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History of the US
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History of the US
Scholars, as well as historians, refer to the 15th and the 16th centuries as an expansion and exploration age. The period was marked with state-sponsored voyages from different regions headed to America. Transoceanic voyages featured Columbus, da Gama, Magellan, and many other mariners from Europe. It is indeed justifiable that this age was an age of expansion, as Europe’s exploration led to profound historical changes, with ramifications for Africans, Eurasia people, and particularly for the Americans, whose longstanding isolation turned to be a blessing. To date, this expansion is the subject of discussion and research by historians, and this essay seeks to highlight the major motives and experiences of the voyagers who set foot in America.
One major reason behind the voyages that took place during the age of exploration was to identify the main sea routes. European adventurers wanted to identify main sea routes to East Asia, which they referred to as the Indies. Sea routes stood as a fascination, and sailors went great lengths to find them. These sea routes would help the Europeans to identify new civilizations as wells as lands that they would conquer. Mariners, warriors, and merchants also sought new routes that would enhance their trade. Columbus discovered the Americas while he was attempting to forge his way to India and its associated riches. The Norwegian warriors found themselves in North America around 1000 years back as they pursued their ambitions.
Other motives also marked the age of exploration. Many people wanted to make use of the golden opportunity to visit new places and learn. Advances in education and technology were on the increase in the middle of the period, which meant a time of novel learning. Several advances made traveling easier, and explorers ventured into new lands. One of the major developments was in cartography or the science and art of developing maps. A translation of a particular book known as the Guide to Geography to Latin from Greek by a scholar from Italy assisted in cartography greatly. The result of these advances was a change in the way the Europeans perceived the world. In the 1500s, maps showed that the earth was like a sphere. A German cartographer developed the first map that clearly showed South and North America demarcated from Asia.
The Age of Exploration gave rise to both benefits as well as challenges. It was because of this exploration that new trade and communication routes for business came into the scene. The market for goods such as exotic fruits, tea, and new technologies increased tremendously. As Spain gained power towards the end of the age of exploration, it had gained power and had great influence in Europe. More than anything, the discovery of America led to increased standards of living and development of capitalism. The age of exploration made the business people gain a middle class status. Despite the many advantages, the discovery of America also led to several negative impacts, especially to the Natives. The Europeans killed and took over the land that initially belonged to Native Americans in the process of their settling in a new land. The period also marked the initiation of slavery, which left many Africans in pains and suffering. Finally, explorations meant that Europeans and Africans encountered new diseases, particularly tropical diseases.
NURSING PLAN CARE
NURSING PLAN CARE
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Explain how your own perceptions about quality of life and health promotion might affect your care for a dying patient with a lingering illness such as cancer.
For patients with chronic illness, one of the most valuable things to note about recovering is the fact that the patient does not only require medical treatment to facilitate their wellness, but also emotional support to sustain their speedy recovery. Emotional support complements the patient’s well being. Another essential point to note is that members of the family are the closest people who can achieve effective emotional support (DeMarco, 2011, p. 116). Hence, the fact that Mrs. Thomas does not have emotional support especially from her family is one of the limiting factors to her speedy recovery. At the same time, it is also essential to note that cooperation will lead to emotional support; hence the family’s disagreement reduces the emotional support Mrs. Thomas gets. Secondly, her husband has been severely frustrated mainly because he does not get support from his sons in looking after their mother, and his emotional support is, therefore, not sufficient. Lastly, it is necessary to note that patients with chronic illnesses require regular medical check ups since a key aspect of chronic diseases is their rapid progression. Mrs. Thomas will, therefore, need people especially her immediate family who will always check up on her and ensure that she sticks to the medication plan.
Discuss three strategies that you could use in the Thomas’s situation to improve the quality of life for Mrs. Thomas and her husband during this illness.
There are three strategies that could be adopted by the Thomas’ in order to improve their quality of life. First, medical checkups will help indicate any change in the patient’s condition. Secondly, they should jointly adopt the changes in the patient’s health as well as the consequences that will come with it, for example, the dietary changes. Mutual adopting of the changes especially in their diet will make it easier not only for the patient, but also the husband. Lastly, it is also useful for the family to include the wife’s situation in their financial budgets. This is because her medical insurance cover does not cater for long term illnesses, and for this reason, she will have to support herself after some time.
Create a holistic nursing action plan appropriate for managing Mrs. Thomas’s care at home.
1. Discuss ways to optimize Mrs. Thomas’s functional ability at this stage of her illness.
2. Discuss ways to provide care for Mrs. Thomas once self-care is no longer possible.
From a holistic medical point of view, a critical analysis of Mrs. Thomas condition will be required, and this will include a chemo-test to determine the disease’s extent. If the extent of the infection does not allow chemotherapy based on a number of possible reasons such as the cancer’s progression, it will be beneficial to place the patient under oral medication, in this case Vicodin which is a hydrocodone/ paracetamol medicine that is nonreactive and nonallergic.
If the patient’s medical condition progresses to a point whereby she is not in a position to remain under self-care, there are a number of different measures that the family can choose from, the most ideal being putting her under specialized care. This is the most ideal choice primarily based on the fact that the family will constantly interact with the patient. Alternatively, facility healthcare can be adopted; this is a cheaper means that will put the patient under specialized care. However, many families do not prefer this option because they are not in daily contact with their patient.
Explain how you, as the community health nurse, can intervene in this situation in the management of Mr. Thomas’s chronic depression.
As a community nurse, there are a number of ways through which the patient’s depression can be managed. First, it is necessary to make the patient accept her medical condition. Secondly, Mrs. Thomas should be encouraged to work out and exercise a lot because this will keep her busy and the less she thinks of her condition, the less depressed she becomes. Lastly, it will be beneficial to let her know the necessity of adhering to the doctors’ medical subscriptions as well as regular medical check up (Nies, 2010, p. 89).
References
DeMarco, R. (2011). Community health nursing. New York: McGraw-Hill.
Nies, M. (2010). Community/public health nursing: promoting the health of populations. New Jersey: Wiley.
Nursing Patient Teaching Plan 6 year old diabetic Type 1
Nursing Patient Teaching Plan “6 year old diabetic Type 1”
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Nursing Patient Teaching Plan “6 year old diabetic Type 1”
Diabetes type 1 can also be referred as insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. This diabetes increases the amount of blood sugar levels due to absolute or relative insufficiencies of insulin. Insulin is a hormone produced by pancreas. The role of insulin in the body is to regulate the body metabolism (Valentine et al, 2002). After a meal, digestion breaks carbohydrates down into sugar molecules and proteins into amino acids. During the process, amino acid and glucose are absorbed directly into the bloodstream, and the level of blood glucose levels rise sharply. Eventually, blood sugar level rise thus signal critical cells in the pancreas called beta cells that secrete insulin. Insulin is poured in to the bloodstream and 20 minutes after meal its level in the blood to its peak. The work of insulin is to enable glucose to enter cells in the body, particularly muscle and liver cells. Here, glucose is burnt to release energy or stored for future use by hormones or insulin. Increase in the level of insulin makes the liver stop functioning hence produced glucose is stored it in other forms till the body needs it again (Valentine et al, 2002). The moment the blood insulin level reaches its peak, the pancreas reduces production of insulin. Approximately 2-4 hours after a meal both insulin and blood glucose are at low levels, insulin being slightly higher. Therefore, blood sugar level can also be referred to as fasting blood glucose concentrations. In this type I diabetes, the body does not produce insulin hence it mostly occurs during childhood.
Pathophysiology is a process by which the body is disturbed from its’ normal function, which is caused by disease “diabetic type I.” The first thing to be detected in a patient affected by this condition is thickening of the glomerulus. At this stage, the kidney leaks more plasma protein in urine than usual. As it progresses, it increase the numbers of glomeruli that are destroyed by progressive nodular glomerulosclerosis. This appears in a decompensated diabetic manner with glycemia which is higher than 500mg/dL. However, unspecific chronic changes are shown by the interstitium (Fox & Kilvert, 2007)
According to Fox & Kilvert (2007) type 1diabetes is known for its sudden appearance, and the speed with which it progresses in 6 year old patients. The warning signs and symptoms are frequent urination, having an extreme hunger, unusual thirst, weakness, and weight loss, and extreme fatigue, irritability, having a blurred vision, nausea and vomiting. Additionally, swelling occurs around the eyes in the morning, and the patient experience headaches and frequent hiccups.
There are several tests carried out to identify the cause and the nature of the type 1 diabetes. Testing for glucose abnormalities is one of the tests that are normally carried out on patients. This is a simple blood test taken after 8 hours of fasting. It indicates; normal: U100 mg/dL, pre-diabetes: between 100-125 mg/dL, diabetes: 126mg/dL among many other tests.
There are many complications that come as a result of diabetes type I. It has being noted that these complications can reduce the normal lifespan by about 5-8 years. One of these complications is diabetic ketoacidosis, which is caused by insulin deficiency. Diabatic ketoacidosis pose a risk of low blood glucose level which results in hypoglycemia (Fox & Kilvert, 2007). Other complications are; heart disease and stroke, kidney damage, neuropathy, amputations and foot ulcers, eye complications, respiratory infections, depression, osteoporosis and hearing loss.
Life style modification is the process of treatment which patients with type I diabetes undergo (Lenz, 2007). It includes regular exercise, smoking cessation and dietary changes which reduces the risk in patients with cardiovascular disease. This is done through motivating the patients; try to negotiate a plan to enable them to do so, and monitoring the way they progress.
There are several barriers that hinder a patient of diabetes type I from following lifestyle modification procedures. A research conducted by diabetes nurses indicates that, lack of education on the importance, and the need for screening examinations hinder lifestyle modification (Lenz, 2007). They also found out that there is limited physician knowledge regarding the history of diabetic patients. Another barrier is physical failure to adhere to clinical practice recommended for guideline testing. Lastly, lack of awareness from the physician about the diabetes program and diabetes education network offered by health plans.
Benefits of lifestyle modification are the cornerstone of diabetes treatment. The long term benefit is that the amount of carbohydrates that patients consume helps to regulate their blood glucose levels and adjust their insulin doses (Lenz, 2007). AIC as a short term benefit help in pursuing a low glycemic index diet for those patients with diabetes. The introduction of sugar alcohols causes less hyperglycemia than naturally occurring sugars. It also decreases the risk of dental carries. The level of insulin helps to convert amino acids into glucose. Weight loss, nutrition, increased physical activity and smoking cession are recommended to improve medical condition for type 2 diabetes (Feinglos & Bethel, 2008). Weight loss is recommended since it enables to lower the calorie diet hence remaining consistent with dietary changes. Eating fewer fats, particularly saturated fats, whole grain and the fiber which is dietary can lower the quantity of lipids in the body, therefore, reducing the risk of developing a metabolic syndrome. Increase in physical activity plays a major role in preventing diabetes. Regular exercise such as walking decreases the rate of diabetes. Weight loss is also achieved through daily activities such as walking, jogging and running. Smoking cessation decreases the risk of ischemic vascular disease. Those who are smokers should be helped to quit smoking. This can be achieved through group therapy.
Physical activity and diet are important in the management of the ABCs of patients with Type 1 diabetes since it helps the body to utilize excess glucose reserves (Escott-Stump, 2007). To be able to manage AIC and achieve stable blood sugar control, it is important to figure out how to balance food intake, insulin and physical activity. Diet is particularly important since it significantly improves blood sugar control and decreases the risk of diabetes related complications, such as coronary artery disease, nerve damage and kidney disease. Additionally, a dietitian can help to create a food plan which fits to a child’s medical needs, lifestyle and personal preferences. Meal timing is a very fundamental aspect for patient with type 1 diabetes to consider. Those who take long acting insulin are being encouraged to take meals consistently at the same times daily (Feinglos & Bethel, 2008). However, if a meal is skipped or delayed, the patient will have high chances of experiencing low levels of blood glucose. Meals with a high content of fats such as snacks can be eaten occasionally, but blood glucose levels must be monitored. This is because this food entails high fat content hence reduces the level of blood sugar level shortly after eating and then rise hours later. Patients who use insulin pumps have an alternative of using more insulin hence are well positioned to manage their levels of blood sugar after consuming a high fat meal than their counterparts who do not use that pump (Shafer, 2001).
The main energy source in the diet is carbohydrates, which includes starches, fruits, vegetables, sugar and dairy products. According to Shafer (2001) due to consistence eating of carbohydrates at each meal, blood sugar level is controlled mostly with patients who take long-acting insulin. As time goes by, a patient is supposed to be enrolled to exchange planning where all food are being categorize as either carbohydrate, meat or meat substitute or even fat. These foods are excellent sources of fiber and high sodium content. Eating a consistent number of calories every day will help to maintain body weight. The recommended calorie intake for men and active women is 15 calories/pound.
A sample menu for a patient who needs [1.600] to [2.000] calories on a daily basis (diabetesdietfordiabetic.com, 2011):
Breakfast: ½ cup cooked oatmeal cereal with 1 medium sized banana {1S.2F}
1 cup of low fat milk {1M}
Lunch: 1 slice of cheese with 2 slice of bread. 1 strip of bacon {2S.2M&S.1Ft} and 1 slice of turkey
Dinner: 1 small potato {1S}
2{6 inch} tortilla {2S}
3 ounces of cooked, minced lean meat with 1 cup tomato sauce {3 M&S.2V}
½ cup steamed with broccoli {1V}
Snacks: 1 small roll {1S}
1 small ear of corn {1S]
½ cup of unsweetened apple juice {1F}
The patients of diabetes Type 1 are taught how to follow medical prescription by undergoing patient teaching plan for the medical condition (Humphrey, 1999). This disease is a lifelong condition which can be controlled through adjustment of lifestyle and medical treatment. There are many types of insulin treatment that can be that can be successfully control by the level of blood sugar. Therefore, this will help people with diabetes to live a full life and keep their blood sugar level under control when they take insulin. The information you are conveying to the patient is that, his/her pancreas produces very little insulin leading to Type 1 diabetes. Insulin eventually is required, and it must be given as a shot. A doctor helps the patient to adjust the dose over time hence blood sugar level should be regularly checked per day. According to Humphrey (1999) insulin treatment plan is categorized into two general types: standard insulin treatment and intensive insulin treatment. Intensive insulin treatment is recommended since its best for keeping blood sugar in a very tight control. 3 shots of insulin per day for the patient with diabetes type 1 and frequently checking the level of blood. As Escott-Stump (2007) notes, this treatment improves blood sugar control in diabetic patients and this makes it significant to the patients. It also improves how a patient feels on the daily basis and minimize risk of health complications later in life.
The following are the objectives for the teaching plan:
The patient is supposed to be able to describe the diabetic medications that they are on and take medication properly.
The patient should be capable of describing the benefits of regular exercise and how it can improve blood glucose level.
Proper skin and foot care should also be demonstrate well with the patient
Self monitoring of blood glucose using a blood glucose meter should be performed well by the patient.
Teaching will be carried out in 6 days, and each class will consist 2-3 hours sessions of education.
Day 1 there will be an overview of diabetes, Day 2 monitoring of blood glucose and the role of blood glucose, Day 3 insulin and medication, Day 4 complications from Diabetes, foot care and skin, exercise and diabetes, Day 5 coping with diabetes, diet and diabetes. Day 6 questions and answers so that to gauge if the patient has understood. The last 1 hour is to review any concepts requested by patients.
Diabetes is an alarming disorder of the third world. Through several researches that have being carried out, the prevalence of diabetes coming the year 2025 will likely to increase by 35%. Diabetes Type 1 is a very complex disease for both patients and the health professions. We believe and have hope in the recommendation presented that will help to fight this Type 1 disease. Through diagnosis, these approaches and strategies have proved to be effective in treating diabetes and its complications.
References
Escott-Stump, S. (2007). Nutrition and diagnosis-related care. Philadelphia : Wolters Kluwer Health.
Feinglos, M. N., & Bethel, M. A. (2008). Type 2 diabetes mellitus: an evidence-based approach to practical management. Totowa, NJ: Humana Press.
Fox, C., & Kilvert, A. (2007). Type 2 diabetes: answers at your fingertips. London: Class Pub.
Humphrey, C. J. (1999). Home care nursing handbook. Gaithersburg, Md.: Aspen Publishers
Lenz, T. L. (2007). Lifestyle Modifications in Pharmacotherapy. Philadelphia : Wolters Kluwer Health.
Shafer, S. (2001). Diabetes Type 2: Complete Food Management Program. New York: Three Rivers Press
Valentine et al. (2002). Diabetes type 2 and what to do. Los Angeles: Lowell House
Wilson, A. L. (1997). Managing the patient with type I diabetes. Gaithersburg, Md. : Aspen Publisher.
diabetesdietfordiabetic.com. (2011, May). Diabetes Diet Menu: A Few Examples. Retrieved from http://diabetesdietfordiabetic.com/diabetes_diet_menu.htm