A 17-year-old African American female from the inner city complains of severe chest and abdominal pain. Upon examination, the attending physician performs an EKG, chest x-ray, and an abdominal and chest clinical examination and finds nothing. Assuming she is drug seeking, he sends her home. She comes back to the ER 4 hours later and now you see the patient. She explains that she was running track this past afternoon at school and that despite being very hot (100 F) she pushed on. Afterwards, she starts feeling extensive pain in her chest and abdomen. She has jaundiced eyes, her blood pressure is 98/50, pulse is 112, T = 99.9 F, R = 28. The pain seems out of proportion to the physical findings. During a review of her medical history, she tells the provider that she has history of sickle cell anemia. At this time, it is determined that she is in a sickle cell crisis.
1. What is the etiology of sickle cell anemia?
2. Describe in detail the pathophysiological process of sickle cell anemia.
3. Identify hallmark signs identified from the physical exam and symptoms.
4. Describe the pathophysiology of complications of sickle cell anemia.
5. What teaching related to her diagnosis would you provide?
Jesse is a 57-year-old male who presents with gradual onset of dyspnea on exertion and fatigue. He also complains of frequent dyspepsia with nausea and occasional epigastric pain. He states that at night he has trouble breathing especially while lying on his back. This is relieved by him sitting up. His vitals are 180/110, P = 88, T = 98.0 F, R = 20. After a thorough work-up, he is diagnosed with congestive heart failure.
1. What is the etiology of congestive heart failure?
2. Describe in detail the pathophysiological process of congestive heart failure.
3. Identify hallmark signs identified from the physical exam, diagnostic lab work and symptoms.
4. Describe the pathophysiology of complications of congestive heart failure
5. What teaching would you provide this patient to avoid heart failure symptoms?
Investigation of ‘Ordinary Use’ by Alice Walker Disclaimer: This work has been put together by an understudy. This isn’t a case of the work composed by our expert scholarly essayists. You can see tests of our expert work here. Any feelings, discoveries, ends or suggestions communicated in this material are those of the writers and don’t really mirror the perspectives of UK Essays. Distributed: Mon, 20 Nov 2017 Carly Fischer Dr. Gregory Brown April 28, 2015 American Classics Regular Use of Heritage in a Growing World Legacy is a fundamental principle to human life. The spigot enables individuals to interface and relate. With the end goal for people to proceed to relate and advance legacy needs to develop also. “Regular Use” by Alice Walker is the account of two sisters, one taught explorer and one straightforward shut-in. Through a straightforward clash, so much is uncovered about how the two sisters experience their lives and what is of incentive to them. This story, albeit short, conveys a major message about legacy in a developing world. Legacy taking care of business can’t be stopping or simply something of the past, yet rather it should continually change and create as time unfurls. This story, described by their mom, relates a cumbersome gathering of two sisters, Maggie and Dee. Maggie has dependably been a less difficult young lady who wanted to remain at home with their mom, Mama, in Augusta, Georgia. Dee, in any case, was sent to class, ventured to the far corners of the planet, and picked up progress. Dee’s entry is premediated by a quality of uneasiness as neither Maggie nor Mama realize what bizarre traditions Dee may have grabbed. As the time gravitates toward an auto methodologies and Dee develops with an outside sweetheart. Maggie is clumsy and cool to the new visitor, and Mama is exhausted. Dee reports that she has changed her name to “Wangero Leewanika Kemanjo” in light of the fact that she wouldn’t like to be named after the general population who mistreated the African Americans so she gave herself a customary African name to respect her foundations (for contentions purpose she will even now be alluded to as Dee). Dee’s landing is met with much more uneasiness as she treats Maggie like a nitwit. She at that point requests that Mama bring home family ancient rarities that are as yet utilized by the ladies in their regular day to day existences, for example, an old margarine stir. As Dee keeps on asserting rights to these old family things, feeling that she can appropriately welcome them, she goes over some specific family effects that lead the story to its contention about the significance and present day estimation of legacy. Dee experiences Mama’s trunk and develops with blankets woven with the garments of their family’s progenitors including their Grandma Dee’s dresses and their awesome granddads common war uniform. Dee says that she will remove the blankets from their hands with the goal that she can gladly hang and show them at her home. This does not go over well as these blankets were at that point guaranteed to Maggie. Dee rebukes this by expressing that Maggie will utilize them as though they are only a typical, unsentimental thing and will destroy such valuable legacies. The story finishes up with Dee deprecating both Mama and Maggie saying they don’t comprehend their own particular legacy and that Maggie needs to isolate herself from the family homestead and make a big deal about her life as she drives off (Walker 1531-1537). “Ordinary Use” raises numerous focuses that can be connected to society in general. The story contains numerous exercises to be learned in legacy, convention, and roots. Dee has a contradicting conclusion to Mama and Maggie. Dee considers legacy to be something that will be shown and respected, yet ought to be left previously. Her mom and Maggie see no mischief in proceeding to live the manner in which their predecessors dependably have. They believe that by doing this current one’s legacy is being regarded and legitimately kept up. Keeping in mind the end goal to really acknowledge legacy it is imperative that it is proceeded as a lifestyle, nonetheless, this does not imply that it can’t change and individuals must be solidified previously. It is evident that Dee has proceeded onward from the straightforward lifestyle of her mom and sister, and in doing as such she has estranged herself from her family and her foundations. She, be that as it may, doesn’t appear to see as regardless she needs to show still-practical antiquities of her kin around her own particular house. This is confirm in the piece of the story where Dee sees the margarine stir not for a beat, but rather for a protest of beautification: “‘I can utilize the agitate top as a highlight for the niche table,’ she stated, sliding a plate over the agitate, ‘and I’ll consider something creative to do with the dasher.'” (Walker 1535) As if this wasn’t a sufficient censured of her handy legacy, she again demonstrates this point amid the blanket fit among her and her mom: “She can simply make some more,” I said. “Maggie knows how to knit.” Dee (Wangero) took a gander at me with scorn. “You will just not get it. The fact of the matter is these blankets, these blankets!” “Well,” I stated, baffled. “What might you do with them?” “Hang them,” she said. As though that was the main thing you could do with quilts (Walker 1536). It is extremely clear that Dee has confined herself from her past and she has grasped a more worldwide point of view. In any case, this isn’t really a terrible thing as individuals should be persistently advancing to survive. Joe Sarinowski calls attention to the legitimacy behind Dee’s side and compliments her on her development of thought. Despite the fact that Dee’s restricting perspective to her sister and mom influence her to appear as though she doesn’t comprehend where they are originating from, and why their lifestyle is so profitable to them, she esteems her legacy and typifies another cutting edge see. She advances another path for African Americans to adapt to their disparities from whatever is left of America and the issues that they face and offers an approach to utilize their legacy in a glad, open manner that Mama and Maggie don’t (275). The other outrageous of legacy safeguarding found in the story is Maggie and Mamas’ view, that the steady usage and routine with regards to ones legacy as it generally has been will keep it in judgment the best. In spite of the fact that the characters are living in the twentieth Century, Maggie and Mama appear to be stuck in the Civil War period. Dee calls attention to the mistake of their courses toward the finish of the story when she discloses to her sister, “You should endeavor to make a big deal about yourself, as well, Maggie. It’s extremely another day for us. Yet, from the manner in which you Mama still live you’d never know it.” (Walker, 1536) This sort of social conservation is excessively outrageous and doesn’t take into consideration individuals to improve past the point they are trapped. Be that as it may, similarly as Dee’s extraordinary perspective of legacy had some legitimacy, so does Maggie and Mama’s. They are genuinely using their past further bolstering their good fortune. The opposite side of the blanket episode, actually, calls attention to the advantages behind their view with Mama’s pleasure in Maggie’s planned utilization of the blankets when Mama says “‘I figure she would,’ I said. ‘God knows I been sparing them for quite some time with no one utilizing them. I trust she will!” (Walker 1536). Inside these contradicting thoughts of legacy one can endeavor to choose which is correct, yet the appropriate response is more perplexing. It effectively can be said that parts of the two convictions joined make reality of legacy. Culture can best be saved by a mix of the limits we see in “Regular Use”. With a specific end goal to protect legacy getting it done Dee’s component of modernization needs to meet Maggie’s component of usage. Dee’s conviction of social legacy is fixated on acclimating to an advanced world and Maggie’s conviction is centered around protecting the manner in which she lives and not modifying anything. The center ground, where culture can be acknowledged for what happened and proceeded as a lifestyle yet adjusted to fit a changing, present day world. A creator who likewise contends this conviction is Federico Lenzerini: In light of the way that culture is a living and variable element, one given social appearance can speak to a culture through the progression of time just if such sign is able to do ceaselessly altering itself in parallel to the changes portraying the social entire of which it is a section (108). An essential part to the continuation of mankind is flexibility. On the off chance that culture can’t adjust, at that point neither can individuals. An essential image in the story that further accentuates this point is the margarine agitate. Dee sees the spread stir as an old relic that could be utilized as a workmanship piece. While Mama still observes the spread beat for its utilization for making margarine, making note of the hand denotes that have been engraved in the handle following quite a while of use. Durham expresses, “Representative items additionally have a specific solidness. Yet, in the event that they are not utilized, the work that brought them into being is it could be said dead” (Durham 2013) so as to clarify that the utilization of social items is basic to the continuation of legacy. In the event that the margarine beat is an image then it isn’t only a relic that symbolizes a past people; it is a question that is as yet utilized by Mama and by utilizing the spread agitate they are, as it were, saving a bit of their way of life. “Regular Use” is the account of two sisters that have become separated physically, inwardly, and mentally. Dee has ventured to the far corners of the planet and has proceeded onward from the manner in which she was raised while Maggie remained home and proceeded with the correct lifestyle that she was brought up in., in particular so on the grounds that her mom has never moved far from the conventional existence of her predecessors. The two different ways of life found in this story both epitomize the limits in which one can grasp their legacy. Individuals don’t need to experience each day in and out rehashing customs of the past to keep up their underlying foundations, however there is a whole other world to living inside ones legacy than acknowledging relics of the past. Legacy must be something beyond an important beautification, for that design would simply be an image of the individuals who a>