Rhetorical Analysis Always Like A Girl Essays - 1720 Words

Jaelyn Romo English 111G Prof. Manley 10/24/14 #LikeAGirl Always â€Å"Like a Girl† commercial was not only a hit in the media world, but a hit to the hearts of many women across the nation. In this commercial Always attempts to reach out and inform Americans of the damage caused to a female’s confidence when they do finally hit that age in their lives where insecurities begin to exist. Positively using their credibility and reputation to target a worldwide issue among woman so that it gains enough awareness to hopefully get fixed. Women working their whole lives to break society’s doubt so that they aren’t classified under another demeaning stereotype when asked, â€Å"What does it mean to do something ‘Like a Girl?’’’. â€Å"Show me what it looks†¦show more content†¦This was just a strategic way for Always to use their reputation and apply it to a cause that needed awareness. Immediately after Always uses a form of contrast with men’s opinions, the commercial follows with comparisons. The documentarian then brings a younger generation of interviewees (little girls) and asks the same exact questions that she asked the women who have been or are going through puberty. As the audience can compare their answers, the confident responses given from the young girls expresses what Greenfield is aiming to convey. â€Å"What does it mean to run like a girl?† â€Å"It means to run as fast as you can.† The writer here then gains the trust of her audience by proving to show that she’s accurate. The statement â€Å"Like a Girl† hasn’t changed, but because of this confidence crisis the way it is interpreted, has. What’s being said in the questions themselves that are being asked, allows the audience to really interpret and understand that this is the expectation that women live up to. Which can be seen in the commercial, is not initially very high. Greenfield uses the young boy and the man in the commercial in a logical way that allows the audience to really see how girls are not only depicted in society, but how women are also portrayed when it comes to a man’s opinion. When the little boy is asked if he just insulted his sister, filming that he was somewhat puzzled and including the take where he fumbled andShow MoreRelatedSymbolic Convergence in Gossip Girl: The Fantasy of the â€Å"In Crowd†1665 Words   |  7 PagesFrom high school girls desperately trying to be one of cool kids in school to corporate warriors rubbing elbows for that next promotion, nearly everyone has fantasized about being a part of the â€Å"in crowd†. What is it that makes the bonds and barriers of â€Å"in crowd† so unbreakable? Through sharing stories and reaching conclusions through discussion of those stories, members of small groups develop a common bond that shapes their social reality. 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Porters Five Forces In Retail Industry - 955 Words

Andrew Foles Georgia Breunig Sameer Omar Xiyang Sun Industry Environment: Analysis of United States retail industry using Porter’s Five Forces. What is the retail industry? Retail industry sector encompasses companies and individuals that are engaged in selling products to consumers. As the biggest economy in the world, retail industry in the U.S. is one of the biggest industries in the world with total sales of nearly $5 trillion in 2016 as per www.census.gov. National retail foundation’s report mentions retail industry as the largest private sector employer in the United states with about 15 million people working in the industry. Retail industry in the united states comprises brick and mortar stores and a growing e-commerce sector.†¦show more content†¦This requirement might deter new entrants. 2. Low product differentiation and economies of scale: There isn’t much product differentiation at play in the retail industry as there are well known manufacturers whose products are offered for sale, which leaves price to compete on. Current well established retailers with thousands of stores enjoy the economies of scale to control their cost that a new entrant might not be able to replicate after immediately entering the industry. 3. Switching Cost: If there is anything that can go in favor of a new entrant is switching cost of the buyer. Only loyalty buyers typically have these days is to value. If a new entrant can offer better value, buyers can switch to the new entrant with no switching cost. Better value can only come from sacrificing profits which might deter new entrants as a low profit margin does not promises long term growth. Force 2 - Bargaining Power of Buyers (customers): Companies in the retail industry operate in a high price elasticity environment as there is not much product differentiation to leverage. Buyers face almost no switching cost if they chose a substitute offering better value. On the contrary, large and diverse population making small purchases works in favor of the industry. No one individual or a small group has the power to significantly impact the industry, but overall buyers enjoy have a high bargaining power in the industry. Force 3 – BargainingShow MoreRelatedAlibaba Porters Five Forces Analysis989 Words   |  4 PagesThe analysis of Porters Five Forces is a vital management tool used to analyze industries and how they comprehend hidden levers of gain. Alibabas leaders can utilize Porters Five Forces to see how the five focused powers impact profits and build up a methodology for upgrading Alibabas upper hand/long haul productivity in Specialty Retail. 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Clinical Reasoning Cycle Effective Framework

Question: Discuss about the Clinical Reasoning Cycle for Effective Framework. Answer: Introduction Clinical reasoning cycle is an effective framework for clinical practice that helps in detecting chronic symptoms of illness in patients and assists in developing a rationale for planning an effective intervention. A nurse with effective clinical reasoning skills has a positive impact on patient outcomes (LeMone et al., 2015). This case study utilizes clinical reasoning cycle framework to plan and evaluate the condition of the patient in the study. It considers the patient situations to process health related information. The report mainly identifies three nursing problems based on an assessment of patients and then establishes the goal of nursing care related to the problems identified. Finally, it gives detail on evaluation and reflection on patient's outcome. Consider patient situation and process information The first step for the nurse to work according to clinical reasoning cycle is the considering the patient situation. The case study is about a 79-year-old widowed woman, Mrs. Connie Brownstone, who has been admitted to the Emergency department with severe shortness of breath or dyspnea. It was found that she had a history of non-productive cough since three days. Apart from this, she also has a pre-existing history of asthma, and she was also admitted to intensive care unit five years ago. This detail suggests that patient has the problem of shortness of breath due to the Exacerbations of Asthma. Pulmonary edema might also cause her current condition. To collect more cues/information about the patient ailment, the patient assessment was done. The assessment of patients was done according to Australasian Triage Scale. The use of this tools ensures patients are seen promptly commensurate with their clinical urgency. The patient was triaged on arrival by triage nurse which lasted for 10 minutes. That is why she was categorized as category 2 according to Australasian triage scale and assessment was mainly done to check her respiratory distress symptoms (Hodge et al., 2013). The necessary nursing assessments include monitoring Mrs. Connie's ventilation, work of breathing, lung function, airway resistance and air flow. The nurse monitors whether the patient was having difficulty in speaking between breaths and to detect the presence of cyanosis or diaphoresis (Forbes Watt, 2015).This is significant findings to judge and consider the level of severity of the condition in the patient. The assessment by triage nurse showed Connie was distressed, slightly diaphoretic and peripherally cyanosed. The three sign of cyanosis, inability to maintain respiratory effort and decreased consciousness suggested that Mrs. Connie had an imminent respiratory arrest (Murray et al., 2012). The next step was to determine patient work of breathing. In this area, nurses monitor the key signs like the use of accessory muscle to breath, inability to lie flat and speak full sentences, extreme diaphoresis, restlessness or unconsciousness. This assessment showed that Mrs. Connie s working too hard to breathe which is evident from her symptoms of slight diaphoresis, use of accessory muscle and persistent hypoxia despite Hudson mask (Osborne et al., 2015). Assessment of further vital signs showed her to be tachycardic at 125 beats/min, febrile at 39.4 C and SpO2 at 85%. Thus this method of processing patients information helped in determining the level of severity in the patient. Three nursing problem or issues in dealing with Mrs. Connie After the assessment of patient's vital signs and breathing patterns, the nurse can identify that three key problems in Mrs. Connie are peripheral cyanosis, hypoxemia, and tachycardia. Managing this three condition will be vital to prevent any health complication in Mrs. Connie. Peripheral cyanosis occurs due to low oxygen levels in the red blood cells and leads to bluish color of the skin and mucous membrane. The persistent of this sign suggest that there is some serious problem, and it is interfering with Mrs. Connie ability to deliver oxygen-rich blood throughout the body (Tran, 2016). It will be a challenge for the nurse to manage this problem. Pulse oximetry and arterial blood gas helped in measuring oxygenation level in the patient and determine the factors that contribute to this problem (Welsh Carr, 2015). Chest X-ray is also essential in this regard to check the fluid in lungs or heart. But the Chest X-ray report showed mid-heart enlargement, but pleural spaces were clear. Good patient outcomes also rely on the nurse's ability to assess ventilation and other vital signs. As the number of choices is increasing, it will be a complicated process for the nurse to determine whether Mrs. Connie needs interventions like airway management, ventilation, intubation or noninvasive ventilation or not. It will be necessary for the nurse to recognize retraction and accessory muscle use (Stefan et al., 2015). The nurse can question the patient whether she can lie down properly or she suffers from orthopedic. The patient was also in distress which is evident from her slight diaphoresis. Assessment in the area of respiratory rate and pulse oximetry would also be problematic for the nurse as pulse oximetry results confuse oxygenation with ventilation (Murray et al., 2012). Priority of nursing care The priority of nursing care for Mrs. Connie is to reduce her symptoms of hypoxemia, peripheral cyanosis and tachycardia using planning effective interventions. It will also be necessary to plan an intervention that minimized the patient support for supplemental oxygen via Hudson mask. It will be necessary for the nurse to maintain the airway potency in patients and assist them with interventions to facilitate gas exchange (Stumbles et al., 2013). The care priorities for the nurse will be to enhance nutritional intake, prevent complication in patient and provide information about the disease process or prognosis to Mrs. Connie. Sharing information about the disease process and the treatment regimen will help Mrs. Connie in adhering to treatment as well as self-management to minimize risk (Ignatavicius Workman, 2015). Nursing cares for the patient The nursing care is planned after assessment of vital signs of Mrs. Connie and evaluating the test done on patients. Some tests were performed on Mrs. Connie such as full blood examination, urea and electrolytes, C-reactive proteins, blood cultures, troponins, iSTAT venous blood gases and Chest X-ray. The blood test, urea and electrolytes and C-reactive protein were within normal range. The troponin test detects the presence of troponin I proteins in the blood. This is released only when heart muscles are damaged. Mrs. Connie had no such condition, so it was under normal range. The following are the nursing care for Mrs. Connie- Maintain ineffective airway clearance- As the patient had a history of non-productive cough, airway clearance can be done by steps like Auscultate breath sounds, noting the degree of respiratory distress, encourage purse lip breathing and increase fluid intake in patients (Hodson Sherrington, 2014). Reduce impaired gas exchange- As the patient had increased work of breathing, the nurse will aid the patient to assume a position that eases work of breathing. Peripheral cyanosis indicates advanced hypoxemia, so regularly assessing color of skin and mucous membrane is essential. Thick sputum is a major source of impaired gas exchange, so suctioning will be helpful. Vital signs, sleep patterns, and activity tolerance should be monitored regularly in the patient (Gurin et al., 2013). Reduce risk for infection- The role nurse will be to educate the patient about the importance of breathing exercises and balancing rest and activity periods. The patient will be instructed about the rationale for breathing exercise, coughing and others exercise. The nurse will also look after the nutritional needs of the patient (Ignatavicius Workman, 2015). Evaluation of nursing care strategies To assess ineffective airway clearance, auscultate breath sounds is essential to determine the degree of obstruction. For example moist crackle sound may suggest bronchitis while absent breath sounds may suggest severe asthma (Boucher et al., 2013). Changing position of the patient to assume a comfortable position is also an effective strategy as it facilitates respiratory function by use of gravity. It will help in reducing muscle fatigue and aid chest expansion (Gattinoni et al., 2013). Increasing fluid intake is essential to decrease the viscosity of secretions and facilitate expectoration. Regular pulse oximetry test and chest X-ray is also essential to detect changes in oxygen saturation levels. As Mrs. Connie is a patient with hypoxemia, restlessness and anxiety is a common exacerbation of respiratory distress. Therefore, it is necessary for nurse to monitor the standard of consciousness and mental status of patient. Mrs. Connie might not be able to perform self-care activities, therefore teaching exercise program helps in increasing endurance and strengths without causing dyspnea. Dyspnea also prevents relaxation and inhibits. Therefore it will be necessary for the nurse to monitor patient activities to allow the period of uninterrupted sleep (Miller et al., 2014). Reflection on potential outcomes It is expected that after the planned nursing care has been taken on the patient, Mrs. Connie's condition will improve, and she will not have to rely on accessory muscle bags. The patient airway potency will increase with better breath sounds and patient will be free from respiratory distress symptoms like tachycardia, peripheral cyanosis and diaphoresis. However, assessment of patient is a critical step in nursing care. Therefore it will be essential for the nurse to have adequate skills to monitor the test and not get confused with different indications from the test of pulse oximetry and ventilation. Conclusion From the analysis of case study by using clinical reasoning cycle framework, it can be concluded that it helps nurse to plan and evaluate effective nursing strategies for the care of patients. Critical thinking in clinical practice is a skill that nurse can learn with experience, and it depends on attributes like creativity, flexibility, contextual perspective, inquisitiveness and perseverance (Chao et al., 2013). The clinical reasoning cycle helps nurse to work in a systematic way to process critical information of patients and then provide better health outcome to a patient in distress. Reference Boucher, N., Prystupa, A., Witczak, A., Walczak, E., Dzida, G., Panasiuk, L. (2013). Lung auscultationIdentification of common lung sound abnormalities and associated pathologies.Journal of Pre-Clinical and Clinical Research,7(1). Chao, S. Y., Liu, H. Y., Wu, M. C., Clark, M. J., Tan, J. Y. (2013). Identifying critical thinking indicators and critical thinker attributes in nursing practice.Journal of Nursing Research,21(3), 204-210. Forbes, H., Watt, E. (2015).Jarvis's Physical Examination and Health Assessment. Elsevier Health Sciences. Gattinoni, L., Taccone, P., Carlesso, E., Marini, J. J. (2013). Prone position in acute respiratory distress syndrome. Rationale, indications, and limits.American journal of respiratory and critical care medicine,188(11), 1286-1293. Gurin, C., Reignier, J., Richard, J. C., Beuret, P., Gacouin, A., Boulain, T., ... Clavel, M. (2013). Prone positioning in severe acute respiratory distress syndrome.New England Journal of Medicine,368(23), 2159-2168. Hodge, A., Hugman, A., Varndell, W., Howes, K. (2013). A review of the quality assurance processes for the Australasian Triage Scale (ATS) and implications for future practice.Australasian Emergency Nursing Journal,16(1), 21-29. Hodson, M., Sherrington, R. (2014). Treating patients with chronic obstructive pulmonary disease.Nursing Standard,29(9), 50-58. Ignatavicius, D. D., Workman, M. L. (2015).Medical-surgical nursing: Patient-centered collaborative care. Elsevier Health Sciences. LeMone, P., Burke, K., Dwyer, T., Levett-Jones, T., Moxham, L., Reid-Searl, K. (2015).Medical-surgical nursing. Pearson Higher Education AU. Miller, S., Owens, L., Collins, T., Silverman, E. (2014). Psychophysiology of respiratory disease: clinical considerations for the advanced practice nurse.MJHS, 24. Murray, J. F., Matthay, M. A., Luce, J. M., Flick, M. R. (2012). An expanded definition of the adult respiratory distress syndrome.American Review of Respiratory Disease. Murray, J. F., Matthay, M. A., Luce, J. M., Flick, M. R. (2012). An expanded definition of the adult respiratory distress syndrome.American Review of Respiratory Disease. Osborne, S., Douglas, C., Reid, C., Jones, L., Gardner, G. (2015). The primacy of vital signsacute care nurses and midwives use of physical assessment skills: a cross sectional study.International journal of nursing studies,52(5), 951-962. Stefan, M. S., Au, D. H., Mularski, R. A., Krishnan, J. A., Naureckas, E. T., Carson, S. S., ... Lindenauer, P. 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Osteogenesis Imperfecta Essays - Skeletal Disorders, Rare Diseases

Osteogenesis Imperfecta Osteogenesis imperfecta (OI) is a rare genetic disorder of collagen synthesis associated with broad spectrum of musculoskeletal problems, most notably bowing and fractures of the extremities, muscle weakness, laxity in the ligaments, and spinal deformities.(Binder, 386). Other collagen-containing skeletal tissues, such as the sclerae, the teeth, and the heart valves are also affected to a variable degree. OI has a common feature of bony fragility associated with defective formation of collagen by osteoblasts and fibroblasts(Smith, 1983, 13). This disease, involving defective development of the connective tissues, is usually the result of the autosomal dominant gene, but can also be the result of the autosomal recessive gene. Spontaneous mutations are common and the clinical presentation of the disease remains to be quite broad (Binder, 386). OI is most commonly referred to as brittle bones, but other names include: fragilitas ossium, hypolasia of the mesenchyme, and osteopsathyrosis. Osteogenesis imperfecta is still not completely understood, and while there has been advances in diagnosing the disease, treatment is still limited. Osteogenesis imperfecta is the result of mutations in the genes that code for type I collagen. In the mild dominantly inherited form of OI (type I), a non-functional allele for the alpha 1 (I) chain halves collagen synthesis, (Smith, 1995, 169) and is largely responsible for the inheritance. Single base mutations in the codon for glycine causes lethal (type II) OI by wrecking the formation of the collagen triple helix. Types III and IV are the less dramatic outcomes of similar glycine mutations in either the alpha 1 (I) or the alpha 2(I) chains (Smith, 169). The clinical signs can be caused from defective osteoblastic activity and defective mesenchymal collagen (embryonic connective tissue) and its derivatives, such as sclerae, bones, and ligaments. The reticulum fails to differentiate into mature collagen or the collagen develops abnormally. This causes immature and coarse bone formation and thinning (Loeb, 755). The signs and symptoms of OI vary greatly depending on the type. The most commonly used classification is the Sillence (type I to IV). Type I is the mildest form of OI and is inherited as an autosomal dominant trait. The sclerae (middle coat of eyeball) is distinctly blue. Type I is broken down into IA and IB -- the difference being whether dentinogenesis is present. IA has a life expectancy nearly the same as the general public. The physical activity is limited, and may appear to have no disability at all. The bones have a mottled or worm like appearance, forming small islands (Isselbacher, 2111). Type II is lethal in utero or shortly there afterbirth. The survivors live from just a few hours to several months. The karyotypes of parents are usually normal. This type is broken down into three subgroups: IIA is characterized by a broad, crumpled femora and continuos rib beading, IIB by minimal to no rib fractures, and IIC by a thin femora and ribs with extensive fracturing. While in the uterus, there is poor fetal movement, low fetal weight, poor ossification of the fetal skeleton, hypoplastic lungs, the long bones of the upper and lower limbs are shortened or deformed, and the head is soft. Intrauterine fractures occur, and death is usually from intracranial hemorrhaging due to vessel fragility or respiratory distress from pulmonary hypoplasia. The bones and other tissues are extremely fragile, and massive injuries occur in utero or delivery. The ribs appear beaded or broken and the long bones crumpled (Isselbacher, 2111). Type III and IV is intermediate in severity between types I and II. Type III differs from I in its greater severity and from IV in that it increases in severity with age. It can be inherited as either an autosomal recessive or dominant trait. The sclerae is only slightly bluish in infancy and white in adulthood, although the average life expectancy is 25 years. Type IV is always dominant. With types III and IV multiple fractures from minor physical stress occurs leading to progressive and severe deformities. Kyphoscoliosis (curvature of the spine) may cause respiratory impairment and predisposition to pulmonary infections. Popcorn-like deposits of mineral appear on the ends of long bones (Isselbacher, 2111). The symptoms of OI (types I, III, and IV) can appear when the child begins to walk, and