smoke or drink. He is married with two children. There is no cancer within the family.
No known drug allergies. Current home medications are Omeprazole 20 mg 1 tablet daily,
Ondansetron 4 mg 1 tablet daily, Oxycodone 5 mg 1 tablet p.r.n. for pain. He was recently started on
FOLFOX with chemotherapy. Currently patient has been on Hydrocodone, morphine IV for pain,
Ondansetron IV for nausea, and Lovenox SC for DVT prophylactic. Patient has been not taking any
blood pressure or diabetes medication as per hospital record which may lead to raise in blood
glucose level and blood pressure (due to pain) postoperatively. Close monitoring of vital signs, pain
scale and CBG will be the important in patient's care. Due to his extensive metastatic condition,
obesity and being prediabetic makes his overall prognosis poor with high chance of having
complications postop including fistulas, bowel injury, infection, slow wound healing and

Oxygen Therapy Case Study
9. Discuss the dangers of oxygen therapy
– Flammable
– Copd, co2 build up, in some patients with COPD as example they use oxygen and this suppress
the drive to breathe, affecting how well the respiratory system works. They can manage this by
adjusting the oxygen flow rate.
– Higher risk of infection because of the tubing or masks not getting changed. (Chrisp & Taylor,
2011)
10. What is the maximum amount of oxygen in Litres per minute that non–breathing oxygen mask
can deliver?
– 15 Litres (Chrisp & Taylor, 2011)
11. What is the appropriate amount of oxygen that nasal prongs should deliver?
– 3 Litres (Chrisp & Taylor, 2011)
12. What is a Tracheostomy?
– Invasive airway, through the windpipe to gain access
13. Give 3 reasons for a Tracheostomy?
– Acute obstruction
– Oral and maxillofacial ... Show more content on Helpwriting.net ...
Identify 3 complications associated with indwelling and intermittent catheters.
– Invasive
– Infection
– Perforation of the bladder
– Perforation of the prostate (Chrisp & Taylor, 2011)
34. What is intravenous therapy?
– Medication or nutrients deposited directly into the vein for the fastest form of absorption (Chrisp
& Taylor, 2011)
35. List 5 reasons for intravenous therapy.
– Fast access to a vein, versatile
– Fast relief of pain or symptoms of illness
– Pt cannot swallow medications
– Pts gut cannot process or stand certain medications eg. Chemo
– Hydration and electrolyte therapy (Chrisp & Taylor, 2011)
36. Provide a definition for extravasation, phlebitis and air embolism.
– Extravasation: In an IV it's the accidental administration of iv infused medications into the
extravascular space/tissue around infusion sites
– Phlebitis: phlebitis may occur at the site where a peripheral IV line was started and including

redness, fever, pain, swelling, or breakdown of the skin. This is when its tender red area along the
veins on the skin, feel hard, warm, and tender. The skin around the vein may be itchy and swollen,
the area may begin to throb or burn, low grade

Information About Caring For Yourself After Your Procedure
Laryngectomy, Care After
Refer to this sheet in the next few weeks. These instructions provide you with information about
caring for yourself after your procedure. Your health care provider may also give you more specific
instructions. Your treatment has been planned according to current medical practices, but problems
sometimes occur. Call your health care provider if you have any problems or questions after your
procedure.
WHAT TO EXPECT AFTER THE PROCEDURE
After your procedure, it is common to have:
Difficulty breathing.
Difficulty speaking.
Temporary inability to speak.
Difficulty swallowing.
Refer to this sheet in the next few weeks. These instructions provide you with information on caring
for yourself after your procedure. Your caregiver may also give you more specific instructions. Your
treatment has been planned according to current medical practices, but problems sometimes occur.
Call your caregiver if you have any problems or questions after your procedure.
After your voice box (larynx) is removed, your windpipe (trachea) is stitched (sutured) to the skin
around the hole through which your larynx was removed. You will breathe through this hole
(stoma). A plastic tube will be inserted in your stoma to keep it open while it heals. At first, you will
have a bandage (dressing) around your neck. You also will have a small plastic container, shaped
like a bulb, attached to your neck. The bulb can be squeezed to create a suction to drain fluid from
your wound.

The Purpose Of The Experiment Was To Uncover Whether A
The purpose of the experiment was to uncover whether a small, young leaf has all the stomata that
the mature leaf will have, all compressed into the smaller surface area. To assess such a question, the
following statement was made: Young and old leaves of the same plant species do not have different
stomatal densities. Leaves contain, in their outermost layer of cells, called the epidermis, small pores
which are regulated by two guard cells, that help balance the gas exchange and water loss within the
plant. These small pores along with the guard cells are called the Stomata: they open and close due
to environmental signals, allowing for the exchange of carbon dioxide and oxygen as well as
allowing water vapor to escape the plant. A ... Show more content on Helpwriting.net ...
Then we water mount the both the young and old leaf to a slide to examine them under the
microscope. First we put the young leaf on the microscope and we had to find it on the 4x.
Once we did that, we move on to the 10x to find the young leaf and got a little better look at it.
Finally we moved on to the 40x and get a good view of the stomata on the young leaf. Once we had
a good view of the stomata, we started to count the stomata on the young leaf. As you count the
stomata you had to move the slide around to make sure you counted all of the stomata. Once we
finished with the young leaf, we moved onto the old leaf. Like the young leaf, we started at
4x to be able to find the leaf. Once we found the leaf we moved on to the 10x to get a better view of
the leaf and made sure we were still able to view the leaf. Finally we were able to move on to 40x
and get a better view of all of the stomata. Once we got a better view of the stomata we started to
count them, moving the leaf around to make sure we got all of them. Once everyone in our group
counted the stomata on both the young and old leaf, we recorded our data on the table we were
given and then shared our data with the rest of the class. Once the rest of the class shared their data,
we wrote the data in the table and compared both the young and old leaf. From all the data we have,
we were able to get the summary values and mean of the leafs.
4
Results:
As demonstrated in Table–1,

Adapting A Holistic Care Package For A Patient Requires...
Complexities in Children 's and Young Peoples Nursing
Formulating a holistic care package for a patient requires children 's nurses to make clinical
decisions by identifying needs, prioritising, planning and delivering care. Nurses are expected to use
current and relevant evidence in their judgement and decisions to ensure the best practise is
implemented (Thompson, C. et al. 2004). Nurses within the healthcare team must integrate scientific
knowledge, patient and family perspectives, available resources and sufficient experiential
knowledge to ensure that their decisions will also be accurate and safe (Gillespie, M. & Patterson, B.
2009).
Within this assignment a scenario has been chosen to discuss the elements of clinical decision
making made by nurses. To justify the decisions which have been made, a critical appraisal of the
available information will be utilized. The scenario focuses upon Joe (See Appendix), an infant who
was born prematurely at twenty–eight weeks gestation and is diagnosed with short gut syndrome
and is close to being discharged. There many needs within the scenario which have been identified,
such as medication training for parents, Joe 's physiological development, travel issues but this
assignment will concentrate on managing an ileostomy, discharging Joe on Total Parenteral
Nutrition (TPN) and social support for the home environment. The aim of the nurses clinical
decisions will be to prevent infection, skin breakdown and re–admission, therefore

Reflection On Stoma Care
Introduction:
During my current Professional Experience Placement (PEP) is in Medical Ward, I got an
opportunity to take care of the patient (Mrs Leoine), who had a bowel surgery as she had a bowel
cancer for which ileostomy stoma was created on the lower side of her abdomen to discharge faecal
matter and urine. Mrs Leoine was required full assistance with her stoma care as she was not fully
aware about stoma care. Therefore, my learning skill is stoma care that plays a significant role in
delivering a person–centred care to Mrs Leoine.
Sets achievable action plan; describe the outcomes 5%
To achieve my learning needs, I discussed my concerns about stoma care with my preceptors while
she was changing the patient stoma bag than she briefly explained to me, including type of stoma,
sign of infections and how should change the stoma bag. From her explanation, I learnt that critical
thinking plays a vital role in any change in colour of surrounding skin and the output of stoma.
Changing skin colour may indicate for sign of infection and high output of stoma can cause of
dehydration following low blood pressure and a risk of fall respectively (Kwiatt & Kawata 2013).
My facilitator also organises a skill day to impart us depth knowledge about the documentation of
stoma care that would help in maintaining the continuity of stoma care (Williams 2007). My
facilitator demonstrated the whole skill step by step which made me more confident in performing
the skill. Similarly, to

Drinking Stutrition : Imbalanced Diet And Nutrition
NURSING DIAGNOSIS
Imbalanced diet and nutrition
Related to: abdominoperineal resection (APR), permanent end sigmoid colostomy and post
operation
Desired outcome:
Short Term:
Begin to gain an understanding of the diet changes required to effectively care for a colostomy,
ensuring a wide variety of nutritious foods from each of the food groups
Drinking at least 2 litres of fluid a day.
Long Term:
Simon can maintain a nutritious diet by himself at home.
Maintain Simon's weight within a healthy range, ensuring he is not gaining or losing a significant
amount of weight.
Assessment/Interventions:
Rationales:
Resume a regular diet with solid foods slowly
It is important that Simon does not rush back into a diet with solids food as this can often cause
abdominal cramps.
Often patients who have had abdominal surgery are nil per mouth for usually the first 24–48 hours'
post operation (Sona 2013, p.1285). Once Simon is ready to begin to slowly return to a normal diet
it important to implement diet intake while judging Simon's response (Sona 2013, p.1285). This is
through providing clean liquids such as water, apple juice or tea as often excessive amounts of fluid
can lead to vomiting (Sona 2013, p.1285). For Simon, it is important to begin with providing clear
liquids, following onto full liquids, a light diet of solid food, and finally a regular diet (Sona 2013,
p.1285).
Providing Simon with a supplemental drink twice a day, as this will allow for him to receive
essential nutrients which he may be missing during recovery.
It is important that Simon is consuming supplemental drinks twice a day. This is because his solid
food will be limited which will result in him receiving less nutritious intake (Fearon 2012, p.45). By
providing Simon with a supplemental drink will ensure that he is still receiving a sufficient amount
of vitamins and nutrition (Fearon 2012, p.45).

Suggest and recommend to Simon a diet which is best for a colostomy
It is important to keep to Simon's normal diet as much as possible. However, it is important that he
is aware of eating regularly and which foods to avoid which may cause diarrhoea, constipation, gas
and odour (Escott–Stump 2010, p.418). It is essential to educate Simon

Head and Neck Essay
Common head and neck surgery includes the removal of the voice box: largyngectomy and
tracheostomy: making an incision on the anterior aspect of the neck and opening an airway through
an incision in the trachea. The removal of the larynx occurs in cases of laryngeal cancer and in this
case the airway is separated from the mouth, nose and oesophagus meaning that the patient will
breathe through a stoma in the neck. In tracheostomy cases the resulting stoma can act as an airway
and a tracheotomy tube is inserted, enabling the individual to breathe without the use of their nose
and mouth.
Tracheostomys may be required for long term control of excessive bronchial secretions, particularly
in those with reduced consciousness or to maintain an ... Show more content on Helpwriting.net ...
This means that air does not pass through the vocal cords and so speech is not possible. Sometimes
patients can have a tracheostomy tube that allows some air to go through the vocal chords and out of
the mouth. Patients can have this type of tube if they are able to swallow without difficulty and if
they do not need a tracheostomy tube with an inflated cuff in order to get air into the lungs.
The last option is surgical voice restoration which was introduced by Singer & Blom in
1980(Blom,1995) Not all patients are suitable for this however, It involves a tracheoesophageal
speaking valve, a small fistula is surgically created through the tracheal wall into the oesophagus. A
small, one way valve is inserted into the fistula and it allows air to be shunted from the trachea to
the oesophagus and up through the pharyngo–oesophageal segment creating an acoustic wave form
and voice. A longer flow of voice can be achieved as pulmonary air is used as the initiator for voice.
Another problem that arises in head and neck patients is that of malnutrition and weight loss. They
are particularly at risk of developing nutritional problems. Many patients with head and neck cancer
have histories of high alcohol intake, tobacco use and poor dietary habits. Malnutrition often when
alcohol is involved. Patients nutritional needs should be assessed and patients at high risk of

Photosynthesis Lab
Background: Photosynthesis fuels ecosystems and replenishes the Earth's atmosphere with oxygen.
All enzyme–driven reactions, the rate of photosynthesis can be measured by either the
disappearance of substrate, or the accumulation of products. The leaf is composed of layers of cells.
Mesophyll layer is normally infused with gases, oxygen, and carbon dioxide. The disks cut from
leaves will normally float in water because of the gases. If the leaf disk are placed in a solution with
an alternate source of carbon dioxide in the form of bicarbonate ions, then the spaces of mesophyll
and the leaf becomes buoyant and floats. Oxygen and carbon dioxide are exchanged through
opening in the leaf called stoma. The buoyancy of the leaf disk is the an indirect ... Show more
content on Helpwriting.net ...
If air is removed from these spaces the change of density in the leaf. The air is return to these spaces
through photosynthesis. In the lab experiment the goal is to remove the air from the disk leave and
return the air into the spaces by using baking soda, instead of carbon dioxide. The rate of
photosynthesis is measured in the lab by timing how many leave disks float back to the surface of
the bicarbonate, water, and soap mixture.
Question: If the rate of photosynthesis can be measured by a process of extracting the air from the
leaves, then putting those leaves in a bicarbonate solution, will two different brands of spinach have
a similar or different rate of photosynthesis?
Hypothesis: B. H. Spinach Epinard J&D Produce Inc. spinach and Baby Spinach will have a similar
photosynthesis rate, after the spinach disk lost and the air in them and put in a bicarbonate and soap
solution because the spinaches are the same leave but different brands.
Purpose: To determine the rate of photosynthesis after CO2 has been removed from disks of spinach
then placing the disks in a beaker containing bicarbonate, soap, and water

Surgical Wound Care Case Study
Problem 1
Wound Care
Justification
Dougherty and Lister (2011) stated that it is important to keep post–surgical wound free from
infection because the healing of the wound depends on the amount of care being provided. There are
potential complications associated with infected post–surgical wound, which includes wound
dehiscence, surgical–site infection, and hematomas. These complications often occur within hours
after surgery, so therefore, high priority should be place on wound care for a patient who has had a
resection of recto–sigmoid tumor and is left with a laparotomy wound.
Problem 2
Stoma Care
Justification
When a patient undergo a ostomy operation, it is important for the skin around the operation ...
Show more content on Helpwriting.net ...
Empting and rinsing the pouch regularly with the appropriate solution eliminates germs, smells, and
refreshes the pouch for patient comfort (Sanabria et al., 2014).
Evaluation
There will be absent of impaired skin, rashes and skin irritations around the stoma and specific issue
that may possibly contribute to skin breakdown will be recognizable.
Nursing diagnosis –3
Disturbed Body Image related to stoma, knowledge deficit, and ineffective coping evidenced by
wife requesting information about surgical procedure and her anxieties about hospital regular trips.
Goal
The goal is for patient and family to accept body changes, have a good knowledge and cope with the
diagnosis.
Nursing Interventions
Give education about stoma care to patient and family regarding the diagnosis, treatment and
prognosis and maintain privacy when teaching and providing stoma care.
Encourage patient to talk about his feelings, and possible anxieties in regards to his altered body
image.
Encourage patient and family member to observe, and participate in stoma

The Colostomy Procedure
The colostomy procedure has changed the medical world in a major way because it allowed people
with intestinal issues to live a longer life. Having a colostomy means a "portion of your colon
(digestive tract) was removed, which left an opening in your abdominal area; the opening is
something many refer to as an ostomy with the stoma being the correct terminology for the actual
opening of the abdominal wall." This makes the condition more efficient to handle whereas the
surgery makes it possible for patients to defecate again without passage through the rectum or anus.
Having this surgery does not mean you possess any type of sickness, but that you had to alter the
way your body works due to an incident that did not allow you to carry out regular human functions.
The colostomy has made it feasible for many people to lead normal lives even though being gone
through something. We are unsure today who invented this glorious idea, but we do know the 1st
known and successful procedure was done by "Dr. M. Pilore, a French surgeon in 1776." Getting a
colostomy can be the aftereffect of having an illness, colon cancer, a disease of the stomach area,
damage to the colon or rectum, or incomplete/complete blockage of the large intestine. This
technique was to made to permit the passage of bodily waste out,yet it carries many risks and a
number of things that could go wrong if not properly ... Show more content on Helpwriting.net ...
Having a colostomy can be looked upon as something horrible, but it has made thousands of lives
better. Some people after the surgery may have sociological issues though, and the best way to get
over them is by having a sense of humor and/or a positive outlook on life. Nothing but the way the
digestive tract works have changed with the surgery so patients can lead their normal lives, therefore
making the procedure a world changing

Mr. S Case Study
Mr. S is a 29–year–old male with past medical history of (PMH) hypertension (HTN) and obesity
who presented to local emergency room (ER) with headache and chest and back pain. Mr. s had
been seen at urgent care three days prior for a headache and near syncope and was told to hold his
metoprolol due to bradycardia. Due to health insurance related problem, he has been off amlodipine
and lisinopril for a month. Mr. S was driving when he experience a stabbing chest and back pain for
the first time. The pain was so severe he immediately went to his local ER. Pulmonary ventilation
and perfusion (VQ) scan and Computed tomography angiography (CTA) was done at his local ER.
VQ scan was negative for pulmonary embolism (PE). CTA of the chest revealed ... Show more
content on Helpwriting.net ...
After extubation, the patient endured acute delirium. The attempt to control agitation using ativan,
haldol, and thorazine was not successful. Consequentially, dexmedetomidine was used to sedate the
patient. Seroquel was started and dexmedetomidine was in the process of weaning off when he
developed a fever to 102.7 degree Fahrenheit (°F), worsening acute kidney injury (AKI),
leukosytosis, hypotension on post–operative day (POD) five. He underwent CTA chest and
Computed tomography (CT) of the abdomen and pelvis with and without contrast which revealed
cecal and ascending colon pneumatosis. IC was suspected. Since Mr. S was sedated, assessing for
symptoms of IC were not possible. However, he had three bowel movements (BM) on POD four
and one BM on POD five without melena or hematochezia. Following the CT scan findings,
nasogastric (NG) tube feeding was stopped immediately and general surgery team was consult. On
the same day, Mr. S underwent a right hemicolectomy with end–ileostomy for ischemic bowel. The
intra–operative findings include dilated right colon and transverse colon, a foot long necrotic
terminal ileum, and necrotic right colon up to close to the hepatic. Brooke ileostomy was perfomed.
The stoma located at right lower quadrant (RLQ) of the

Ostomies: Article Analysis
In her journal article, "Ostomies: Nursing Care and Management" (2016), Mary L. Schreiber
addresses the importance of assessment, care, and patient education regarding ostomies of all types
and locations. She begins by providing a scenario describing the effects of an unmanaged ostomy on
a patient. These effects are pain, skin breakdown, possible infection, and disturbed body image and
are all elaborated on throughout the article. Schreiber begins her teaching by explaining reasons or
causes for ostomy placement, the parts included in the ostomy system, and the different types of
ostomies and locations in which they are placed. Type and location of the stoma determines the
consistency of drainage from the stoma site. There more distal the ... Show more content on
Helpwriting.net ...
First of all, having a better understanding of different ostomy types and the meaning of their
locations will help me know how to educate my patients and anticipate their needs. For example,
knowing what nutrients might be lacking with an ileostomy, as well as which ones may be helpful in
caring for a urostomy, will allow me to better care for my patients. I will be able to teach them how
to maintain adequate nutrition following discharge. After learning what to watch for and how to
prevent skin breakdown and infection around stomas, I will be sure to keep peristomal skin clean
and dry without using soap around the immediate area. I would have used soap prior to reading this
article. I will be able to assess and care for the potential skin problems Schreiber addressed. If I
make sure to monitor for things like irritation, bleeding, and skin stripping, I will decrease my
patient's risk for infection related to the ostomy. Teaching the patient how to monitor for these
conditions, keep the skin clean, and empty the ostomy independently will also be a high priority. I
will want to make sure the patient has retained the education and is comfortable going home with an
ostomy if he or she is able. In addition, I hope to also encourage my patients to ask questions and
discuss any concerns related to self–image and usual physical

Investigating the Amount of Stomata on a Variety of...
Investigating the Amount of Stomata on a Variety of Different Sized Leaves
Introduction
During this experiment I am going to investigate the stomata on a large leaf and a small leaf from
the same plant to compare the amount of stomata per mm². The stomata are small openings found in
the lower epidermis of leaves. Each stoma is surrounded by two bean–shaped guard cells containing
chloroplasts. A stoma is a very efficient structure because it can control the rate of transpiration
(water loss) and the exchange of gases. When it closes, no transpiration occurs. When it opens,
transpiration takes place. The stomata open to allow carbon dioxide into the leaf for photosynthesis
and to allow oxygen out. ... Show more content on Helpwriting.net ...
The thin outer walls lose pressure which causes the thick inner walls to close, meaning the stoma is
now closed and now more water is lost, therefore controlling the balance of water within a leaf.
Prediction
I predict that the bigger leaves will have more stomata because it is the bigger leaves that help most
during photosynthesis. The smaller leaves are not as important therefore they will not need as many
stomata per mm². The bigger leaves are more important to the plant as they have a larger surface
area which means that they can absorb much more sunlight than the smaller leaves, therefore they
need more stomata to control the water levels. I think that the number of stomata per mm² in each
size of leaf will vary quite a bit because I think that the younger leaf will not need near as many of
stomata as the younger leaf as I think that transpiration is less important to a younger leaf.
Method
1. First of all I am going to collect two leaves from the same plant. The leaves I will use are from the
plant Tradascantia. I am going to obtain a larger leaf and a smaller leaf enabling me to compare
them.
2. I am then going to use clear nail polish to paint a thick layer of varnish on the underside of the
leaf. I am going to paint 5 dots which will give me a wider

Sun And Appropriate Hypothesis
Abstract
This experiment is useful since it indicates how sunlight, one of the environmental factors affect
plants. The effects of sun and shade on stomata density of Tsuga heterophylla plant were
investigated. The dependent variable was stomata density, and the independent variable was sunlight
(sun and shade). The stomata impressions were made by using the nail polish to inscribe the stomata
on the leaves bottom. The imprint was applied in the calculation of leaf stomata density. A t–test was
used to compare the results between two variables (sun and shade). A significant difference of
stomata density was observed between the leaves in the sun and shade. The leaves in the sun had the
highest stomata density than the leaves in the shade.
Introduction
Sunlight provides energy for all organisms. This ... Show more content on Helpwriting.net ...
How sun and shade affect the stomata density. The following questions were asked;( 1) can sun
increase the stomata density? (2) Can shade increase stomata density? (3) Is it true that both shade
and the sun increase stomata density? It was hypothesized that the stomata density was greater in the
sun than in the shade. In this experiment, one plant species (Tsuga heterophylla) was assessed. Tsuga
heterophylla is an evergreen coniferous plant.
Methods
Site description
Tsuga heterophylla was collected from Tongass National Forest. Tongass National Forest is located
in Southwest Alaska in the United States of America. It is the largest national forest in the USA. The
forest is part of temperate and Pacific rain forest. The experiment was performed at this site between
9.00am to 4.00pm.
Field sampling
Twelve of Tsuga heterophylla plants from sun and shade were collected. Compass was used to
determine west and east; this was conducted to find the sunlight path to determine whether there
were objects blocking sunlight from reaching the plant leaves. Two light meters were used to
measure shade and sun leaves.
Lab

Diverting Colostomy Case Studies
Write an appropriate actual nursing diagnosis. Be sure to include a "related to" and "as evidenced
by". Diagnosis: Disturbed body image related to surgical procedure (an elective colectomy with
diverting colostomy, requiring a bag), as evidenced by refusing care except for medications and vital
signs, reluctancy to allow assessment of surgical site, overall hostile behavior and negative talk
while replying to questions about the stoma or how the surgery is affecting overall lifestyle patterns–
this includes looking away, giving vague one word answers, and being overall "put off" by
questions, and refusing teaching about how to care for the stoma by covering up the abdomen and
patient stating "I don't care what they want to teach me, I'm not

Bariatric Surgery
Bariatric Surgery is derived from the Greek words "weight" and "treatment". Bariatric Surgeries are
major gastrointestinal operations that seal off most of the stomach to reduce the amount of food one
can eat and they rearrange the small intestine to reduce the calories the bodies can absorb. Weight
loss operations fall into three categories. The first category is the Restrictive procedures make the
stomach smaller to limit the amount of food intake. The second category is the Malabsorptive
techniques reduce the amount of intestine that comes in contact with food so that the body absorbs
fewer calories and the third category is a combination of the operations that employ both restriction
and malabsorption.
There are several different types ... Show more content on Helpwriting.net ...
A circular window is made through the stomach a few inches below the esophagus. A surgical
stapler is used to create a small vertical pouch by putting a row of staples from window toward the
esophagus. The pouch is carefully measured at the time of the surgery and will hold about one
tablespoon of solid food. The next step involves a polypropylene band being placed through the
window around the outlet of the pouch and it is secured to itself with stitches. The band controls the
size of the outlet and keeps it from stretching. VBG limits the amount of food a patient can eat at
one time. It works solely by restricting the amount a patient can eat, unlike the Roux–en–Y Gastric
Bypass. The procedure is performed under general anesthesia and requires four or five days in the
hospital.
The Roux–en–Y Gastric Bypass is the most common Gastric Bypass Surgery. The stomach is made
smaller by creating a small pouch at the top of the stomach using surgical staples or a plastic band.
The smaller stomach is connected directly to the middle of the portion of small intestine, bypassing
the rest of the stomach and upper portion of the small intestine. This procedure requires a four to six
day stay in the hospital or two to three days for the laparoscopic procedure. It is possible to return to
normal activity three to five weeks after the

Being A Great Nurse Means To Be In A Mutual Partnership
Being a great nurse means to be in a mutual partnership with the healthcare professionals and
commit to each individual patients condition. It is to collaborate with other health care professionals
to provide the best care possible. Becoming an equal partner with a physician, the nurse will become
a leader and as such will take part in developing health care plans, tracking improvements, making
modifications and participate in important boardroom decision. Interprofessional collaboration and
coordination moves the nurse from the bedside to the boardroom. To achieve this I plan to actively
participate in leadership development and use my vision to transform health care systems. I will be
involved in mentoring programs to progress my ... Show more content on Helpwriting.net ...
Better nursing education will result in improved knowledge hence well–informed nursing practice.
The attainment of higher levels of education will result in more relevant research applicable in
evidence–based practice. Improved policies in collaboration with nurses will result in improved
working environments for nurses and improved patient outcomes. Preceptor Practicum Experience
The Institute of Medicine states, "patient needs have become more complicated, and nurses need to
attain requisite competencies to deliver high–quality care" (IOM, 2010). To improve patient care
outcomes registered nurses need to use evidence–based practice and keep up to date with research
and evidence. Evidence–based practice increases accountability in safety and improvement of
healthcare standards and guides clinical decision making. Evidence–based research integrates
clinical expertise with research evidence and calls for personalization of care by taking into account
patient preferences (Stevens, 2013). During my preceptorship experience I was able to provide
patient care using evidence–based practice that supported my practice at the point of care. I was
preceptored in Stern Family Center for Rehabilitation where I was given the opportunity to increase
my knowledge and skills as a future registered nurse. In this clinical

Stomata In Leaves
Contents:
Introduction
Literature Review
Method
Results
Photos of the results
Conclusion
Reference List
Appendix
Plagiarism
Introduction:
This project is to show the difference in Stomatal Density in leaves that are in the shade and that are
in the sun. The focus question that I have asked is what is the difference between the Stomatal
Density between leaves found in the sun and leaves found in the shade? The hypothesis is leaves
that are found in the sun should have a higher Stomatal Density than leaves that are found in the
shade. The reason that I have chosen this topic is because it is a required topic for my biology class
and we are learning about Stomata in leaves so this project would benefit our knowledge.
Literature Review ... Show more content on Helpwriting.net ...
What my source has told me is that, 'The amount of sunlight a leaf is exposed to greatly affect the
number of Stomata one can find on its underside.(Telwar,2015)Turns out that leaves that are found
in the sun were able to produce more Oxygen and required more Carbon Dioxide. In order to cope
with these demands of gaseous exchange you would need a high density of Stomata which is what
the leaves in the sun contain. Leaves in the shade do not come into direct contact with the sun or any
sort of light would have a lower density of Stomata. Reason why leaves in the sun did not require as
many Stomata was because of the lack of sunlight; therefore 'they produced a smaller amount of
Oxygen and required a smaller amount of Carbon Dioxide'.

United Ostomy Network (Uon) Meeting the Differentiation...
The demographic profile of the general ostomy population and the results from the surveys has
created the facts needed to make the following recommendations on the following:
1. What does the survey tell us about the demographic profile of the general ostomy population
within North America
2. Is the current survey constructed well enough to collect decisionable / actionable data in the
future? 3. Should UON invest in designing a website which will differentiate themselves from others
with quality information which is not available on other websites
Before I analyzed the data from the surveys, I looked at several websites which offer similar
information.
I found the websites very unorganized and not user friendly or intuitive. The ... Show more content
on Helpwriting.net ...
As you look at the data in graph 3, 49% of the respondents said this medical condition has impacted
their life negatively or for the worse, 31% stated that it has had a positive impact and 19% stated
that it has had no effect on their life. This is significant as with almost half the respondents stating
this had a negative impact on their life will lead us to believe that information and management of
this is going to be critical in the future. The need to be informed is important, but, the way help is
acquired does not appear to be through internet sources, but more through the support / discussion
groups available.
United Ostomy Network (UON) Meeting the Differentiation Challenge
Page 2
76 74
80
67
70
59
60
50

39
40
30
10
Not at all
18
20
1
11
4
9
56
22
Yes, quite well
Yes, somewhat
0
Does not
Has greatly Has greatly affect my life affected my affected my at all life for the life for the better
worse
Has
Has
somewhat somewhat had a had a positive negative effect on my effect on my life life
Graph 3 – Impact stoma has had on quality of life
Finally, we can see that since the surgery, over 85.7% of the respondents stated that their health is in
good to very good. Now although the previous data states that that 49% said this condition has

The Impact Of Ostomy Surgery On Body Image
Abstract Title. The Impact of Ostomy Surgery on Body Image: A Rapid Review Aim. This paper is a
report of a literature review conducted to answer the question 'How has the perception of body
image following stoma formation been explored and interpreted through existing research?' Finding.
Broad themes of perception of body image following stoma formation identified: 1. That the initial
reaction to seeing the stoma stays with the ostomate. Therefore, pre– and post–operative education
is needed. 2. That for all patients, their hospital course and discharge experiences are crucial to
maintaining a positive body image. Their satisfaction with the care received, confidence in changing
the appliance, and the support of the staff nurse all appeared to affect patient's body image. 3. That
body image testing may also be of benefit before surgery as patient with poor scores tended to have
poorer body image, post–surgery. Based on the score, patients could be offered psychological
support before and after ostomy surgery, to help with adjustment. These findings highlight the
impact that a change in body image has on the ostomate. They suggest the need for further research
into body image, to explore how ostomates adapt to change, so that healthcare services can be more
individualized to patient needs. Understanding the individual's experience of body image changes
related to living with a stoma may help to inform clinical practices and direct the focus of education
programs.

Terrie Carrie Smoking
"Smoking is the number one preventable cause of death in the U.S., killing over 1,300 people per
day." (ALA). I chose to talk about the harmful effects of tobacco products. The commercial from the
Centers for Disease Control and Prevention (CDC), because I think it greatly identifies the harmful
effects of smoking tobacco. This commercial shows a women that was a former smoker, and the
effects she deals with now.
At the beginning of the video it shows a picture of her when she young without any problems or
disabilities. She is still fairly young in the video, 51, which shows how harmful smoking is. Roughly
twenty to thirty years of smoking affected her in a severe way. This advertisement is mainly directed
to the youth of today and people who are still smoking. I feel the ad is meant to scare people in a
way to stop them from consuming tobacco products. There has been a study done that link tobacco
and poverty or low income citizens. Tobacco and poverty low income people smoke more and die
more from tobacco use.
I find this ad particularly appealing because it shows the state that she is in because of her tobacco
use. This ad show Terrie after years of smoking. She was diagnosed with throat cancer. When Terrie
had surgery for her cancer, her voice box was removed. Some people who have this surgery have an
artificial voice box in order to speak. ... Show more content on Helpwriting.net ...
The CDC definitely tries to stress the importance of not using any tobacco products. I feel that this
ad does a better job that most other smoking ads because this ad gives you an inside look and a
personally view of an individual's life and what she has to deal with. Other ads just state facts such
as how many people died in a year, but people don't really think about it or they think that they
won't be including in this statement. But I don't anyone wants to live how Terrie is living because of

Scholarly Journal Critique Paper
The article chosen for this Scholarly Journal Critique is "Physical activity and exercise after stoma
surgery: overcoming the barriers" by Sarah Russell. The article discusses a survey and its finding.
There were 2631 respondents participated in the survey "Living with a stoma, your experience" in
2016. This is one of the largest known surveys to date. The survey, in particular, looked at the
physical activity and the quality of life from people living with stomas in the UK. The results,
presented by Sarah Russell, emphasized a fear of exercise in patients after their stoma surgery.
Physical activity after illness or surgery is important for rehabilitation, physical recovery, and mental
wellbeing. Having abdominal surgery and the formation of a stoma could cause trauma to the
anterior abdominal wall musculature. Association of Stoma Care Nurses UK (ASCN) national
guidelines (ASCN, 2016) recommend that patients should exercise their abdominal and core
muscles appropriately to reduce the risks of developing ... Show more content on Helpwriting.net ...
For demographics, more women than men responded to the survey. Also, the main reason for stoma
surgery was ulcerative colitis, followed by colorectal cancer, and Crohn's disease. For general
physical activity, 37% people reported that their activeness are "about the same" as they were before
the surgery; however, 19.5% said they are "much less active" and 18.8% responded "little less
active." Although other reasons contributed to the lack of physical activity after the surgery, this
finding is significant because it indicated that people were afraid to exercise because they could
develop hernia. For age groups, younger patients tend to be more active than older people; thus,
their quality of life improved. Although stoma patients, overall, are much less active after surgery,
physical activity level in cancer survivors is even

Nursing Assessment: Patient/Caregiver
Assessment I. Nursing assessment Fecal Odor and color for the stool are normal and consist No
symptoms of constipation or diarrhea Patient is unable to handle her own feces and will be handle
by her family II. Nursing Diagnosis (3) Risk for Constipation /Diarrhea Planning III. Expected
Outcome Patient /caregiver will be able to identify symptoms of diarrhea/ constipation before home.
Patient /caregiver will pick the correct food to avoid Constipation/Diarrhea even discharge. IV.
Nursing Interventions Suggest patient to keep the record of the input and output during
hospitalization and discharge. Educate patient to monitor the signs and symptoms of constipation /
Diarrhea during hospitalization Review medication and oral ... Show more content on
Helpwriting.net ...
Encourage patient to maintain adequate fluid intake. Encourage patient to have adequate vegetable
intake if possible. V. Rationale "Delay may indicate persistent ileus or stoma obstruction, which may
occur postoperatively". (Doenges, Moorhomer, & Murr, 2010 p. 341) "Because of edema,
improperly fitting pouch (too tight), prolapse, or stenosis of the stoma. Absence of stool requires
emergency medical attention". (Doenges, Moorhomer, & Murr, 2010 p. 341) "Adequate intake of
fiber and roughage provides bulk, and fluid is an important factor in determining the consistency of
the stool". (Doenges, Moorhomer, & Murr, 2010 p. 341) Evaluation VI. Outcome Assessment
"Delay may indicate persistent ileus or stoma obstruction, which may occur postoperatively".
(Doenges, Moorhomer, & Murr, 2010 p. 341) "Because of edema, improperly fitting pouch (too
tight), prolapse, or stenosis of the stoma. Absence of stool requires emergency medical attention".
(Doenges, Moorhomer, & Murr, 2010 p. 341) "Adequate intake of fiber and roughage provides bulk,
and fluid is an important factor in determining the consistency of the stool". (Doenges, Moorhomer,
& Murr, 2010 p.

Biography of Rolf Benirschke
Heroes come in all sizes, shapes, genders, and backgrounds. Heroes can be defined by many
different standards and are people of great character, who spend their lives doing what they can to
help others in need. Everyone has his or her favorite hero, my favorite hero is one that is little
known but to me is a true inspiration. My hero is Rolf Benirschke. He is my hero for the courage,
inspiration, and help that his words provided me when I was recovering from lifesaving surgery. I do
not know Rolf, I do not know if I ever will get to meet him, but one thing I do know is that he had to
fight the same life changing illness that I did, Ulcerative Colitis. This provided the relationship and
admiration that I have with and for him as my hero. First, Rolf Benirschke was a normal every day
young man who had a family and normal upbringing, just like me. Rolf has a good build, he is
skinny, tall, and has brown hair and brown eyes. Throughout high school, college, and into his
profession, Rolf's life seemed to be just like every other normal person. He was drafted into the
National Football League (NFL) to be a kicker. Soon after he began his third season as a kicker in
the NFL, Rolf fainted on the team plane.
When he woke up he was in a hospital with tubes connected all to his body and he was confused.
Rolf was diagnosed with a gastrointestinal disease called Ulcerative Colitis. Ulcerative Colitis is a
type of irritable bowel disease that affects the lining of the

The Importance Of Professionalism In Nursing
A professional nurse is one who puts the needs and importance of patient care above all others.
While striving for professionalism, nurses need compassion, patience, empathy, strong moral and
ethics, accountability and the commitment to always act in the best interest of their patients. Nurses
are held accountable for providing quality, safe, and effective nursing care (Hood, 2014). A
professional nurse has the responsibility to continually improve and implement nursing standards
while maintaining integrity by involving themselves in various tasks. Regular involvement in
reading professional literature and sharing of evidence– based research with other healthcare
personal helps increase knowledge and skills. This nursing ability can be used to encourage the
actions of others in the healthcare team resulting in improved patient care. Nurses should encourage
each other to become involved in hospital committees, provide an environment to encourage the
discussions of ethical dilemmas, promote professional growth of nurses to voice their concerns and
share viewpoints to address issues. "A professional nurse should expect to commit to a life of
continuous learning growth and development". (Hood, 2014, pp. 29). Nurses choose this profession
to help others. As professional nurses we must maintain our ethics, values, characteristics, and
commitment to drive our profession forward (CCN, 2015). Nurses must be autonomous,
accountable, and be able to delegate to unlicensed assistive personnel. Being autonomous as a nurse
means having control over their practice (Hood, 2014). It allows a nurse to take risks while being
held accountable for ones' actions (Hood, 2014). Delegation is the responsibility of the
knowledgeable and educated nurse. The nurses understanding of the level of skill the person posses
is imperative to the successful act of delegating. Once the skill is performed it is the responsibility of
the professional nurse to evaluate if it was completed and documented accurately. "Professional
nurses use nursing judgment in delegation" (CNN, 2015). Application of Nursing Theory to Practice
Nursing theory is defined as "a creative and rigorous structuring of ideas that project a tentative,
purposeful, and

What Is Inter-Professional Collaboration?
Inter–professional considerations
Inter–professional collaboration refers to a collaboration between health workers across different
professional roles to provide high–quality care (Liesveld 2017, p.429). The main professionals in
Simon's care are, a physiotherapist to assist Simon with movement and any musculoskeletal
problems which may arise, a dietician to ensure that Simon has the knowledge and understanding of
the diet he should have with a colostomy to be able to maintain his health and prevent
complications, a medical officer who is responsible for Simon's medical diagnosis and determines
the therapy required (Gonda & Hales 2015, p.116–117). Simon may need support from a social
worker who can counsel and support him, and an occupational ... Show more content on
Helpwriting.net ...
2017, p.1334). The Stoma Therapy Nurse will be an important part of and will direct Simon's
preoperative and postoperative care (Crisp et al. 2017, p.1334). In addition, the Stomal Therapy
Nurse is trained to care for Simon's stoma whilst in the hospital (Burch 2013b). They will be able to
answer any questions or queries Simon has about his preoperative and postoperative care (Burch
2013b). Additionally, providing educatation for Simon about practical care teaching him what is
normal, abnormal and what he should do should a problem occur, information about diet and any
diet changes Simon would need to make to prevent complications from occurring, let Simon know
how to obtain stoma supplies in the community and general information such as hobbies, exercise
and work (Burch 2013b). The Stomal Therapy Nurse is an important part of the inter–professional
collaboration in helping Simon post–operatively as they can help educate Simon about stomas and
changing of stoma appliances (Fleming & Mortensen 2015). Should any complications or
difficulties occur the stoma nurse can offer advice to Simon, and allow for the problem to be
resolved (Fleming & Mortensen 2015). Due to the expertise of Simon's Stomal Therapy Nurse, they
are vital to his stoma management and post–operative recovery (Fleming &

Patient Case Summary
The patient's skin integrity must be assessed on an ongoing basis. John was assessed numerous
times throughout the days for pressure areas, oedema, and skin integrity surrounding the stoma and
midline surgical incision. The surgical incision had a lower sinus which was being packed with
betadine wick as per surgical team. The patient was seen by TVN and in conjunction with the
surgical consultant a vac dressing was placed in situ for the midline sinus. The surgical transferring
ward were aware of same and competent in the care of surgical wounds and stoma care. Medically
Discharge: In ICU, the discharge of the patient to the ward lays primarily with the ICU consultant
and their team. The discharge request must be verbal and written confirmation

Startling Anti-smoking Advertisement Essay
Anti–Smoking Campaign's Startling Advertisements
A child who has lost his mother in a busy airport is a scenario that most audiences pay attention to.
It's thrilling in a way– will the protagonist find his mother? This video commercial is one that leads
the way in the anti–smoking campaign. A young boy is walking alongside with his parental and the
next minute is alone. Looking around trying to locate her, the effort is unsuccessful. Unaware what
to do next, he cries and cries (See Figure 1). A narrator voices, "If this is how your child feels for
losing you for a minute, just imagine if they lost you for life. (13QUIT)"
Figure 1
Based on the voice of the narrator, we can conclude that the commercial was produced in Australia.
The ... Show more content on Helpwriting.net ...
It features a middle–aged woman who gives the audience tips on how to get ready for the day. She
was first identified as a former smoker and is shown with a stoma, which she speaks out of (See
Figure 2). From there, "Terrie" goes through the routine of putting in her teeth, wig, and "hands free
device" (CDC).
Figure 2
This advertisement was produced within the last five years by the United States Centers for Disease
Control and Prevention (CDC), a government agency. The audience is again, smokers in general. I
like to think it is designed partially for smokers who haven't yet been damaged (physically) by
smoking. The damage has been done on aged smokers, which might not be as influenced, knowing
what it can do. This advertisement is rather nauseating and crude due to its rough material.
Displaying a woman living with a stoma is stunning for any audience. It becomes one's best interest
to not smoke after seeing this– logically, consumers are going to be turned off by cigarettes with the
possibility of needed a stoma one day. I don't quite agree with the setting of the phrase near the end,
"Smoking causes immediate damage to your body. (CDC)" This is probably true but not appropriate
when advertising someone with a condition that was cause by years of smoking.
Both advertisements have very strong messages to send. Neither can really be captured using still
images due to the fact they have such an intense story to display. The major differences that I

The Effects Of Chemo And Radiation Therapy On The Cancer
A 45 year old male, with a history of smoking ½ packs of cigarettes a day for the past 30 years has
been diagnosed with laryngeal cancer. The patient comes into the hospital for a follow up visit to his
health care provider. Where he has been getting radiation and chemotherapy treatments for the
cancer. He has complaints of pain, dyspnea at times and dysphasia. While discussing the progress of
his condition the doctor states that the chemo and radiation therapy has not been successful and the
cancer has started to progress. The doctor then states the next steps to prevent the spread of the
cancer, and that's to have total laryngectomy surgery. The patient understands the severity of his
condition but is now experiencing anxiety because of ... Show more content on Helpwriting.net ...
The purpose of laryngectomy is to remove tumor or cancerous tissues. It is done when the larynx is
badly damaged or when cancer has advanced. Often, if the cancer has spread, other surrounding
structures in the neck, such as lymph nodes, are removed at the same time. Partial laryngectomies
are done when cancer is limited in one area of which the tumor is located, will be removed. Also
laryngectomy is performed because cancer treatment option, such as radiation or chemotherapy has
failed. (Gale Encyclopedia of medicine. 2008). Nurses play a critical role in patient education
throughout the entire spectrum of healthcare. Nursing care of people who have a total laryngectomy
starts in the pre–operative period with patient education and continues after discharge with follow–
up care. The nurse–patient relationship begins in the outpatient setting, where the nurse performs a
complete head–and–neck assessment and comprehensive review of the patient's past medical and
social history. (Cheryl Bressler, MSN, RN). First, to start the process of preop care, making sure the
patient had a restriction of foods and liquids at least six to nine hours before the surgery. The nurse
would make sure the patient signed a consent form after thoroughly explaining the procedure. A

Laryngectomy
A description of the probable etiologies (causes) of the condition:
A laryngectomy is usually the result of treatment for laryngeal cancer. This operation is the removal
of the larynx, either a full or partial removal. It is typically performed because of the presence
cancerous tissue or tumors. A laryngectomy is usually only implemented after all other treatment
options have been exhausted. A total laryngectomy is typically done when the cancer is advanced.
There have been rare cases where the reason of a laryngectomy was caused by a wound from a
gunshot, auto accident injuries, accidents from violence or other damages to the larynx.
Outline and describe the signs and symptoms of the condition:
An individual with a laryngectomy will have a ... Show more content on Helpwriting.net ...
A speech–language pathologist will work with a patient's surgeon and other doctors to create the
best plan of care. A speech–language pathologist's main goal is to recover the patient's ability to
communicate. There are a few voice restoration treatments to choose from including, esophageal
speech, trachea–esophageal puncture, and the electrolarynx. The choice of which treatment to use is
based on the nature of the patient's surgery and what is best for them. Esophageal speech is where
the esophagus is used to create vibrations like the vocal cords once did. If a patient had the
tracheoesophageal puncture created during surgery, they go through another surgery to create a hole
within the stoma. A voice prosthesis is then placed in this hole and the patient can cover the stoma
with their finger to create tracheoesophageal speech. The electrolarynx is a device used to produce
vibrations when placed below the mandible to create speech. While they have been described as
sounding "robotic", they allow for intelligible and understandable speech. The more recent
advancements in rehabilitation have resulted in the evolution of tracheoesophageal speech, which
has become the most common form of voice restoration for

Analysis Of Sabrina 's Medical History / Care And Background
This paper will discuss a patient, who 's care I was involved in for a period of 4 weeks, using two
Chapelhow et al (2005) perspectives. I have gained consent from the patient. In accordance to the
Nursing and Midwifery Council (NMC) code of conduct and also to maintain confidentiality the
patient shall be referred to as Sabrina. Chapelhow et al (2005) stated there is a number of enablers
which are essential in underpinning and providing satisfactory care as a health practitioner, these are
known as; assessment, communication, professional judgement and decision–making, risk
management, record keeping and documentation and managing uncertainty. The essay will begin
with an introduction to Sabrina's medical history/care and background and will then go on to discuss
communication and documentation.
Sabrina's family was originally from Bangladesh, Although she has grew up in Britain and is
bilingual. Sabrina is 26 and has spent most of her life in and out of hospital due to being born with
thoracic kyphosis, Price (2013) describes this condition as a forward rounding or curvature of the
middle and upper back, which is also known as the thoracic spine. According to Price (2013) Some
symptoms of kyphosis include musculoskeletal aches and pains, breathing problems, gastrointestinal
problems and increased mental stress. Sabrina uses a frame due to decreased mobility caused by her
thoracic kyphosis and complains about constant pain. Sabrina was admitted to hospital due to an
abscess

Best Practice in Caring for Patients with an Ostomy
Best practice guidelines are evidence–based recommendations that assist practitioners with
assessment and management of appropriate healthcare (Taylor, 2012). One area that utilizes best
practice to ensure excellent patient outcomes is ostomy care. The patient may have an ostomy for a
number of reasons. They can be either temporary or permanent and are for patients who have bowel
or bladder cancer, inflammatory bowel or diverticular disease, trauma, or perforation of the bowel.
For ostomy care, it is important to focus on the areas of pre–operative, post–operative and discharge
care (Taylor, 2012). According to the Wound, Ostomy, and Continence Nurses Society, (WOCN),
before focusing on the ostomy care, the nurse should establish a relationship with the patient and
their family. A comprehensive assessment should be performed that focuses on all aspects of the
patient's wellness; physical, psychosocial, cultural and spiritual. The nurse informs the patient about
dietary needs, bathing/showering, and returning to work (Cronin, 2005). In doing so, the nurse gains
the patient's trust and confidence helping ease them throughout the intervention process. The
assessment allows the nurse to fully recognize the patient not as another client needing a procedure
but as a person who is going to have questions, concerns, and needs (WOCN, 2010). Once the nurse
and patient establish a rapport, and the patient is comfortable and willing to proceed with the
intervention, preoperative care

Evaluating The Readability Of Patient Teaching Materials
Assessing the Readability of Patient Teaching Materials Effectively teaching a patient on how to
properly care for their new stoma and ostomy pouch is essential to having favorable outcomes. The
idea of having to change how they have always cared for themselves is already in itself
overwhelming. Furthermore, not receiving proper training can lead to frustration and possibly
harmful outcomes. If the lay person has a lower comprehension, the use of medical langue can
further their hindrance. Many times, they are already unable process all that is happening while in a
hospital setting, and then they are sent home with a tremendous amount of paperwork for them to
review. Once the patient is home, they cannot ask the questions as they arise. ... Show more content
on Helpwriting.net ...
Gently clean the skin around your stoma: Use mild soap and water. Do not use soaps that have oil or
perfumes. Pat your skin dry.
Use a pouch with the right size opening: Use a pouch that has an opening that is ⅛ of an inch larger
than your stoma.
Use skin products to help reduce irritation: These products can help protect your skin and keep it
dry.
Use slight pressure to place your pouch: Center the pouch over the stoma and press it firmly into
place on clean, dry skin. It may be helpful to hold your hand over the new pouch for 30 seconds.
The warmth of your hand can help stick the adhesive skin barrier into place.
Dispose of the used pouch correctly: If the pouch is disposable, place the old pouch in another
plastic bag and throw it in the trash. If you use a reusable pouch, talk to your healthcare provider
about how to clean it. (www.drugs.com, 2016, "How do I change my pouch?")
Analysis of Reading Comprehension
The reading level comprehension from the website www.readabilityformulas.com, scored this
writing at a seventh–grade level. The analysis of the word statistics reveals the material published
uses long sentences, words containing more than three syllables, as well as, words with many letters.
The average sentences length average for a fifth to sixth grade level should be ten to twelve words,
whereas the material has and average sentence length of thirteen to sixteen. The percentage of words
containing more the three

Photosynthesis Is Essential For The Life Of The Cell
Photosynthesis
The Basics of Photosynthesis
Photosynthesis is an oxidation–reduction process powered by light in order to create energy for the
cell. Plants, algae, and photosynthetic bacteria (Kingdom Protista) use light energy to synthesize
organic compounds (Whitmarsh and Govindjee). The chemical equation for photosynthesis looks
relatively simple, however, is truly complicated because the cell has to use over 30 different proteins
to synthesize organic compounds within the cell. Photosynthesis is represented by the chemical
equation, 6CO2 + 6H2O + light → C6H12O6 + 6O2. The equation shows that carbon dioxide,
water, and light react to form glucose (a carbohydrate) and oxygen. Each year, photosynthesis is
responsible for ten percent of the atmospheric carbon dioxide on earth being reduced to form
glucose (Whitmarsh and Govindjee). Photosynthesis is essential for the life of the cell because it
provides energy for the cell to do all of its biological needs. Photosynthesis is also really important
for other living organisms, including humans, because the waste product of photosynthesis is
oxygen, which is essential for life of most living things. Photosynthesis creates two compounds,
adenosine triphosphate (ATP) and nicotinamide adenine di–nucleotide phosphate hydrogen
(NADPH). ATP and NADPH are the "energy currency" of the cell (Whitmarsh and Govindjee).
Photosynthesis occurs in two main processes, the light dependent reactions, and the dark reactions.
The structure of a

Double Barrel Colostomy Research Paper
Double –barrel Colostomy Patient Education What is a Double –barrel colostomy? A double– barrel
colostomy is a reversible bowel diversion procedure in which the bowel is surgically separated and
two separate stomas are created in the abdominal wall. This procedure is often a temporary method
of resting the bowel to facilitate healing by keeping the bowel empty. How long will the colostomy
be in place? The healing process for this procedure can range from weeks to years, thus the length of
time will be dependent on the time required for the bowel to heal fully prior to surgical reversal of
the colostomy. What are the reasons for having this procedure? Temporary procedures such as the
double–barrel colostomy are preformed to allow the ... Show more content on Helpwriting.net ...
Try new foods one at a time to learn which foods may cause unpleasant side effects such as excess
gas, diarrhea or constipation. Foods such as broccoli, fish, cabbage, onions and beans are known to
produce excess gas and odor. Foods such as nuts & seeds, popcorn, peas, corn and vegetable peels
are not completely digestible and may cause stoma blockage if consumed in large amounts.
Consuming foods such as parsley and yoghurt can help to deodorize fecal matter. Drink a minimum
of 8 cups of water daily. Ostomy care and maintenance: Empty collection pouch when ½– ¾ full
Change pouch every 3–5 days or if leakage occurs; this will assist in keeping the skin around your
stoma in good condition. Clean skin gently and apply barrier guard/ cream as instructed by your
physician. When to contact your Physician Contact your physician immediately if you experience
any of the following: Abdominal pain or discomfort, dizziness, nausea or vomiting Any bleeding,
rashes, changes in the surrounding skin or stoma color (darkening, grey, purple, black) Any unusual
pain discomfort or discharge No bowel movement for 3 days More bowel movement or pouch
changes than

The Artificial Airway: Tracheostomy
Tracheostomy, also known as an artificial airway is a long–tern or permanent surgical procedure
where a hole is made into the trachea (windpipe) called the stoma. A tracheostomy tube is then
placed through the opening and into the trachea, in which it replaces a person's nose and mouth as a
secondary airway for breathing to provide oxygen to get into the lungs. Tracheostomies are most
commonly used for purposes of mechanical ventilation in chronically ill patients, treatment of an
upper airway obstruction and head trauma in coma patients. This procedure dates back at least 200
years and has been done in countries all around the world. The tracheostomy is a common surgical
procedure which is performed in the Intensive Care Unit (ICU), as opposed to the operating room
(OR). The patient is given general anesthia, a 2–3 cm incision is make from the second tracheal ring
down divide the thyroid isthmus if needed. A hole is made between the third and fourth tracheal
rings where a tracheostomy tube which are given by their inner and outer diameter, curvature and
length to fit the patients' trachea is inserted. A chest x–ray may be taken to check that the tube is
correctly in place and there are no complications. The patient is often placed on a ventilator
(breathing machine) to assist with breathing. A ... Show more content on Helpwriting.net ...
There are trials of weaning the patient off the ventilator and if successful without any complications
the tracheostomy tube is removed which is called decannulation. Usually long–term tracheostomy
patients will undergo speech and language therapy over the duration to help them verbally
communicate until possible surgery for the removal of the trach. Patients who become permanent
with the tracheostomy learn to adapt to total dependency of being on a ventilator. (Robert Hyzy aug
8,

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