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Pernicious Anemia

Scenario: A 45-year-old woman has been diagnosed with pernicious anemia 2 years after having gastric bypass surgery. She has not followed her prescribed post-surgery diet and medication regimen for 3 months because she thought she “was better” and didn’t need them any longer. Assessment reveals a tongue that is tender, beefy red, and shiny. She reports feeling overall weakness, tingling in her feet, and having no appetite.

NGN Item Type: Extended Drag and Drop
Use an X to indicate which actions in the left column would be implemented for this patient by the nurse. Note that not all nursing actions will be used.
Nursing Actions Relevant Nursing Actions
Teach the patient about increasing intake of foods that contain cobalamin.
Assess the patient for neurologic difficulties.
Prepare to administer oral cobalamin.
Teach the patient and/or a family member how to self-inject intramuscular cobalamin.
Assist the patient with regular physical activities (such as ambulation and personal care) as needed.
Prepare to administer blood products.

Sample Solution

To start with, it is never to kill guiltless individuals in wars, upheld by Vittola's most memorable suggestion deliberately. This is generally acknowledged as 'all individuals have a right not to be killed' and assuming a fighter does, they have disregarded that right and lost their right. This is additionally upheld by "non-soldier resistance" (Frowe (2011), Page 151), which prompts the topic of warrior capability referenced later in the exposition. This is certified by the bombarding of Nagasaki and Hiroshima, finishing the Second World War, where millions were eagerly killed, just to get the point of war. Notwithstanding, some of the time regular folks are inadvertently killed through battles to accomplish their objective of harmony and security. This is upheld by Vittola, who infers proportionality again to legitimize activity: 'care should be taken where evil doesn't offset the potential advantages (Begby et al (2006b), Page 325).' This is additionally upheld by Frowe who makes sense of it is legitimate to inadvertently kill, at whatever point the soldier has full information on his activities and looks to finish his point, however it would include some significant downfalls. In any case, this doesn't conceal the reality the accidental actually killed guiltless individuals, showing shamelessness in their activities. Along these lines, it relies again upon proportionality as Thomson contends (Frowe (2011), Page 141). This prompts question of what meets all requirements to be a warrior, and whether it is legitimate to kill each other as soldiers. Soldiers are individuals who are involved straightforwardly or by implication with the conflict and it is legal to kill 'to shield the guiltless from hurt… rebuff criminals (Begby et al (2006b), Page 290).However, as referenced above regular citizen can't be hurt, showing soldiers as the main genuine focuses on, one more state of jus in bello, as 'we may not utilize the sword against the people who have not hurt us (Begby et al (2006b), Page 314).' furthermore, Frowe proposed warriors should be distinguished as soldiers, to keep away from the presence of hit and run combat which can wind up in a higher passing count, for instance, the Vietnam War. In addition, he contended they should be essential for the military, remain battle ready and apply to the standards of jus in bello. (Frowe (2011), Page 101-3). This proposes Frowe looks for a fair, simply battle between two members staying away from non-warrior passings, yet couldn't this prompt higher demise rate for soldiers, as the two sides have generally equivalent opportunity to win since both utilize comparative strategies? By the by, seemingly Frowe will contend that warrior can legally kill one another, showing this is simply, which is likewise upheld by Vittola, who states: 'it is legitimate to draw the blade and use it against transgressors (Begby et al (2006b), Page 309).' moreover, Vittola communicates the degree of military strategies utilized, yet never arrives at a resolution regardless of whether it's legal to continue these activities, as he continually tracked down a center ground, where it very well may be legitimate to do things like this yet never consistently (Begby et al (2006b), Page 326-31). This is upheld by Frowe, who estimates the real strategies as indicated by proportionality and military need. It relies upon the size of how much harm done to each other, to pass judgment on the activities after a conflict. For instance, one can't just nuke the psychological militant gatherings all through the center east, since it isn't just relative, it will harm the entire populace, an unseen side-effect. All the more significantly, t
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