Perfume †Grenouille Analysis Essay

Throughout the story â€Å"Perfume† by Patrick Suskind, Grenouille is presented as an outsider who is a product of both social and moral decay shown through his birth, description of the setting and description of Grenouille’s characteristics. Grenouille was born in the malodorous fish market of Paris in the â€Å"18th century†, where the 18th century was a period of tragedy and chaos where foul smells were everywhere. Moreover, Grenouille being born in a â€Å"fish market† indicates the evil and unnatural nature of Grenouille as he is born in the worst smelling, filthiest and unnatural place in Paris. Even more, being born in a fish market in a â€Å"pile of fish guts† shows Grenouille as a victim of social decay where society and degraded so far to the point where babies mattered just as much as fish guts. Obviously, Grenouille’s future is seen to be full of sin and filthiness as seen from his birth place. Furthermore, from the moment Grenouille was born, he was endowed with a powerful sense of smell which he â€Å"used as a language† further suggesting his filthy and malicious future as the first smell he smelt was the disgusting stench of the fish market foreshadowing his disgusting future intentions. Using smell â€Å"as a language†, shows the difference between him and all other people in society making him an outsider. Similarly, like an animal, Grenouille uses sense of smell to communicate and judge his surroundings portraying his animalistic characteristics inside as well as the predator within him using scent to track prey as animals do. Clearly, Grenouille’s powerful sense of smell foreshadows his violent, animalistic future intentions. Conversely, through free indirect discourse, Suskind develops sympathy for Grenouille and portrays him as an outsider and a product of social decay. There is described to be a â€Å"stench barely conceivable† showing Grenouilles abundance of a smell setting him aside and different to â€Å"the people, the stairwells, the parlours and the bedrooms.. † making him different to anything normal making him an outsider. However, sympathy is developed for him when he describes everything in society to have a stench showing that he felt everything in society and all the people in it stank thus causing him to become a victim of social decay. Grenouille is further conveyed as a victim of social decay when upper class supposedly high ranked and highly respected people are portrayed as fools and almost idiots. Through Comic Irony Father Terrier is seen as an uneducated fool and childish when using the phrase â€Å"poohpeedooh†. The repetition of this phrase further illustrates the foolish nature of a highly respected person showing social decay. Moreover, presenting the upper class in France as silly and foolish shows the decay of society and how even foolish people such as Father Terrier are respected and looked up to making Grenouille a victim to this social decay as well as an outsider as he does not respect these foolish upper class people and does not follow the demands of society. Similarly, Grenouille is again seen as an outsider when society refuses to accept him. His mother leaves him to die in a pile of fish guts and many others refuse to take him in, leaving him as an unwanted outsider. Again this foreshadows his future actions of violence and murder when society rejects him and many people act on their basic instincts and leave him to die suggesting a sense of evil in him. Grenouille is further shown as an outsider when he is described to have a â€Å"lack of scent†. This lack of scent clearly shows he is unnatural and he is not a normal being as well as further suggests his evil nature as he is able to move around unnoticed by anything allowing him to be able to do things unnoticed. Clearly, Grenouille has an unnatural, evil feel to him as seen through his characteristics and the way he is rejected purely but instincts by society. As seen from his birthplace, the setting and his characteristics Grenouille is clearly an outsider in society and this will ultimately lead to the murder of several women as well as chaos.

The Psychological and Social Effects of Sexual Abuse

In today's society, while parents are supposed to nurture their children, some are either the ones who cause them the most pain or are oblivious to the fact that their child is depressed or abused. The effect that sexual abuse has on a young child is inexpressible and can affect the way an individual functions. In society, many people underestimate the impact of sexual abuse, especially on young teenage girls, but in the two novels that I studied, the impact that sexual abuse has on a child's life is clearly severe and apparent.Father absences often cause many problems in the legislations a child has with either their significant other or other family members. In an article written by Ellis (2003), father absences are what cause females to become sexually active or pregnant. However, in the novels, Push and The Color Purple, the fathers are the ones who are sexually active with their daughters. These two disturbing, yet powerful novels are based on the perspective of two poor, Africa n- American girls, named Precious and Cell. Their entire lives revolve around emotional, physical, and sexual abuse.In these two novels, the sexual abuse Is caused by their father's dominant personalities, their psychological problems, and their own hatred towards men, while the deterioration of family relationships, low self-esteem, and gravitation towards females are all effects of sexual abuse. Psychological and social problems are often regarded as the most significant effects of sexual abuse against young teenage girls. Women have always been oppressed by men and have been subjected to so much negativity as a result of male dominance.In Precious' case, Precious' dominant father compels her to have sex with him in order to satisfy his own sexual needs. The most prominent cause of sexual abuse In this Instance Is mainly his lack of appreciation towards his daughter and his oppressive behavior. Throughout the novel, his failed relationships with Precious and Mary provoke his aggre ssion towards Precious. Mary and Allophones relationship lacks stability and has a negative impact on the relationship Precious has with both her father and mother. Precious' parents were never married to begin with, but after a period of time, Precious' father decides to abandon his family.According to two authors at Princeton university, Beck and McClellan (2010), there are different causes of low relationship quality and stability, and this is simply one of them. Impaired family relationships are the most essential factors of sexual abuse in both novels. Carol's dominant personality is the main causation of all the problems he encounters with Mary, thus provoking him to leave her permanently. His dominant traits are shown when Mary feels obligated to him and complies with him Into raping their own daughter. Despite the fact that Precious Is his daughter, Carl disregards the Immorality of his actions.The torment that he puts Precious through Is unbelievable and the sexual abuse co ntinues for many years. In this case, Carol's dominance and control over the two females Is widely Incorporated In the novel. The time before she becomes impregnated by him, not once, but twice. The two babies she gives birth to symbolize the struggles that she has had to overcome and the struggles that she will face in the future. Despite the fact that she was only 12 years old at the time her first baby was born, she becomes impregnated for the second time, four years later, at the age of 16.The abuse that she becomes subjected to causes her a great deal of pain and suffering, and it also causes a great deal of tension between Precious and her mother, Mary. Since Mary despises the idea of Precious achieving anything good in her life, she insists on Precious quitting school. Her overbearing and aggressive personality causes Precious to quit the one thing she feels so deeply for, which is her education. Precious' entire life is a very abusive and ongoing cycle, and for the most part , it is a result of the sexual abuse and the abandonment of her father after the birth of their two children.Since Precious has the responsibility to take care of two children, Mary, being the ruthless person that she is, uses this as an opportunity to help her through her own financial difficulties. However, when Precious entertains the idea of attending an alternative school and moving out with her two children, Mary clearly discourages this idea since she relies on the welfare to escape her financial struggles. A countless number of problems arise through these discussions and that soon causes Mary to reach her ultimate breaking point with Precious.All these problems that they encounter are problems which surfaced after Carol's absence. Their poor family relationship is one of the main effects of Carol's abuse towards Precious, and it is quite evident that his dominating personality is what caused the abuse. The problems illustrated by Sapphire are what ultimately causes the dete rioration of their family relationship and forces Precious to lose the last bit of hope that she has for her family. The main character of The Color Purple, Cell, is taken advantage of by her dominant and aggressive father, Alphorns, who uses her vulnerability to sexually abuse her.In the novel The Color Purple, Collie's parents have a very dysfunctional relationship, especially because Collie's mother is ill and is incapable of pleasing her husband's sexual desires. His controlling behavior raises a huge concern for the entire family, and their worst fears are brought to reality when he impregnates his daughter twice. Collie's mother's illness is a burden to Alphorns, and he uses it as an excuse to sexually abuse Cell. After being impregnated by Alphorns twice, she gives birth to two beautiful babies, but has them taken away from her by him.His oppressive behavior causes Celli to become fearful for both her and her sister, Nineties. Alphorns may not be Collie's real father, but he is still her stepfather, but she only sees him as a remorseless, dominant child molester. His dominance is shown by the way he speaks to his daughter, commanding her to have sex with him and do house work. The abuse is what causes Collie's entire youth to be destroyed, and it only worsens as she is forced to marry a man who exemplifies everything her father stands for, which is controlling and abusive.After everything that has occurred with their family, Allophones relationship with his daughter reaches its ultimate breaking point once her mother sees, after which, he decides to enter into a new relationship with a girl who is Just around Collie's age. After dealing with the sexual abuse for quite some time, Celli feels discomfort when she is near her father, and after the death of her mother, their and characters is evidently the fact that both girls are mistreated by their controlling fathers.In addition to the sexual abuse, both their fathers remain absent throughout their life, whether it is physically or emotionally, and their mothers are either dead or abusive. While both Celli and Precious' superior fathers cause the sexual abuse, the effect that sexual abuse has on these two young girls is depicted as their family relationships begin to deteriorate. Due to the immense impact that sexual abuse has on these two young girls, their entire life becomes a painted picture of their destroyed family, and most importantly, the absence of their fathers.The psychological problems that one has to deal with can often control their life and become the reason why they act a certain way. This is evident in the case of Precious' father, Carl. Carol's problems with Mary, and his own insecurities, are what cause him o abuse his daughter, both verbally and sexually. A person does not abuse another individual for no significant reason, but there is always reasoning behind their actions. In the beginning of the novel, Sapphire illustrates Carl as a man who shows no remorse o r compassion, someone who likes to take advantage of young girls.The abuse inflicted on a young child can often cause the deterioration of their character, most importantly, their self-esteem. Throughout the novel Push, there are many instances that depict the psychological issues that Precious is subjected to, mainly as result of the sexual abuse she endures from her father. Afterwards, Precious becomes very insecure and feels disgusted at the fact that she has tolerated the abuse for so long, regardless of the fact that she is only a child and is not capable of preventing it.According to Borer and Fine (1992), a child's development can be severely affected by sexual abuse, as well as other forms of child maltreatment. Being sexually abused as a child can dictate how an individual functions in their everyday life, and that is evident in Precious' case. Precious becomes so accustomed to the dead that she is nothing but a useless, obese, and illiterate girl, and that no man would eve r want to be with her. She lets the abuse dictate how she feels about certain matters, especially regarding her appearance.Her most apparent weakness is her lack of self-esteem as she constantly refers to herself as a girl from a poor neighborhood, with parents who wish nothing but her ultimate worst. Although it is evident that she feels a sense of emptiness from the psychological and sexual abuse she was subjected to by her father, and the agony her mother puts her through, she goes not acknowledge the fact that that is the reason why she behaves the way she does. Her perspective on what a perfect family consists of becomes shattered, and she feels as if she will always be a victim of abuse.The abuse from both her parents causes her to become extremely vulnerable and weak, and she constantly disregards the fact that the relationship she has with her parents is the causation of all her problems, especially problems dealing with her lack of confidence. Stress, anxiety, depression, a nd grief, can often impact an individual's behavior, and if one feels as f their sexual needs have not been satisfied, their desires will expand. â€Å"The sexual cycle begins with desire. Desire is in the mind† (â€Å"When Sexual Desire Disappears, 2014†).Constant fights over sexual needs can cause many problems, especially because of differences in sexual drive. In Collie's case, this is very apparent. Collie's father and mother have a very distant relationship and it only causes more burden behaves as if she is already dead, mainly since she is ill and cannot do many things to satisfy him. As a result of her illness, Alphorns expresses his anger by demanding Celli to satisfy the sexual needs that her mother failed to do, which ultimately means that she must replace her mother. His lack of security and love in his own relationship causes him to behave inappropriately towards Cell.As a result of all these problems that he has to deal with, he feels a lack of stability in his relationship and suffers from his own issues within himself. However, since Celli is forced to deal with the behavior of her father, her lack of self-esteem is displayed more and more, especially since she is the only child that has to tolerate the abuse. Collie's self- esteem becomes the root of many of her problems as she often discusses her lack of appearance, knowledge, and talent, especially when compared to her sister, Nineties.While Nineties exemplifies everything a woman would want to be and everything a man would want in a woman, Celli portrays herself as the ugly sister that no one would want, which is the ultimate reason why she feels a certain way towards her sister. Evidently, since she is the only one child that has to endure her father's brutality, she becomes more and more vulnerable throughout the entire novel, which causes her to ender what exactly attracts her to this all this negativity in her life.It is only appropriate for her to question what she is do ing so wrongly that she is the only person being forced to experience this, and that becomes the reason why she has an ongoing battle with her sister. Her constant comparison with her sister affects the way she looks at herself, mainly since she knows that Nineties is someone who is incomparable. Despite Collie's constant effort in establishing a relationship with her father, she becomes distraught over the fact that her father displays so much love ND appreciation towards Nineties, regardless of the fact that Celli is the only person who complies with his orders.Allophones psychological issues regarding his relationship with Collie's mom and his failed relationships become the causation of his attitude towards Cell. Meanwhile, the abuse Celli experiences only causes her to have less and less confidence in herself. Being impregnated twice, by your own father, can severely affect your perspective on men. When an individual is subjected to such abuse, it can have an immense impact on their perspective of men or women, and the way they look at life in general.Many children who suffer from sexual abuse find it extremely difficult to depart from their past struggles, and hold a grudge against those who cause them so much pain. Women with a history of sexual, emotional, or physical abuse may regard men as â€Å"keyholes†, â€Å"inconsiderate†, and â€Å"unloving†, and as they reach an older age they often remember all the events that occurred when they were younger. In both novels, it is evident that both Precious and Celli share the same hatred and fear towards men, and a special bond with other females.Their fear causes them to become abused by their fathers as it is seen as a sign of weakness. After being subjected to so many negative events, it causes them to feel some sort of resentment towards their fathers and any other male character that shares the slightest similarity with their fathers, thus making them gravitate towards females. As P recious' parents are unable to support Precious' desires to gain her GEED, Precious' teacher at her alternative school provides her with the support and love that her parents have failed to do. Ms.Blue, Precious' teacher, shares a mother- receives help from her in ways that she could never have imagined. While Precious appears to lack relationships with men, the bond she shares with Ms. Blue is the polar opposite of the bond she shares with any other individual, especially those who are men. Sapphire emphasizes the importance that female characters have on Precious, mainly the importance of Ms. Blue and Precious' female friends from her class. In an article written by Abash (201 1), he discusses the disproportion of teenage pregnancies, especially among minority youth.He makes it clear that teenage pregnancies deeply affect one's academic accomplishments and that applies in Precious' case. This particular article is relevant to Precious' circumstance as her most important goal is to successfully complete school, and while all her problems are caused by her father, her achievements are a result of the help she has from her female friends and Ms. Blue. As it is extremely difficult for girls in Precious' neighborhood to get an education, Precious feels even more appreciative towards Ms. Blue. Ms.Blue helps Precious become aware of the effort it takes to attend school and obey the teacher's rules, and in this form she learns how to act like a civilized person. In addition to that, Ms. Rain helps Precious by allowing her to stay over at her house as Precious states â€Å"l can tell by Ms Rain's face I'm not goanna be homeless no more† (Sapphire, 1996, p. 79). While Sapphire makes it evident that Precious feels discomfort whenever she is near men, she also states that Precious feels a sense of belonging when she is surrounded by other women, with the exception of her mother.In the novel The Color Purple, Collie's fear and hatred towards men is very noticeable . Her father's abuse towards her scars her for life and deeply affects the way she views men. However, she fears him because she knows what he is capable f, and she feels as if she has to show a sense of strength for her sister. Even after tolerating the abuse for so long, she is forced to marry a man named Albert. Albert shares many similarities with her father as they are abusive, dominant, and unloving.With that said, after being in an abusive relationship with Albert, Collie's slightest bit of hope for a loving marriage and family is thrown away. With all these men taking advantage of her, she puts this abuse to an end by isolating herself from the men that cause her so much pain, and she does this with the help of her female friend, Chug Avery. With the help of Chug, Celli is able to leave her husband behind and sever ties with her husband and her father. Her emotional and physical relationship with Chug is one that she believes she could never share with any man. Us sleep like sisters, me and Chug†, Celli states (Walker, 1982, p. 146). In this particular instance, Celli expresses her feelings to Chug, feelings regarding Albertan appalling behavior. As the novel progresses it is evident that their bond becomes stronger and stronger, but once another man interferes with their relationship, Celli begins to despise the man, claiming that he is an opportunist. Chug remains married to Mr†¦ Grady in spite of Collie's concerns, which only cause Celli to become more Jealous.Her issues with men are made more and more apparent throughout the novel, and that is the most important reason as to why she feels such a special bond with other females, such as Nineties, Chug Avery, and Sofia. Sofia is Collie's stepson's wife, and unlike Cell, Sofia is brave and able to stand up to her husband. The relationship that she has with Sofia is what empowers her, and her bond with these three girls is what confirms her actions of a man, whether it is her father of her h usband, and with so much activity in her life, these three women become the only people to truly help her.In both Push and The Color Purple, there are countless similarities shared between not only Precious and Cell, but between the two fathers, Carl and Alphorns, as well as the two most important women in Precious and Collie's lives, Ms. Blue and Chug Avery. In both novels, these two African-American teenage girls are forced to do things that most teenage girls could never imagine doing. Their controlling fathers compel them to have sex with them and impregnate them not once, but twice. Sexual abuse and father absences are the most recognizable themes in both novels, Push and The Color Purple.In these two novels the main female characters are forced to deal with the sexual abuse and torment inflicted on them by their dominant fathers. Dominating personalities, psychological problems, and hatred towards men are all causes of sexual abuse, while the deterioration of family relationsh ips, low self- esteem, and gravitation towards females are all effects of sexual abuse. All three forms of abuse, sexual, physical, and mental abuse are applicable to the two irritations in both novels, and these forms of abuse evidently deprive them of their freedom.As a result of the sexual abuse they endured from their father, they become impregnated twice, and evidently, the abuse causes them to have an incredibly difficult time appreciating themselves, let alone anyone else. It soon causes more trouble for them as they lose their trust in men and only surround themselves with women. Psychological and social problems are widely regarded as the most prominent effects of sexual abuse against young teenage girls in battered families.

Rene Desacartes and David Hume Essay

Rene Descartes and David Hume were two great philosophers during the modern period. Many of their issues focused on the existence of God. Hume’s writings on the existence of God are different to Descartes’. Descartes tries to prove Gods existence while Hume tries to show the foolishness of believing in God. However, both philosophers fail to solve the issue because they both hold many arguments. The major issue between Descartes and Hume is their conflicting methods on how the issue should be approached. Rene Descartes was an Enlightenment philosopher. He was also a rationalist. This is the opposite of empiricism as this theory claims that some knowledge can be known a priori, independently of experience. This means that if God were to be proved then experience would not necessarily be needed as some truth. The explanation of oneself is essential to Descartes’ thesis. That all â€Å"object relations except God are delusions promoted by the coherence of experience† (Weissman); that is, our everlasting subjective experience of the world could be false, although God is known to be true. Having decided that the empirical world and matter could be simply the creation of a devil, Descartes decides to follow his own consciousness, which is the only thing he could rely on. He is the type of person who only depends on himself and always thinks â€Å"I am† in situations. Descartes makes the unnecessary assumption that he is the carrier of his combined states. He states, â€Å"It is so self-evident that it is I who doubt, who understand and who wish, that there is no need to add anything to explain it†. This, as well as the truths of mathematics, is perceived â€Å"clearly and distinctly†. Clear and distinct ideas are very much relied on in the Cartesian philosophy of mind; for Descartes they are the necessary truths, grabbed by the intelligence. This central consciousness he claims equates to a â€Å"person†; the divisible body as an extended thing in space and time is finite, opposed to the infinite, non-physical, monadic soul. This distinction is the foundation of Cartesian ontological dualism. The mind and body are separate materials, existing on their own. Descartes believed that he developed a method by breaking a problem down into parts, accepting ideas that couldn’t be doubted and getting rid of one conclusion from another. Descartes came to the conclusion that the universe has a mathematically logical structure providing a unified body of knowledge. He believed that in order to obtain knowledge, there must be a normal method for achieving the truth, or any experience can not be a dependable source. David Hume was an empiricist which means that he believes all knowledge must come from experience, as there is no innate knowledge within the mind. If the existence of God were to be proved, it would require someone to experience or suppose his existence from experience in some way, because reason alone is inadequate to prove his existence. Hume’s position about knowledge is skepticism, which means he doesn’t believe we have knowledge for certain things. He is heavily influenced by the two philosophers, Locke and Berkley. Hume is similar to Berkley but without the part of believing in God. He believes in the analysis of causation. For example you know your friend is in France when you receive a post card from them in France. Hume’s explanations are more concerned with a passive physical brain and a graphic order of mind; the mind alone can tell us anything about the world. It contains an idea that simple and complex ideas are formed by direct perception of objects or self-reflection. Hume’s change incorporates an explanation on Locke’s ambiguous use of ‘idea’. He refers separately to perceptions of sensations and those of reflection. Simple ideas of Locke such as space and time became complex ideas for Hume. All perceptions are substances, capable of existence independent of the observer. Therefore we are perceptions, with a non-observable ‘self’. Furthermore since there can be no ‘impression’ of self, the idea of identity is weak. It is important to know that in Hume’s plan in order for people to obtain knowledge of something they must experience it first. Descartes believed that everything known, depends on perception, but if perception doesn’t have evidence not only from itself but also from the outside world than it will not be able to verify anything. According to Hume, â€Å"perceptions,† can be cut down to impressions and ideas. Axioms, were self evident principals which were â€Å"so clear and distinct† that they could not be doubted, and therefore accepted as certain contents of knowledge. Contrary to Descartes belief that effects must come from a cause, Hume believed that causes are senseless and uncertain. This contrasts sharply with Descartes’ proposal of ‘primary and secondary’ qualities. The primary qualities of objects are their geometric, indubitable measurements such as their extension, mass and location in space. These are only indirectly perceived through the secondary qualities of appearance, such as colour and tangibility. Descartes seeks to avoid a merely representationalist stance and attempts to further justify a belief in an external reality beyond our mental field of perception, and show that it is dependent on God. This is closely linked with Descartes’ equivocation of â€Å"clear and distinct† ideas; they refer both to the mathematical axioms of geometry – in a â€Å"triangle there is a certain determinate nature or essence or form of it, immutable and eternal, which has not been feigned by me, nor does it depend on [me]† – and to empirical statements about extension in space; in the Fifth Meditation he seeks to discover â€Å"something certain concerning material things†¦

Post operative care Essay

Whilst the patient is in PACU, identify and discuss airway management (and rationales) as related to the case study (400 words) The post-operative patient is at risk for respiratory problems due to ineffective airway clearance related to changes in pulmonary physiology and function caused by anaesthetics, narcotics, mechanical ventilation, hypothermia and surgery. With increased tracheobronchial secretions secondary to the effects of anaesthesia, combined with ineffective coughing, and decreased functions of the mucociliary clearance mechanism. (Monahan, Neighbors, & Green, 2011) Oxygen is commonly in place as it supports the elimination of anaesthetic gases and helps meet the increased metabolic demand for oxygen caused by the surgery (deWit, 2009). The sedation and muscle relaxation drugs used often cause the tongue to occlude the airway and for that reason endotracheal tubes or artificial airways are not removed until clients are awake and able to maintain their own airway (Berman & et.al, 2012). During the immediate post anaesthetic stage an unconscious client is positioned on the side, with the face slightly down, without the support of a pillow. In this position gravity keeps the tongue forward, preventing obstruction of the pharynx and allows the drainage of any mucous or vomitus out of the mouth rather than down the respiratory tract (Berman & et.al, 2012). Suction should always be readily available to clear secretions. Alternatively if the patient cannot be positioned on their sides the airway can be opened by moving the jaw forward (the nurse’s fingers are placed behind the angle of the jaw, lifting it forward. As the Jaw moves, the tongue comes forward, opening the airway. (deWit, 2009) An artificial airway is maintained in place and the client is suctioned as needed until cough and swallowing reflexes have returned. Generally the client will spit out the oropharyngeal airway when coughing returns and the swallowing or gag reflex it intact (Berman & et.al, 2012) Auscultate the lungs carefully for abnormal sounds as this can indicate retained secretions. Encourage deep breathing and coughing every 2 hours or more for the first 72 hours post operatively. (Monahan, Neighbors, & Green, 2011) Assess the rate and depth of respirations as Hypostatic pneumonia occurs when lack of movement causes stasis of secretions encouraging bacteria  growth. Be certain to turn the patient every 2 hours as this changes the distribution of gas and blood flow in the lungs and helps move secretions. (deWit, 2009) Facilitate deep breathing and coughing by demonstrating how to splint abdominal and thoracic incisions with hands or a pillow. If indicated medicate  ½ hour before deep breathing, coughing or ambulation to promote adherence (Monahan, Neighbors, & Green, 2011) In order of priority, using evidence based literature, identify and discuss the nursing interventions (and rationales) required to care for the chosen patient in the first 24 hours upon returning to the ward. Nursing intervention/care presented needs to be accurate, relevant and Specific to the chosen case study. During the initial hours after returning to the ward the primary concerns for the nursing staff are that the patient has adequate ventilation, haemodynamic stability, no incisional pain, surgical site integrity, Post anaesthesia nausea and vomiting are under control, stable neurological status and that the patient is spontaneously voiding. (Smeltzer & Bare, 2011) Pulse rate, blood pressure and respiratory rates are recorded at least every 15 minutes for the first hour and then every 30 minutes for the next 2 hours. Temperature is monitored every 4 hours for the following 24 hours (Smeltzer & Bare, 2011). Assessments of the patient are to be done at frequent intervals during the first 24 hours postoperatively looking for indications of internal haemorrhage and impending shock. This includes pallor, diaphoresis, cool extremities, delayed capillary refill, restlessness, agitation, mental status changes and disorientations or an impending sense of doom (Monahan, Neighbors, & Green, 2011) . During the initial postoperative period it is important to orientate and reorientate the patient to person, place and time. Informing the client that the surgery is over and that everything went well. Repeating this information until the patient is fully awake and orientated helps to reduce anxiety and confusion (Monahan, Neighbors, & Green, 2011) Margaret is placed in a semi Fowlers position after she recovers from anaesthesia. Aside from being more  comfortable and having less strain on the sutures, the patient will also be able to take deep breaths and cough more easily in this position. (deWit , 2009) Pain assessments should be conducted during each observation for behavioural and physiologic indicators such as facial tension, grimacing, moaning, diaphoresis, increased BP, increased pulse and respiratory rates. (Monahan, Neighbors, & Green, 2011) Use any PRN doses of pain relief medications before pain becomes severe as well as before painful procedures, ambulation and bedtime ask the patient to describe the pain including description, location, and intensity and aggravating and alleviating factors (Monahan, Neighbors, & Green, 2011) Administer pain relief according to the World Health Organisations three step analgesic ladder. If the patient is still in pain some non-pharmacological pain control such as heat or cold packs, tens machines, massage, or distraction techniques may be helpful (Monahan, Neighbors, & Green, 2011) An assessment of the abdomen every 4-8 hours by inspection, auscultation, palpation and percussion for looking for any indications of distention and listening for signs of bowel sounds in all 4 quadrants of the abdomen (Berman & et.al, 2012). Monitor vital signs every 4-8 hours be alert to changes consistent with dehydration including decreasing blood pressure, increasing heart rate and slightly increased body temperature, dry skin and mucous membranes, skin turgor, diminished intensity of peripheral pulses and any alterations in mental status. Monitor the patients urine output and concentration. Checking the NPO status and in the absence of post anaesthesia nausea or vomiting introduce oral foods and fluids cautiously (Monahan, Neighbors, & Green, 2011) As Margaret has a BMI of 30 she is considered obese. Obesity is known to increase morbidity and mortality in the general population and thus is perceived as a risk factor contributing to postoperative complications such as pneumonia, wound infections and wound separations. (Doyle, Lysaght, & Reynolds, 2009) From a surgical perspective, obesity has long been considered a risk factor for adverse post- surgical outcomes as it is associated with pulmonary disorders including obesity hypoventilation syndrome, atelectasis and pulmonary embolism, as well as a possibility of cardiovascular, and wound healing complications. (Doyle, Lysaght, & Reynolds, 2009) Overweight patients are  also vulnerable to pressure ulcer formation due to positioning required for surgery therefore the perioperative nurse must provide adequate padding and other measures to protect the client’s skin. (Berman & et.al, 2012). Obesity can increase the risk of wound dehiscence both directly by increasing tension on the fascial edges at the time of wound closure, a nd indirectly, by increasing the risk of wound infection which is also a risk factor for wound break downs. (Doyle, Lysaght, & Reynolds, 2009) Margaret is placed in a semi Fowlers position after she recovers from anaesthesia. Aside from being more comfortable and having less strain on the sutures, the patient will also be able to take deep breaths and cough more easily in this position. (deWit, 2009) The use of incentive spirometer and other respiratory devices (Monahan, Neighbors, & Green, 2011) can also help to reduce the incidences of respiratory issues. Drainage must be checked frequently for signs of fresh bleeding, the drain is left in place as long as necessary and is then removed by the surgeon (deWit, 2009) The nurse needs to determine the colour, consistency and amount of drainage for all tubes and document accordingly (Berman & et.al, 2012). Evaluate patency of all surgically placed tubes or drains. Monitor insertion sites for indications of infection. Warmth, swelling, tenderness and unusual drainage. (Monahan, Neighbors, & Green, 2011). The wearing of compression bandages and the promotion of calf pumping, ankle circling, and foot board- pressing exercises to encourage circulation and prevent thrombophlebitis in the lower extremities (Monahan, Neighbors, & Green, 2011) Constipation can all be related to immobility, the use of opioid analgesics, dehydration and disruption of abdominal musculature. Auscultate each abdominal quadrant for at least 1 minute to determine presence of bowel sounds. Treatment is usually through stool softeners, high fibre diets and hydration (Monahan, Neighbors, & Green, 2011). Encouraging early and frequent ambulation can also help to improve gastrointestinal motility and to reduce abdominal distention by the accumulation of gases. (Monahan, Neighbors, & Green, 2011) As part of your role as a primary nurse for your patient, you are required to initiate discharge planning. Identify the allied health professional/s you would refer your case study patient to and discuss the rationale behind your referral, what treatment may this health professional/s provide. (300 Words) For Margaret’s discharge I would refer her to the following allied health professionals. Dietician- Would work with Margaret with the intention to assist her to reach optimal health and weight loss through food and nutrition. Providing expert nutritional advice for people of all ages and can prescribe dietary treatments for conditions such as obesity, diabetes and gastrointestinal diseases (Nutrition Australia, 2014) Post-acute care- Is a program that ensures a safe discharge for hospital by providing people with community based supports to help them recover in their home or community and to reduce the risk of readmission to hospital. Assessments of the persons needs are performed and includes the person’s healthcare and psychological needs. It includes community nursing, personal care, home care and allied health such as physiotherapy. (Monash Health, 2014) Wound care nurses or District nurses to help with: Client education for self-care †¢ Appropriate dressings/bandaging based on diagnosis and patient lifestyle preferences †¢ Cleansing and debridement of wound †¢ Hygiene (cleansing self and wound waterproofing as required) †¢ Diet (the importance of essential vitamins and minerals as required) †¢ Signs and symptoms of complications †¢ Bandaging/dressing techniques †¢ Exercise regimes †¢ Lifestyle factors/changes †¢ Disease process and health maintenance †¢ Prevention of recurrence (Fremantle Hospital and Health Service, 2012) †¢ Pain management †¢ Medications †¢ Analgesics †¢ Topical antimicrobials/antifungals †¢ Local anaesthetics †¢ Topical corticosteroids †¢ Oral antibiotics Follow up GP appoint to discuss any further issues and to remove any sutures if not done by the district nurses. References Berman, & et.al. (2012). Kozier and Erbs Fundamentals of Nursing. Frenchs Forest: Pearson. deWit, S. C. (2009). Medical- Surgical Nursing Concepts and Practice. Missouri: Saunders Elsevier. Doyle, S. L., Lysaght, J., & Reynolds, J. V. (2009). Diagonositc in Obesity and Complications. Obesity and post- operative complication undergoing non-bariatric surgery. Obesity Reviews, 875-886. Fremantle Hospital and Health Service. (2012). Nurse Practitioner Wound Management- Clinical Protocol Minor Surgical Procedures. Fremantle: Department of Health. Monahan, F. D., Neighbors, M., & Green, C. J. (2011). Swearingen’s Manual of Medical-Surgical Nursing: A Care Planning Resource. Maryland Heights: Elesevier Mosby. Monash Health. (2014). A world of healthcare. Retrieved August 29, 2014, from Monash Health: https://www.monashhealth.org/page/Services/Services_O_-_Z/Post_acute_care/ Smeltzer, S. C., & Bare, B. G. (2011). Textbook of Medical-Surgical Nursing (2nd Australian And New Zealand ed. ed.). (M. Farrell, & J. Dempsey, Eds.) Sydney: Lippincott Williams & Wilkins Pty Ltd.

Barriers to communication Essay Example for Free (#4)

Barriers to communication Essay 1.3 Identify barriers to effective communication A child, young person, their parent(s)/carer(s) or even a member of staff whose first language is foreign may make it harder for any communication spoken to them to be understood. They may only understand very small words of the language you’re speaking, so information will be harder to put across. For example; in my setting, there is a child who can understand what you are saying, but it seems, most of the time they seem very quiet. This may be due to their parent(s) being from a foreign country, so they may be able to communicate in their parent(s) language, but not in ours so may find it hard to communicate some of their needs/feelings. Someone may have a sensory deprivation – such as hearing or sight. This will make giving and receiving information harder to do – they may need an interpreter at all times for example. When talking to a service provider, they may use technical language that the service user may not understand which will make it harder for them to process the information and may worry what they have meant. Someone may be going through a difficult time that is making their emotions go all over the place – such as they may take things the wrong way, get upset easily, no full concentration and not trying as hard to complete/do things. Environmental/setting problems can cause a barrier for a communication – someone who may not be able to see very well will find it hard to read any written information in a dimly lit room. Or, for example, someone in a wheelchair can find it hard to communicate with someone if they are at a desk that is above the wheelchair users head. Barriers to communication. (2016, Aug 05). We have essays on the following topics that may be of interest to you

Neo-Classical Art and Romanticism Essay Example | Topics and Well Written Essays - 500 words

Neo-Classical Art and Romanticism - Essay Example It started as a response to the more flamboyant Rocco Art and its objective was to recuperate the Greco-Roman cultural values. Europe, Western France and England embodied this art style to express idealism, patriotism, ethics and civic virtue. The popularity of neoclassicism was caused by several happenings of that time such as the reputation of Rome which was growing increasingly and the discovery of old Roman cities by archeologists. This art form depicted and accentuated rationality and tradition. The first of these were Jacque-Louis David whose work the ‘Oath of the Horatii’ depicted three mythological warriors swearingloyalty to the Roman Republic (David & Dorothy, 87). Some other famous neoclassical pieces include ‘The Death of Marat’ and ‘Napoleon Crossing the Alps’. Romanticism was a reaction against the time of Enlightenment in the eighteenth century. Contrary to the neoclassical style, this style of art recognized humans as more emotional, complex and not that rational in a new civilization that was more materialistic, scientific and generally more urban. The famous artist from this period Jean-Jacques Rousseau laid down the basis of Romanticism by liberating the human emotions and showing a freedom of expression and thus challenging the rationality of the Enlightenment. Another popular artist who lead the Romantic Revolution was Eugene Delacroix. His masterpiece ‘Liberty Leading the People’ represented the French Revolution and the heroic splendor along with the ghastly destruction and chaos that was spread. In this generation of the Romantic artists who came after Napoleon and lived under Louis XVIII and Charles X were happy with the ‘petit revolution’ and regretted to have not seen the real grandeur and glory of t imes under Napoleon. Under Louis XVIII artists were free to paint whatever they wished and were unbound from Napoleon control. Theodore Gericault showed the incompetence of the new government with his

Assay Essay Example | Topics and Well Written Essays - 500 words - 1

Assay - Essay Example He replied that the symptoms manifested the day before, and that he has not had any medications as yet. He appeared to be a very healthy man in his forties. The pharmacist later revealed to me that the patient was a regular at the pharmacy. The patient’s blood pressure and cholesterol levels were within normal range and he did not suffer any medical conditions. After the interview, I observed that the pharmacist advised him to take Dimetapp which is an over-the-counter, no-drowse, cough and cold remedy. The pharmacist also advised him to increase his water intake in order to facilitate his recovery from his colds. A review of various articles and researches on the effectiveness of non-antibiotic remedies for cough and colds revealed that the most promising remedies for cough and colds include â€Å"dextromethorphan, bisolvon, and guiaphenesin for cough, antihistamine- decongestant combinations for a wide range of symptoms, nasal decongestants (at least for the first dose) and possibly zinc lozenges† (Arroll, p. 1478). Dimetapp is an antihistamine-decongestant, hence highly recommended for colds and cough. Another patient came in to buy a sedative nasal decongestant. I observed the pharmacist interview where the pharmacist asked him if he was taking any other medication, and he said he was taking Exxefor. I reviewed my knowledge of Exxefor and was able to establish that Exxefor is an antidepressant classified as an SSRI (Selective Serotonin Reuptake Inhibitor). It is a prescription drug for major depressive and anxiety disorders. This drug is also contraindicated for patients who are hypersensitive to Venlafaxine. I was further able to establish that the most common side-effects for Exxefor are the following: headache, nausea, insomnia, dry mouth, dizziness, and sweating. When taken with any sedative drug, the chances for the occurrence of these side-effects would increase. I then understood why the