Nursing -improper identifacation of non pressure wound Research Paper

Nursing -improper identifacation of non pressure wound - Research Paper Example Nurses often fail to recognize non-pressure ulcers and document them as pressure ulcers, thus leading to confused and suboptimal treatments and devastating consequences to the patient. In diabetic ulcers, delayed and inappropriate treatment increases the risk of amputation. Thus, it is very important to identify and documents ulcers appropriately. In this essay, improper identification of non-pressure wounds will be discussed through review of appropriate literature. Evaluation and improper identification and documentation of non-pressure wounds The first step in the evaluation of a patient with ulcer is taking appropriate medical history and hence this aspect is very important to ascertain whether the ulcer is pressure or non-pressure type. History should include age and sex of the patient and presenting complaints. The chronology of events, whether the onset of the wound was traumatic or spontaneous, the treatments taken for the wounds and the outcomes of the treatments must be enq uired. The history should also include whether the ulcer is associated with pain and if present, whether the pain is sudden in onset, and whether it is nocturnal or present when the leg has been in the dependent position for a long time. Other details to be included in the history are history of any chronic disease like diabetes and hypertension, occupational history, history of varicose veins, previous history of lower limb wounds/ulcers/gangrene, history of amputations and history of any other surgeries. Family history of similar ulcers also must be enquired into (Kunimoto, 2001). Influence of biological and social factors also must be assessed. The next step in assessment is to determine the etiology and risk factors of the wound. Age, malnutrition, collagen disease and drugs like steroids inhibit wound healing (Kunimoto, 2001). After medical history, physical examination of the wound must be undertaken. Physical examination gives valuable information especially in the elderly wh o cannot recall history details. One of the aims of physical examination is to differentiate between venous leg ulcers and non-venous leg ulcers. Venous leg ulcers occur in the distal medial third of the lower extremity and they are shallow without punched margins. The amount of granulation tissue and its color must also be assessed. Nurses are often confused here. Differences in documentation of the quantity and color of granulation tissue by the nurses have been reported (Frank-Stromborg et al, 2001). Decreased granulation tissue or bluish hue color of this tissue are indicators of bacterial infection. The drainage from the wound must be examined as to whether it is serous, purulent or serosanguinous. There is evidence that there is no homogeneity among nurses and other health professionals in ascertaining the type of secretion from wound (Stremitzer et al, 2007) and this aspect plays a very important role in wound evaluation and diagnosis. Purulent discharge is an indicator of ba cterial infection. The length, depth and width of the ulcer must also be assessed. Surrounding skin examination gives a valuable clue to differentiate between venous and non-venous ulcers. Peripheral arterial circulation assessment is a must in ulcer evaluation. Palpation of the dorsalis pedis artery is useful for this purpose. However, it is absent in about 10% of people. Color and perfusion are other markers for arterial sufficiency. Nurses must be aware of

Heroic Paradigms from Iliad to Aeneid Essay Example | Topics and Well Written Essays - 2000 words

Heroic Paradigms from Iliad to Aeneid - Essay Example The Aeneid does not explicitly deal with Roman politics in fact it is a story about a mythological figure Aeneas who lead Trojans to Italy after the Greeks destroy their homeland. Unlike Homer’s Aeneas who is portrayed as a warrior who boasts about his prowess on the battlefield and then proceeds to lose in every one of them since he was a bad warrior Vergil projects him as a tragic figure who is in search of a rational explication about the actions of God who destroy human beings and make them suffer, The same Gods who love and protect him. Some of the major heroic paradigms that are explored in â€Å"The Iliad† include the ideals of heroism: bravery, courage, super-strength, intelligence and nobility. The Homeric Hero is a man of action who is never incapacitated because he survives on his instinct. Unhindered by doubts he soars above humanity and performs action that ensures his ever lasting fame and glory. Achilles fits this description of Homeric Hero although it i s observed that his character develops gradually through out the text. The readers realize that Achilles of Iliad 22 is a man with a higher mission, who is ready to stake everything, including his own life in order to fulfill his mission. Hence he acts totally differently from the man of Iliad 1 who acts as a petulant child with a short temper and has the tendency of making irrational decisions. Therefore it can be inferred that the glory associated with Homeric Hero lives up to the definition of a hero of the Greek times. So it is perceived that the audience of the time believed that a hero should be an individual above all other human beings with special qualities of bravery, strength and intelligence. On contrary Aeneas is introduced in the poem as, â€Å"And suddenly Aeneas felt his limbs go numb with cold †¦I envy your fate†¦Why didn't you kill me on the plains of Troy When you had the chance and free my soul with your strong hand?† (Vergil 3). In the very begi nning the protagonist has surrendered his will to fate and desires death. This explication is in complete contrast to the heroic paradigms set by the Greeks. Hence from this it can be inferred that Vergil’s Aeneid enlightens the readers about the cultural trend during the Vergil’s time had shifted from hero worship to a character more closely related to a common man who suffers pain and is not above the rest of mankind. Western Thought According to Plato and Aristotle the best way of learning is through communicating with others or collectivization. Socrates ‘Dialectic Method’ is a common technique that is employed in most of the classes. According to which he sat in the market place, started of a conversation on a certain topic and then picked up their flaws out of the ensuing argument and then brought each conversation to a proper ending or conclusion. A similar style of discussion and study is also implemented in this course of philosophy. This method h elps the students to not only think about and share their personal ideas but also it enlightens them about the thoughts and feelings of their fellow students as well hence providing them with an opportunity to learn from the experiences or the point of views of other individuals. The Early Western thought processes of each writer vastly differ from one another. For example although Homer and Vergil in their respective epic poems deal with same mythological figures yet