Saturday, December 28, 2019

The Shortcomings Present Within Justice Gibson s...

The aim of this essay will be to provide a sufficient illustration of the inadequacies present within Justice Gibson’s dissenting opinion in response to Eakin V. Raub, making his critique of Chief Justice John Marshall’s opinion concerning Marbury v. Madison and its establishment of judicial review deficient in its purpose. Through a brief summarization of the cases, paired with a comparative analysis of both abovementioned opinions, this dissertation will intend on challenging the commonly held notion of stark confrontation between the assumptions of both men by demonstrating the relative consistencies present in both assessments regarding their respective cases, while also illustrating the intellectual deficiencies present in Gibson’s dissent. In doing so, the argument presented below will clearly clarify the ineffectiveness of Gibson’s rebutting appraisal of Marshall’s interpretation of the Constitutions consignment of judicial review. In his dissenting opinion of Eakin v. Raub, Justice Gibson presented the stark distinction between civil and political judicial functions. He defines civil powers as natural powers of the court, deriving from common law and not contingent upon Constitutional authorization. In contrast, Gibson defined political powers as privileges appointed solely by Constitutional allocation, void under any other circumstance. By depicting and defining the divergence present between both types of judicial powers, Gibson delineated that the ability ofShow MoreRelatedStephen P. Robbins Timothy A. Judge (2011) Organizational Behaviour 15th Edition New Jersey: Prentice Hall393164 Words   |  1573 Pagesappropriate page within text. Copyright  © 2013, 2011, 2009, 2007, 2005 by Pearson Education, Inc., publishing as Prentice Hall. All rights reserved. Manufactured in the United States of America. This publication is protected by Copyright, and permission should be obtained from the publisher prior to any prohibited reproduction, storage in a retrieval system, or transmission in any form or by any means, electronic, mechanical, photocopying, recording, or likewise. To obtain permission(s) to use materialRead MoreLibrary Management204752 Words   |  820 PagesCongress Subject Headings: Principles and Application, Fourth Edition Lois Mai Chan Developing Library and Information Center Collections, Fifth Edition G. Edward Evans and Margaret Zarnosky Saponaro Metadata and Its Impact on Libraries Sheila S. Intner, Susan S. Lazinger, and Jean Weihs Organizing Audiovisual and Electronic Resources for Access: A Cataloging Guide, Second Edition Ingrid Hsieh-Yee Introduction to Cataloging and Classification, Tenth Edition Arlene G. Taylor LIbRaRy and InfoRMaTIonRead MoreDeveloping Management Skills404131 Words   |  1617 Pagesbuilt-in pretests and posttests, focus on what you need to learn and to review in order to succeed. Visit www.mymanagementlab.com to learn more. DEVELOPING MANAGEMENT SKILLS EIGHTH EDITION David A. Whetten BRIGHAM YOUNG UNIVERSITY Kim S. Cameron UNIVERSITY OF MICHIGAN Prentice Hall Boston Columbus Indianapolis New York San Francisco Upper Saddle River Amsterdam Cape Town Dubai London Madrid Milan Munich Paris Montreal Toronto Delhi Mexico City Sao Paulo Sydney Hong Kong Seoul SingaporeRead MoreMarketing Mistakes and Successes175322 Words   |  702 Pagesused in training programs and even appeal to nonprofessionals who are looking for a good read about well-known firms and personalities. TEACHING AIDS As in previous editions, you will find a plethora of teaching aids and discussion material within and at the end of each chapter. Some of these will be common to several cases, and illustrate that certain successful and unsuccessful practices are not unique. Information Boxes and Issue Boxes are included in each chapter to highlight relevant

Friday, December 20, 2019

Founding Brothers By Joseph J. Ellis - 1479 Words

In the book â€Å"Founding Brothers† by Joseph J. Ellis, he explores the challenges faced by the Founding Fathers in a series of 6 defining events as they formed a new government for the U.S. after the revolution. Focusing on the more important figures from the revolutionary era, who he calls â€Å"Founding Brothers†, a slight change from the original â€Å"Founding Fathers†. They are as follows: George Washington, John and Abigale Adams, James Madison, Thomas Jefferson, Arron Burr, Alexander Hamilton, and Benjamin Franklin. In this book there’s 7 sections, each showing a different problem, which Ellis tries to explain in a neutral perspective using both foresight and hindsight. He tries to show the sense of urgency of the issues faced while providing a better perspective using the centuries of hindsight acquired. He tries to focus on the different relationships the men had and how they were influenced by the events and each other during this very formativ e chapter of the country. â€Å"Founding Brothers† is a non-fiction novel in which Ellis attempts to focus on the highlighted events in both post-revolutionary times and the lives of the Founding Fathers. He attempts to address each specific relationship and how they were impacted by the harsh times in which they lived. The 7 sections in the book allows deeper hindsight and foresight into specific matters so we may better understand the hardships these men were subjected to, as well as history’s opinions of them. Ellis shows his intentionsShow MoreRelatedThe Founding Brothers By Joseph J. Ellis1253 Words   |  6 PagesIn the book the Founding Brothers, Joseph J. Ellis, the author puts the key players of post – revolution America on BLAST! His slam book, closely mirrors the political turmoil of today. It is marred by a war of words between candidates, personal attacks, media bias, party politics and long standing feuds. Ellis’ factual account of the hi storical crisis explores challenges each of these ordinary men, our founding fathers faced as they come together to established order and declare their independenceRead More Joseph J. Ellis Founding Brothers : The Revoluntary Generation654 Words   |  3 PagesJoseph J. Ellis Founding Brothers : The Revoluntary Generation   Ã‚  Ã‚  Ã‚  Ã‚  The compelling and infectious novel of Founding Brothers; The Revolutionary Generation written by Joseph J. Ellis combines our founding fathers weakness’ and strongest abilities in just six chapters. His six chapters tell the stories of: The duel between Alexander Hamilton and Aaron Burr. This entertaining chapter describes how duels were undertaken and played out in that time, and helps the reader understand both mens motivesRead MoreFounding Brothers by Joseph J. Ellis Essay1411 Words   |  6 PagesFounding Brothers Essay The founding fathers, or as the book calls them the founding brothers, are an assorted group of men from wildly different backgrounds. In political terms, they were divided. Yet, they came to together to help shape this country into the place it is today. Now on their journey towards the making of this country they did encounter some trouble. They encountered heated debates among themselves though for getting through these debates they show just why they deserve to be calledRead MoreSummary Of Founding Brothers : The Revolutionary Generation By Joseph J. Ellis1377 Words   |  6 Pages2015 Summer Book Review Founding Brothers: The Revolutionary Generation by Joseph J. Ellis Publisher: Alfred A. Knopf Joseph J. Ellis work concentrates on crucial events after the Revolutionary war in the young nation of America. The writer unbiasedly analyzes vital moments in the lives of the Founding Fathers and how relationships between them influenced and were influenced by the unstable era in which they happened to live in. Through the six chapters and preface, Ellis examines the key revolutionaryRead MoreRespectability: Politics in Early America in Founding Brothers by Joseph J. Ellis1507 Words   |  7 PagesIn Founding Brothers, Joseph J. Ellis discusses how the relationships of the founding fathers shaped the United States, looking not only at what happened historically but the myths that have prevailed in modern times. I have few issues with this book one of which is that the narrative often jumps from one time and place to another, and while it provides the relevant information and keeps the reader’s attention, it can be hard to follow at times. In addition there are times were he explains the sameRead Morefounding fathers book report873 Words   |  4 PagesJoseph J. Ellis is a well-known historian. He earned his Bachelor’s degree from the college of William and Mary, and his masters and Ph.D. at the University of Yale. Ellis is currently a full time professor of the Commonwealth at the University of Massachusetts at Amherst. In addition to Founding Brothers: The Revolutionary Generation Ellis has written many books and editorials. His books include; The New England Mind in Transition: Samuel Johnson of Connecticut (Yale University Press, 1983)Read MoreFounding Brothers : The Revolutionary Generation Essay1261 Words   |  6 PagesJoseph J. Ellis, American historian and novelist has written many awards winning novels. One of his most recognized, â€Å"American Sphinx†, winner many prestigious awards such as the National Book Award for Non-Fiction in 1997, and the Ambassador Book Award for Biography in 1998. His Pulitzer Prize winning novel, â€Å"Founding Brothers: The Revolutionary Generation†, talks about the founding fathers’ interactions with each other in the decades that followed the Constitutional Convention of 1787. DuringRead MoreFounding Brothers Book Review Essay627 Words   |  3 PagesEllis, Joseph J.  Founding Brothers: The Revolutionary Generation.  New York: Alfred A. Knopf, 2000. Print. The book being critiqued in the following review is Founding Brothers by Joseph Ellis. Ellis’ goal in writing this book was to define the political events and achievements that gained historical significance because they framed the successive history of the United States. Ellis wrote on this specific topic because he felt the need to argue the fact that the American Revolution and the greatnessRead MoreThe American Revolution : A Historiographical Introduction846 Words   |  4 PagesRevolution: A Historiographical Introduction,† provided by The British Library I would choose to use a book titled â€Å"Revolutionary Characters: What Made The Founders Different,† written by Gordon S. Wood, and a book titled â€Å"Founding Brothers: The Revolutionary Generation,† written by Joseph J Ellis as reference. The article â€Å"The American Revolution: A Historiographical Introduction,† provided by The British Library, goes over how the American Revolution’s history has changed throughout the yearsRead MoreThe Revolutionary Generation, By Joseph J. Ellis1730 Words   |  7 PagesJoseph J. Ellis, the author of Founding Brothers: The Revolutionary Generation, is an American author and historian. Born July 18, 1943 in Washington, D.C., Ellis would grow up to be one of the best, well-known scholars of America. He began his college education at Yale University, then at the College of William Mary. Ellis works include Founding Brothers: The Revolutionary Generation, American Sphinx, and His Excellency: George Washington. His books have brought his name into one of remembrance

Thursday, December 12, 2019

Australian Taxation Authority

Question: Discuss about the assessable income of an individual. Answer: Part A Introduction Assessable income of an individual is the income of that person that is subjected to income tax by the Australian Taxation Authority (ATO) provided such income exceeds the tax-free threshold limit stipulated by the ATO[1]. There are various sources of assessable income that are considered by the ATO while arriving at the tax liability of an individual. In the given case scenario, David is a medical practitioner who has to discontinue his practice due to his illness. The income from practicing is considered to be personal service income of a person. In a similar manner, deductions are available to an individual that are set off against assessable income of an individual[2]. David has other sources of income such as income from investment, dividend and income from rent. The primary objective of this essay is to evaluate and determine that whether deductions can be claimed for compulsory costs that are required to be incurred by David during his period of illness against his assessable income[3]. Elaborate of the above mentioned points. The introduction should be 10% of the total word count allotted. Body (Do not include this heading while writing the final piece) Discuss of the following points: Assessable income of medical practitioners Deductions available and their types Analysis of the case with reference to the provisions of the law stipulated in the ITAA 1997. This portion will include the opinion of the author in light of the legislative provisions and rules stipulated by the ATO. Conclusion A brief summary of the points discussed above. It should also be 10% of the word count. Part B To David Sub: Advise on your assessable income and deductions that can be availed Ref: It can be a letter dated **/**/**** Dear David, Discuss the following: Important issues related to the case Legislative provisions applicable Advise on the matter and a detailed discussion of whether deductions can be claimed Thanking you. Yours sincerely, ABC Solicitors References INCOME TAX ASSESSMENT ACT 1997(2016) Austlii.edu.au Part 10 - Tax Planning For Doctors - Mcmasters' Accountants(2016) Mcmasters.com.au What To Include In Your Assessable Income | Australian Taxation Office(2016) Ato.gov.au [1] What To Include In Your Assessable Income | Australian Taxation Office (2016) Ato.gov.au [2] INCOME TAX ASSESSMENT ACT 1997 (2016) Austlii.edu.au [3] Part 10 - Tax Planning For Doctors - Mcmasters' Accountants (2016) Mcmasters.com.au.

Wednesday, December 4, 2019

Twilight Marketing Plan

Question : Describe the Twilight marketing plan, astartup company. Answer : About the business Twilight is a very different business concept and it needs to be developed well so that the organization can be rest assured that the right set of customers are attracted to counsel themselves before they get retirement. In the past, retirement meant that the person will not be able to do anything more but that is not the case anymore but yes, even today, people are not willing to accept the fact that they cannot work at the age of 60. Twilight should put in efforts to understand that retirement doesnt mean that the person cannot do anything but it just means that one cannot be associated with the old job that they have been doing. Professionals will have to hired at Twilight who can help people to understand the way how life will change after retirement and at the same time, the professional should also look for ways by which they can convey to people regarding the productive things that can be undertaken after retirement. The counselor will have to understand the fact that plenty of changes will take place after a person retires so that needs to be considered while they are in business. Few of the problems that the people nearing retirement may come across with are as follows: 1. The monthly income will stop 2. The people in the house may stop respecting them as their monthly earning has stopped. 3. They will be free all day and hence, what can be done all day. It is the responsibility of the counselor to help the person understand that it is a fact that life changes after retirement but thats not a negative sign. The counselor can also help the retirees to understand the various activities that can be undertaken to adjust to the new life (Blassard 2003). Services offered Different services will be offered by Twilight to be people who will get retired soon. This will help the people to live a normal life after the retirement as well. Few of the services that would help the retirees to be happy even after their retirement are as follows: 1. Plain counseling will be done wherein the retiree can talk to counselor regarding the sacredness that they have in their mind. Respect and income will be two things that will be haunting them. In this situation, the counselor will help them to overcome the mental barrier that the customer has built in their mind. The number of counseling sessions will be decided upon the mental state of the people. If the customer is just few months or a month away from retirement then the number of sessions will be more than the sessions that will be offered to people who have more 5-6 years time. 2. The organization will also take efforts to involve the family members so that the family members can support the person who is about to retire. The family members will be involved so that they can also understand the concerns of their family member who is about to retire. After retirement, the support of the family members is a must as this will help them to feel secured rather than that of being worried about whats going to next. 3. Twilight will have tie-ups with organizations with organizations that require consultants for various jobs. If the customer is really stressed about what they are going to do after retirement then these retirees can be placed for the consulting job so that they can be occupied all day. This consulting job will help the retired employee some money 4. Twilight will have tie-ups with health clubs so that the people who are retired can be a part of the health club at a minimum price. This will help the people to be motivated to be a part of the health club. Most of the people in the health club would be above the age of 55 so the retirees can talk and share their thoughts with people whom they know. This will make the retirees feel relaxed and they wont feel lonely also. 5. Twilight will have tie-ups with NGOs so that the retired people can go and spend time with people in the charity organizations. This tie-up will be beneficial to the retirees as well as the charity organization. The retired people can serve the people in the NGO in different forms. This will keep the retired people active and they will also be aware of what needs to be done next (Diekelmann 1978). Market overview analysis The market overview analysis of Twilight will be different than that of the other businesses which are available in market. Few of the things that one needs to understand about the Twilight business so that people can be more than happy to be a part of the business are discussed below. Customer profile Twilight will target all the people who are nearing retirement. Many people will be very scared with whats going to happen after their retirement so those people will be targeted first. People after the age of 55 will be targeted so that they can be counseled and mentally prepared for the retirement which is about to come in few years time. Many people might have retired few years or months ago and those people may be very uncomfortable with the sudden change that took place in their life. This is when Twilight will come for help. It will help people to overcome that mental trauma and will also help them to look for ways by which they can lead a productive life that can help them to lead a peaceful life (Asebedo 2014). Competitor analysis At this point of time, there arent any direct competitors for Twilight but yes, retirement counseling is done by many NGOs. These NGOs help people to lead a regular life even after retirement with the help of positive motivation. Twilight will do something more than just counseling but those NGOs can actually be a competitor to Twilight. Twilight should market all the services that they provide rather than just marketing the counseling which will be done by professionals (Willett 2008). Segmentation, Targeting and Positioning of business Segmentation of Twilight Twilight will have to identify the segment that can be served and this will help the organization to earn the profit that they have planned. Few of the segments that can be targeted by Twilight so that they can generate sufficient revenue are discussed below. People who are in the age group of 55-60 will be targeted so that the organization can counsel them in advance and help them to have a peaceful life after their retirement. These people will have to undergo regular counseling session so that they can be prepared to face their future with the time. Many people are stressed after their retirement so those people can also be helped. Twilight can talk to these people and help them understand that its not too late to start with something good in life. These people should be motivated to come out of the mental trauma and face the world with confidence (Chris 2012). Targeting of Twilight The company should target the right set of people so that they can plan their marketing strategies accordingly. Looking at the various market segments that are available for Twilight, the company would prefer to go ahead with counseling the people who are between the age group of 55-60. Apart from counseling, before their retirement, the company will also help the employees to get an opportunity before they retire. This will make the retirees feel good and confident about themselves (Diekelmann 1978). Positioning of Twilight Twilight will be positioned as an organization that will help the retired people to feel secure. Different people may have different perception about retirement so all the perceptions and problems will be addressed at Twilight. The organization will take care of the customers requirement rather than just empathizing or sympathizing their situation through counseling (Lai 2009). Marketing strategies It is every important for the organization to have appropriate marketing strategies so that they can reach the right set of people in right manner. Few of the ways by which Twilight can reach the right people in a right way are as follows: 1. Television is one of the most effective ways of marketing. Twilight will place their advertisements on television from 9 PM to 10 PM. This is the time when most of the working people will watch television. This will motivate them to enroll themselves for counseling if they are scared of what can be done after retirement. This advertisement will also reach plenty of other people who may think that they have friends who can use this service. 2. Placing banners at regular intervals will be another idea which Twilight can take up. This will help people to notice while they are driving or just walking. This will help more and more people to be aware of a way by which they can keep themselves busy. 3. The company will also distribute pamphlets to the employees through newspaper distribution. This will help people to be aware of the availability of a service that can help them to know who can help them. The pamphlets will also offer discounts to customers so that the customers can feel motivated to at least come and check if the service is really worth (Willett 2008). 4. The company will have tie-ups with corporate so that the corporate company can share the details of the employees who may retire soon. The marketing executives from Twilight will get in touch with them so that they can get to know the benefits that they can get even after retirement. 5. Events will be held by Twilight. The event will be for those people who are willing to lead a normal life even after retirement. Plenty of ideas will be shared with the people who are willing to be a part of the event. This will motivate them to enroll with the organization so that they can reap further benefits. 6. Word of mouth marketing will be one of the best ways by which more and more people will be attracted to be a part of the event. Word of mouth marketing will be possible only when the customers are satisfied. The company will try its level best to satisfy the current customers so that future customers can be attracted (Cutler 2011). 7Ps of marketing Twilight very well understands that they will have to fulfill all the 7Ps so that the company is satisfied with the results that they achieve. The various activities that will help the company to touch all the 7Ps are discussed below. Product Twilight is a service and hence, the company will have to look for ways by which they can attract the customers to use the service. The experience of the service should be such that people are motivated to use the service further rather than that of looking for some other similar service provider. The counseling area of Twilight will be very bright so that the customer can get a positive vibration while they come for counseling. The company will ensure that the customers experience here is so good that they recommend the same to others as well. Price The company will opt for penetration pricing strategy. This is something new and hence, most of the customers may not be even sure if they should use this service or not. Initially, the price of the service will be very low so that the customers are motivated to try the service once rather than that of compromising with the same time. The company will also give discounts if the customer refers another customer or if the customer has become a frequent visitor. Place The company will start with a single office wherein the people can meet up with the counselors and also the other officials. Apart from that, the company will also set up their office in multiple locations so that they can be reachable to more and more people. This will help the business to grow further. Promotion Various promotion strategies will be implemented by Twilight so that the presence of a new business is known to more and more people. Television, radio, banners and newspaper will be few of the sources that will be used extensively for the purpose of marketing. Apart from that, discounts will also motivate people to be a part of the organization (Kinder 2014). People Plenty of people will be included in the business so that the service can be successfully delivered to all the people. Counselors, back-end officials, front-end officials, admin professionals, HR professionals and IT professionals are few of the people who will be associated with the company so that there is no compromise in the quality of service that will be provided by the company to the customers. Process The process at Twilight will start with marketing so that the people who can be potential customers are attracted. These potential will come to Twilight office so that they can enquire about the services that are available and also the benefits that they can get. Few of the customers may be willing to be a part of the organization and hence, they will make the advance payment. These customers will be introduced to the system with the help of counseling. Counseling will help the employees to understand the benefits that one can derive at. Physical evidence Twilight will be providing service and hence, it is very important for the company to look for ways by which they can use a lot of physical evidence. Physical evidence will help the customers to remember the business. The office will serve as physical evidence. Apart from that, the marketers will distribute pamphlets that motivate the potential customer to walk in the office. A lot of signboards will be put so that the potential customers can get to know about the presence of office (Chen 2011). SWOT analysis of business There are various strengths, weaknesses, opportunities and threats associated with this business. It is the responsibility of the management to understand the various factors so that action can be taken accordingly. The various factors associated with business are discussed below. Strengths of Twilight 1. The sales executive associated with Twilight are very strong with regards to the understanding of the product. This will help the business to furnish easily. 2. The office of Twilight is located in an area where lot of corporate are located and hence, it can easily gain the attention of people. 3. This business will hold a good reputation in the market because of the innovative offering that they have. This will help the business to attract customers. Weaknesses of Twilight 1. The company is facing cash flow problems because of the fewer funds that are available in the business. 2.The record keeping of the business is not that great and this may create a problem in the great future. pportunities of Twilight 1. The customers will be loyal to the business as they will not receive similar business in the market anywhere. 2. Customer demand for such product is very high and hence, sustaining in the market is very easy. Threats to Twilight 1. Today there is no competition but in the future, there are possibilities that plenty of similar business will come and hence, it will be difficult for Twilight. 2. If there is a downturn in the economy then people may be confused if they need to pay for the same service and hence, the customers may not be interested (Rhim 2014). Global opportunities for Twilight Twilight is an entirely new concept and hence, it will be loved by people. Twilight can start the business in a developed country but with time and experience, they can grow to other developed and developing nation. The retirement stress is seen among people in different corners of the world and hence, the opportunities for growth are very high for a business like Twilight. Financial measurement of Twilights performance The liquidity and the profitability of the business will be taken into consideration so that the management can get an idea about the financial performance of the company. It is very important for Twilight to maintain the liquidity of .business so that the organization can pay salaries, rent and other cash related expenses. In the absence of liquidity, the flow of funds in the business will be very less and hence, this can create a huge problem in the betterment of the company. Profitability of the company will be measured continuously so that the management can be updated with the revenue that is generated by the company. The gross profit of the company will be tracked along with the expenses so that the management can get an idea about the actual profit that the company is earning. Conclusion Twilight business has the potential to attract the customers as they have come up with the new concept. This service is something that people have been expecting since long. This service will help the people to lead a happy and relaxed life even after retirement. This service is based on the concept that empty mind is the devils workshop. This business will try to keep the retired employees busy so that they can concentrate on their work rather than that of thinking about things that may create stress. References Asebedo, S, 2014, Positive Psychological Attributes andRetirementSatisfaction, Journal of Financial Counseling and Planning, Vol. 25, no. 2, pp. 161 Blassard, N, 2003, Employers should make pre-retirementcounselingmore meaningful, Vol. 107, no. 12, pp. 18 Chen, C, 2011, Life-career Re-engagement: Considerations and Implications for CounselingPeople inRetirementTransition - Part 2, Australian Journal of Career Development, Vol. 20, no. 2, pp. 32-41 Chris, M, 2012, The ever-changing meanings ofretirement, The American Psychologist, Vol. 67, no. 1, pp. 75 Cutler, N, 2011, Working inretirement: the longevity perplexities continue, Journal of Financial Service professionals, Vol. 65, no. 4, pp. 19 Diekelmann, N, 1978, Pre-RetirementCounseling, The American Journal of nursing, Vol. 78, no. 8, pp. 1337-1339 Diekelmann, N, 1978, Staying well while growing old: pre-retirementcounseling, The American Journal of counseling, Vol. 78, no. 8, pp. 1337 Kinder, G, 2014, When the Market for Advice Doesn't Meet the Need, Journal of Financial Planning, Vol. 27, no. 12, pp. 36 Lai, M, 2009, Managing money andretirementplanning: academics' perspectives, Pensions, Vol. 14, no. 4, pp. 282-292 Rhim, M, 2014, It Is Time for Employees to Set TheirRetirementGPS, Compensation and Benefits Review, Vol. 46, no. 4, pp. 235-238 Willett, M, 2008, A new model forretirementeducation andcounseling, Financial Services Review, Vol. 17, no. 2, pp. 105-130 Willett, M, 2008, A New Model forRetirementEducation andCounseling, Pension Benefits, Vol. 118, no. 1, pp. 11

Thursday, November 28, 2019

Argos and Corinth essays

Argos and Corinth essays Argos was founded by Phoroneus; he named it after his son, Argos. It was the second largest city-state in Ancient Greece, and for centuries, the most important one. Argos was subsidiary to Mycenae until the Dorian invasion in the 12th century BC. Then Argos became the most prominent Greek city-state in the northeastern Peloponnese. Argos and the Early Hoplite Greek lists begin in 680 BC proper, which coincides with the dates attributed to the rise of King Pheidon of Argos, who is attributed with formalizing the hoplite system and reuniting the Argolid city-states under Argive rule.Though, Argos became held in disgrace by other city-states in 480 BC when Athens and Sparta asked Argos polis to send supplies, and Argos refused. Argos had a very successful military. Argos has always been productive during times of war and peace. Argos and Sparta were competing city-states Argos weather is usually hot since its polis is located on a plain. The Argives soil is not very fertile, compelling them to fight the elements for food. This was a major hardship for them, but inspite of this, Argives were superior and an envy to th0e other Greek city-states. In 146 BC Argos became part of the Roman province of Achaea (province of Argos) and flourished as a center of arts and trade during the Roman period. Argos was most famous for its statues of athletes; magnificent and rippling with muscle. The were also famous for their wonderful musicians and poets. Argos was the first place in all of Greece where plays were performed in open-air theatres; they drew crowds of over 20,000. Drama reached new heights in Argos polis. Corinth, as a coastal city, had its own bank and successful works program. From this, their history flourished. Though, Corinth was never the mo ...

Sunday, November 24, 2019

Head-to-Toe Assessment Complete 12-Step Checklist

Head-to-Toe Assessment Complete 12-Step Checklist SAT / ACT Prep Online Guides and Tips Need some info on conducting a head-to-toe assessment? Whether you are just looking for a quick head-to-toe assessment cheat sheet or a total guide to conducting a nursing head-to-toe assessment in a clinical setting, we’ve got you covered! We’ll start with a brief overview of the assessment process, then a quick head-to-toe assessment checklist. After that, we’ll do a deep dive on all the assessment steps, and wrap up with some example videos. What Is a Head-to-Toe Assessment? A head-to-toe nursing assessment is a comprehensive process that reviews the health of all major body systems (from â€Å"head-to-toe,† hence the name). head-to-toe assessments are usually performed by nurses as part of a physical exam, although physician assistants, EMTs, and doctors also sometimes perform head-to-toe assessments. Nurses and other clinicians may not perform a head-to-toe physical assessment for every single patient, depending on the setting they work in. They are typically a key part of primary care visits and annual physicals, but less common when the patient presents with a specific complaint or issue. Quick Head-to-Toe Assessment Checklist In case you’re just looking for a head-to-toe assessment cheat sheet, we’ve created a brief list here of the major things to check for. You can click on each of the body systems to be taken to a more in-depth description with instructions for that part of the head-to-toe assessment. Or maybe you’re looking for a nursing head-to-toe assessment form that you can print out and write on? We have that, too! Just click on this link for a PDF: Head-to-Toe Assessment Checklist Note that different health systems (or professors, if you’re a nursing student!) may have slightly different expectations for all of the specific tests you will perform as part of the head-to-toe assessment. While the below nursing head-to-toe assessment cheat sheet can function as a guide, be sure to comply with the specifications of your place of work or school. Also note that assessments for different sub-populations (like a pediatric head-to-toe assessment) may have different procedures. This is a general adult nursing head-to-toe assessment guide. So this is not a guide to head-to-toe assessment for cats and dogs. Assessment Tools Penlight BP cuff Thermometer Tongue depressor Stethoscope Sterile sharp object (like toothpick or pin) Sterile soft object (like cotton ball) Something for patient to smell (could be an alcohol swab) Vital Signs, Stats, and Neurological Indicators Oriented x 3 Assess temperature Measure blood pressure Assess heart rate Assess respiratory rate Height and weight Head/Face Check distribution and condition of hair Check scalp for bumps, nits, lesions, etc Palpate skull for tenderness Check for symmetrical facial movements Assess sharp and dull sensation on face Eyes Assess symmetry Eyebrow and eyelash distribution Check state of conjunctiva Check sclera Assess state of patient’s cornea PERRLA Check the six cardinal positions of the gaze Assess patient vision with Snellen Charts Ears Inspect and palpate auricle for lesions, tenderness Look inside ear; assess ear discharge and tympanic membrane Tuning fork tests (Weber’s Test, Rinne Test) Assess patient hearing with whisper test Nose Palpate nose and assess symmetry Check septum Check inside nostrils Verify that patient can breathe through each nostril Verify patient sense of smell is intact Palpate sinuses Mouth and Throat Moistness and color of lips Inspect teeth and gums Assess buccal mucosa and palate Examine tongue Look at uvula Look at tonsils Palpate jaw joint Neck and Shoulders Check neck range of motion Check shoulder shrug with resistance Palpate lymph nodes of the head, face, and neck (and under the arms) Palpate neck and trachea Check for JVD Lungs and Thorax Listen to lung sounds front and back Assess respiratory exclusion level Palpate thorax Assess spinal curvature Ask about coughing, respiratory issues Circulatory System Palpate carotid and temporal artery bilaterally Listen to heartbeat and heart valves Gastrointestinal System Inspect abdomen Listen to four quadrants of abdomen for bowel sounds Palpate four quadrants of abdomen for pain/tenderness Ask about problems with bowel or bladder Arms and Hands Assess range of motion and strength in arms/hands Check all pulses in arms Cap refill test on fingernails Check skin turgor Assess sharp and dull sensation on arms Legs and Feet Assess range of motion and strength in legs and ankles Check cap refill on toenails Check pulses of legs and feet Assess sharp and dull sensation on legs Assess gait Genitourinary Exam Check pubic hair for lice and nits Check for tenderness, lumps, lesions Breast Exam Palpate breasts Let's get started! In-Depth Guide to Conducting a Head-to-Toe Assessment Here’s our in-depth guide to conducting a head-to-toe assessment, complete with explanations and linked videos. We’ll start with some general principles to keep in mind throughout the assessment and then move on to a more detailed look at each of the tasks you’ll need to complete for each area/system of the body. 4 General Principles for Head-to-Toe Nursing Assessments Here are four general principles to keep in mind as you conduct your head-to-toe assessment. #1: Documentation Is Important Remember that head-to-toe assessment documentation is a critical part of the process. If you don’t write down your findings, how will you remember them all to translate patient needs into a comprehensive care plan? Many people use nursing head-to-toe checklists or forms to make sure they remember everything and to document patient results. #2: Communicate Throughout Be sure to communicate clearly with your patient throughout the assessment. Always ask before you start touching the patient, and explain what you are doing as you do it. Additionally, ask patient about how they have been feeling. They are the expert on their own body! #3: Keep an Eye on Bilateral Symmetry The human body is, in general, bilaterally symmetrical (i.e., the left side is the same as the right side). When you are examining a patient, make note of any unusual asymmetry. If a patient is weaker on one side than another, or has limited range of motion, or one side seems limper or otherwise different from the other side, there could be an underlying neurological or musculoskeletal issue. #4: Assess Skin Throughout The skin is a great barometer of overall wellness. Note if patient’s skin seems unusually pale, flushed, cold, hot, clammy, or dry anywhere throughout the exam. Also not any lesions, abrasions, or rashes. You might not have a barometer, but you definitely have skin. Step 1: Check Vital Signs and Neurological Indicators The first things you'll want to check are patient vital signs and overall neurological status. Oriented x 3 Is patient alert and responsive? Ask if they can tell you their name, if they know where they are, and what day it is. If yes, patient is â€Å"alert and oriented x 3.† Assess Temperature Take patient temperature and assess whether it is in the normal range. Record whether the temperature was taken orally, rectally, in the ear, at the forehead, or in the armpit as these methods have differing accuracy levels. Measure Blood Pressure In professional settings, you may have an automatic blood pressure cuff or you may need to take blood pressure manually. (As a student you’ll likely need to demonstrate that you can take blood pressure manually). To measure blood pressure manually: First find the brachial pulse, on the inside of the patient’s elbow. Tightly secure the cuff about one inch above the elbow bend (you should be able to fit about two fingers between the cuff and the patient’s arm). Place your stethoscope (diaphragm or bell) over the pulse. Verify that you can hear the brachial pulse. Inflate the cuff until the gauge reads at about 180 mmHg. You should no longer hear the brachial pulse through the stethoscope. Allow the cuff to deflate gradually. The systolic BP is the measurement of the gauge the moment you hear the brachial pulse again. The diastolic BP is the measuring of the gauge when you stop hearing that pulse. Here’s an in-depth guide to taking manual blood pressure with a video. (There’s a briefer video with all the vital signs below). Assess Heart Rate When you measure the heart rate, you’ll count the beats per minute over a patient pulse point with two fingers (not the thumb, which has its own pulse and can mess up the reading). You’ll usually assess at the radial pulse (wrist) or the carotid pulse (neck). Normal adult BPM is about 60-100, although athletes can have lower heart rates. In a patient with a regular heartbeat, you can take the pulse for 30 seconds and just multiple by two, but if the beat seems irregular, go for at least a full minute. Assess Respiratory Rate Respiratory rate is the number of breaths per minute, which you can tell from the rise and fall of the patient’s chest. If you tell a patient you are assessing their breathing, they may actually change their breath rate, so it’s best to assess this surreptitiously after you take the pulse rate. 12 to 20 breaths per minute is the normal adult range. Here’s a quick video guide to checking all the vital signs. This video includes oxygen saturation, which you may or may not need to assess. Height and Weight You may also take patient’s height and weight as part of a head-to-toe assessment. Sadly, "number of puppies seen recently" is not a vital sign. Step 2: Examine Head and Face These steps will have you check the overall condition of the head and face. Subsequent sections will be devoted to the eyes, nose, mouth, and ears. Check Distribution and Condition of Hair Is hair healthy? Evenly distributed? Is it thinning in places? Note any abnormalities, like unusual brittleness or uneven thinning. Check Scalp for Bumps, Nits, Lesions, Etc. Part hair in several places on the scalp to check for bumps, sores, or scabs on the skin. Assess dryness and dandruff. Also check if there are lice or nits present in the hair. Palpate Skull for Tenderness Palpate the skull to determine if there are any tender or sore areas. Check for Symmetrical Facial Movements Have patient smile, frown, raise eyebrows, and puff out cheeks. If patient can move face at will, movements are symmetrical, and there are no involuntary movement, cranial nerve VII is intact. Assess Sharp and Dull Sensation on Face This test assesses the state of cranial nerve V. Hold a sterile, sharp object (like a needle or pin) in one hand and a soft item (like a cotton ball or q-tip) in the other. Ask patient to close eyes and identify whether the sensation they are feeling is sharp or dull. Gently touch the patient’s face in different places with the sharp item or the dull item, varying the order. His head doesn't look so good to me. Step 3: Inspect Eyes When checking patient eyes, you'll assess both patient vision and the health of the eye tissues like the conjunctiva, sclera, and cornea. Assess Symmetry Verify that eyes are symmetrical, that the palpebral fissures are equal and there is no ptosis. Have patient blink; make sure that eyes close completely Eyebrow and Eyelash Distribution Assess state of eyelashes and eyebrows; should be symmetrical and evenly distributed. Check State of Conjunctiva You can assess the conjunctiva by gently applying downward pressure to the skin below the patient’s eyes. Conjunctiva should be pinkish and free of lesions. Unusually pale conjunctiva can be a sign of anemia, and inflammation or infection can cause red conjunctiva. Check Sclera Gently hold patient lids open and examine whites of the patient’s eyes (can be done simultaneously while assessing conjunctiva). They should be white in color with some capillaries visible. There may be some spots of pigmentation but there should not be lesions or yellowness. Assess State of Patient’s Corneas You can examine the cornea by shining your penlight indirectly across the patient’s eye (so not directly into their eyes but shining from the side). This will illuminate the cornea, which should be smooth and clear. The features of the iris should be clearly visible through the cornea. Additionally, patient should blink when cornea is touched gently with something sterile (the corneal reflex). PERRLA PERRLA is an acronym that means that pupils are equal, round, reactive to light and accommodation. This can be tested with a penlight and assesses the state of cranial nerves II and III. You should first look at the pupils to ensure that they are round and equal in size (PER). To check that they are reactive to light, dim the room and move the penlight back and forth between the eyes. Both pupils should constrict equally in response to the light (direct and consensual response). To check that they accommodate, move your finger (or the penlight) slowly closer to the patient’s face. The patient’s pupils should constrict as the object comes closer. Here is a how-to video for checking PERRLA. Check Six Cardinal Positions of the Gaze Hold your penlight or finger about one foot in front of patient’s face. Ask them to follow the movements of your penlight or finger with their eyes only (without moving the head/neck). Move the penlight or finger out to the six cardinal positions of the gaze, moving back into the center before proceeding to the next one (like you are drawing out a compass rose). The patient should be able to hold their gaze at each of the six cardinal positions without any jerking (nystagmus). This test assesses the health of cranial nerves III, IV, and VI. Assess Patient Vision with Snellen Chart Ask patient to stand the appropriate distance away from the Snellen Chart. (Distance from a standard chart is 20 feet, but your health care setting may use a special chart where the patient should stand a different distance away.) Have them first cover one eye and read the smallest row of letters that they can. Have them repeat with the other eye. If the patient wears glasses or contacts, test both with and without vision correction so you can assess the adequacy of the vision correction. Here’s some info on interpreting Snellen Chart results. If the eyes are the window to the soul, you'll be seeing a lot of souls. Step 4: Evaluate Ears As with the eyes, you'll assess both the health of the ear tissue and sensing function (i.e. hearing). Inspect and Palpate Auricle for Lesions, Tenderness Skin of the auricle (and behind) should be intact. Cartilage should be firm with no tenderness on palpation. Auricles should be roughly symmetrical. Look Inside Ear; Assess Ear Discharge and Tympanic Membrane Pull the pinna/auricle upwards and backwards to straighten the ear canal and examine the tympanic membrane in adults (pull down and back in children). Some yellow or brown cerumen (earwax) is normal. Tympanic membrane (eardrum) should be a translucent pearly gray color; note abnormal color or rupture. [picture of tympanic membrane from wikimedia commons] Tuning Fork Tests (Weber’s Test, Rinne Test) The Weber and Rinne tests both check for different kinds of hearing loss. For the Weber test, strike the tuning fork and then place the base of the fork on the center of the patient’s forehead. Sounds should be equal in both ears. If sound is stronger in one ear or the other, indicates possible hearing loss. For the Rinne test, strike the tuning fork and place the base against the mastoid process. Start a stopwatch. Tell the patient to tell you when they stop hearing the sound of the tuning fork. When they stop hearing the sound, move the tuning fork so the forks are in front of the ear (and note the time on your stopwatch). Tell them to tell you when they stop hearing the sound again. Patient should hear the sound of the tuning fork through the air (in front of the air) 2x longer than through the bone. Repeat on the other ear. Assess Patient Hearing with Whisper Test Stand next to and a little behind patient (about 2 feet away) so they cannot read your lips. Ask patient to cover opposite ear. Whisper a two-three syllable word and ask patient to repeat it back to you. Repeat with the other ear (and a different word!) Are you ready to get out your trusty tuning fork? Step 5: Check Nose You'll be checking the nose both externally and internally. Palpate Nose and Assess Symmetry Gently palpate nose for any tenderness. Make sure nose is in midline and symmetrical. Excessive flaring of the nostrils may indicate respiratory distress. Check Septum Use penlight to illuminate septum to check that it is midline and not perforated. Check Inside Nostrils Shine penlight in each nostril. Check that membranes are pink and that there is no discharge or lesions. Turbinates should not be swollen. Verify Patency of Nares Have patient close one nostril with fingertip and breathe in and out through that nostril. Repeat with other nostril. If patient cannot exhale through each naris, the nasal passage is occluded. Verify Patient Sense of Smell is Intact Ask patient to close eyes. Hold easily scented item (like coffee beans, cinnamon, or even an alcohol-soaked cotton ball) under the nose and ask patient to identify scent. Palpate Sinuses Gently palpate patient frontal and maxillary sinuses. Frontal sinuses are palpable over patient eyebrows. Maxillary sinuses are palpable on the cheek just outside the nares. Patient should not feel tenderness to pressure. "Ma'am, I'm going to have to ask you to remove your fingers from your nose so I can examine it properly." Step 6: Probe Mouth and Throat Again, like the nose, you'll assess the health of the mouth and throat both externally and by looking inside. Moistness and Color of Lips Lips should be colorful, pinkish, roughly symmetrical, and free of lesions. Very cracked or chapped lips could be a symptom of a number of issues, from dehydration to wind exposure to autoimmune conditions. Inspect Teeth and Gums Assess patient teeth for number (28 in children, 32 in adults), color, and alignment. Note any cavities or chips. Assess gums for bleeding, puffiness, or retraction (the pulling of the gum away from the tooth, which can give teeth an â€Å"elongated† appearance). Also note presence of halitosis; gum disease and oral infection are some of the most common causes of bad breath. Assess Buccal Mucosa and Palate The membranes of the mouth and cheek should be pink, moist, and free of lesions. Examine Tongue Tongue should be midline, pink with white taste buds, and free of lesions. Patient should be able to move tongue without difficulty. Look at Uvula Patient uvula should be in the midline, pink or reddish in color, and free of swelling or lesions. When the patients says â€Å"ah,† uvula should move forward and up. (This tests cranial nerve X.) Look at Tonsils Depress tongue to inspect tonsils for inflammation, infection, swelling and tonsil stones. Infected tonsils are often red and puffy with white or yellow patches. Palpate Jaw Joint Palpate the jaw joint (the temporomandibular joint) while patient’s mouth is closed, and then again while it is open. Patient should be able to open and close mouth without pain and there should be no pain on palpation. What plentiful mouths you have! Step 7: Examine Neck and Shoulders In the neck and shoulders, you'll primarily assess musculoskeletal function, but you'll also assess the lymph nodes and a few other things. Check Neck Range of Motion Ask patient to look up, down, left, and right to assess that they have full range of motion in the neck. Ask if there is any pain (should be painless). Check Shoulder Shrug with Resistance Ask patient to shrug shoulders. Movement should be symmetrical and painless. Then, place hands on shoulders and ask patient to shrug again. Apply resistance. Patient should still be able to shrug with about equal force on each side. Palpate Lymph Nodes of the Head, Face, and Neck (and Under the Arms) Using the first two or three fingers (using the flat pads as opposed to the fingertips), you’ll palpate the following lymph nodes by moving the skin over the area in a circular motion: the occipital, posterior auricular, pre-auricular, sub-mandibular, sub-mental, anterior cervical chain, posterior cervical chain, and the supraclavicular lymph nodes. You may also wish to palpate the axillary lymph nodes, under the arms. Here is a video of lymph node palpation. Observe/Palpate Trachea and Neck Palpate neck to feel for any lumps, deviations, or tenderness in the neck, especially the trachea area. You may also wish to palpate the thyroid, which requires a glass of water and can be done from the front (anterior approach) or behind (posterior approach). Check for JVD Jugular Venous Distension refers simply to an abnormally full or bulging jugular vein in the neck. It can be a sign of serious heart disease. To assess JVD, you’ll want to lay the patient down with the head of the hospital bed at a 45-degree angle. If you can see the bulging jugular vein in the side of the neck, the patient has JVD. Here’s a video so you can see what JVD looks like and how it is diagnosed. It would take a long time to palpate a giraffe neck. Step 8: Assess Lungs and Thorax When examining the chest area, you'll primarily be assessing respiratory function. Listen to Lung Sounds Front and Back You’ll be listening to the lungs up and down each lung, front and back, with your stethoscope to assess for any irregular breathing sounds. Here’s an in-depth video guide to lung auscultation as well as a guide to regular and irregular lung sounds. Assess Respiratory Expansion Level To assess respiratory expansion, place your hands on the patient’s mid-back with thumbs at midline. Ask them to take a deep breath. Both sides of the chest should expand equally with breath. Palpate thorax Palpate the thorax for any areas of tenderness, lumps, asymmetry, lesions, etc. Assess Spinal Curvature Spine should appear vertical when viewed from the back (with no scoliosis). Should exhibit normal curvature from the side. Ask About Coughing, Respiratory Issues Ask patient if they are experiencing any coughing or other respiratory problems. If they are coughing, is it a dry cough or a wet cough? Lungs or alien heads? You decide! Step 9: Check Circulatory System Function Assessing the circulatory system is something you'll actually be doing throughout the exam as you assess various pulses. but as you are assessing the chest, you'll want to examine the heart. Palpate the Carotid and Temporal Pulses Bilaterally Using index and middle fingers, feel the carotid pulse (at the side of the neck) and the temporal pulse (at the temple). Since you already checked pulse rate, you don’t need to listen for a whole minute; just verify that the pulse is palpable and regular in rhythm. Listen to Heartbeat and Heart Valves You’ll need to listen to the patient’s heart in four places with your stethoscope: the aortic valve, the pulmonic valve, the tricuspid valve, and the mitral valve. You’ll be listening for any irregularities in rhythm or irregular sounds during valve closures. Here’s an in-depth video describing how to find and listen to all of these valves, an overview of heart sounds, and a short video showing how to auscultate the heart if you just need a quick refresher. These hearts don't circulate blood very well. Step 9: Review Gastrointestinal System You'll assess the gastrointestinal system by examining the abdomen and asking the patient questions. Inspect Abdomen Inspect patient abdomen for any visible lumps, lesions, or distension or concavity. Listen to 4 Quadrants of Abdomen for Bowel Sounds Visually dividing the abdomen into four quadrants with the belly button as the midline, listen to bowel sounds in each quadrant. Judge if sounds are hypoactive, hyperactive, or absent. If you do hear sounds, you may only need to listen for several seconds in each quadrant. However, you should listen to each quadrant for five minutes before you determine that there are no bowel sounds. Here’s a video. Palpate 4 Quadrants of Abdomen for Pain/Tenderness After you listen to the sounds, palpate the four quadrants of the abdomen for any pain, tenderness, or lumps with your fingers. Here’s a video showing how to do it. Ask About Problems With Bowel or Bladder Ask patient when their last bowel movement was. Also ask if appetite, bowel movements, and urination have been normal. Aren't you glad that humans don't actually have transparent skin? Step 10: Inspect Arms and Hands In the extremities, you'll assess musculoskeletal function, sensory function, circulation, and tissue perfusion. Assess Range of Motion and Strength in Arms Have patient demonstrate range of motion in arms and hands. They should be able to roll shoulders, show flexion and extension of the elbow joint, circle the hands around the wrist joint, and demonstrate full flexion and extension of the wrist without pain. Also have patient squeeze push against your hands, pull your hands towards them, and squeeze your fingers to assess strength, which should be equal bilaterally. Here’s a video showing this process. Check All Pulses in Arms There are two major pulses in the arms: the radial pulse (at the wrist) and the brachial pulse (in the inner elbow). If you already checked the radial and brachial pulses while you were taking vitals, you can skip this step. It’s most important to check that the pulses are palpable and regular in rhythm. Cap Refill Test on Fingernails To check tissue perfusion, pinch one of the patient’s fingertips, applying pressure to the nail. When you release the fingertip, the nail bed should return to a normal color within 3 seconds. Check Skin Turgor On the back of the hand or forearm, pinch skin. It should immediately snap back to position upon release without â€Å"tenting† (remaining pinched upright). Tenting indicates dehydration or fluid volume deficit (link). However, note that this is not an effective test of skin turgor on elderly patients, as lower skin elasticity means their skin often tents regardless of their fluid levels! Assess Sharp and Dull Sensation on Arms Take your sterile, sharp object (like a needle or pin) in one hand and your soft item (like a cotton ball or q-tip) in the other. Ask patient to close eyes and identify whether the sensation they are feeling is sharp or dull. Gently touch the patient’s arms in different places with the sharp item or the dull item, varying the order. The hands are fine, but where's the rest of you? Step : Examine Legs and Feet You'll perform most of the same examinations on the lower extremities that you did on the upper extremities. Assess Range of Motion and Strength in Legs and Ankles You should test range of motion of the lower extremities with the patient lying down. Patient should be able to flex and extend the ankle joint, and circle the foot. Patient should also be able to bend the knee and then move leg outward (to test hip ROM) on each side. There should be no pain. To assess strength, patient should push against your hands on the top of their feet, push down against your hands on the bottom of your feet, and push up against your hand on their shin. Strength should be equal bilaterally. Here’s a video of these tests (she starts with strength and then tests ROM). Check Cap Refill on Toenails Perform the cap refill test on one of the patient’s toenails. After applying pressure, the patient’s nail bed should return to a normal color by 3 seconds. Check Pulses of Legs and Feet There are four major pulse points on the legs and feet: femoral (hip/groin), popliteal (behind knee), posterior tibial (ankle) and dorsalis pedis (top of foot). Palpate the pulses of the legs and feet with your middle two or three fingers (not the thumb, which has its own pulse!) As you’ve already taken the pulse rate at this point, it’s not necessarily the rate that’s critical here but the regularity and strength of the pulse. Pulse should be palpable and regular. Assess Sharp and Dull Sensation on Legs Repeat the sharp and dull sensation test on the patient’s legs. Take your sterile, sharp object and your soft item. Ask patient to close eyes and identify whether the sensation they are feeling is sharp or dull. Gently touch the patient’s legs in different places with the sharp item or the dull item, varying the order. Assess Gait Observe patient gait (can be done when patient gets up to complete Snellen chart). Should be symmetrical, regular, and balanced. I bet they have complete range of motion and strength in their lower extremities. Optional Step 1: Complete Genitourinary Exam You may not always perform a genitourinary exam as part of a head-to-toe assessment. However, if you do, here are the main things you’ll be checking for: Check Pubic Hair for Lice and Nits Assess for presence of lice or nits in pubic hair. Check for Tenderness, Lumps, Lesions Check for any unusual tenderness, lumps, or lesions on the external genitalia. For men, this will involve lightly palpating the penis and testicles. Optional Step 2: Perform Breast Exam You may or may not need to perform a breast exam in your head-to-toe assessment- sometimes it’s advised to only perform them on symptomatic men or older women. However, here’s an in-depth guide to palpating the breast and feeling for unusual lumps. I almost made a melon joke, but then I decided it was low-hanging fruit. Heads So you can get an idea of how the entire process plays out in real time (and also how it may vary from institution to institution), we’ve gathered a few videos that are useful head-to-toe assessment examples. If you’re looking for more examples, you can find lots of example videos of student assessments on Youtube (just type in â€Å"head-to-toe assessment nursing†). However, be aware that every student is going off of a different professor’s rubric, and not everything may be 100% correct! Student Head This example video shows a nursing student performing an efficient but thorough sample assessment. Florida State College at Jacksonville Student Example This head-to-toe assessment video shows a particularly detailed assessment procedure performed by a nursing student. This video is particularly helpful because the student clearly describes what each step indicates about body function. Capital Community College Assessment This head-to-toe nursing assessment video is useful because it presents the assessment in a realistic-seeming care setting with a patient who asks questions. It also shows the nurse asking questions about the patient’s life quality, and closely explaining every step of the assessment so that the patient knows what’s happening. We made it all the way from head to toe! Time for a nap. Review: Completing a Head-to-Toe Assessment In this guide to the head-to-toe physical assessment, we provided the resources you need to complete a comprehensive head-to-toe nursing assessment! We have a nursing head-to-toe assessment form for you to use as a guide as well as in-depth guidance to every step of the assessment process. We also included several head-to-toe assessment videos so you can see the whole process in action! What's Next? If you're looking for more information on clinical care, we have guides to making care plans for decreased cardiac output and fluid volume deficit. We have a complete list of ICD-10 codes for diabetes and for abdominal pain. Want more information about heart positioning? Or about blood pressure readings? We've got you covered. Considering going into healthcare administration instead? We have a list of the top programs and what degrees you'll need for which jobs in this article.

Thursday, November 21, 2019

Arts Criticism and Cultural & Historical Perspectives on-line Assignment

Arts Criticism and Cultural & Historical Perspectives on-line explorations - Assignment Example Time remains valuable to the human race, and when it passes when one has not accomplished set goals it causes regret or sadness (Heilbrunn Timeline of Art History). Fireflies Over the Uji River by Moonlight is an 18th century painting by Suzuki Shonen based on Japanese culture. The painting signifies a secluded place or a dark neighbourhood that appears threatening for a passer-by. In essence, this Japanese painting basis its theme on the life of a Buddhist who lives in an isolated location such that a passer-by cannot hear music coming from area because of the night rain (Heilbrunn Timeline of Art History). The big idea from the painting invokes a murky situation that leads to feelings of somberness. The heavy rain and mist shows an environment of darkness and dullness (Heilbrunn Timeline of Art History). The General View of the Burial Chamber of Neferkhewet before the Commencement of Clearing represents the 20th century painting of Harry Burton. This Egyptian work shows the tomb of Neferkhewet and family that was found in 1935. The tomb appeared tattered, crumbled and collapsed in many areas leaving it exposed (Heilbrunn Timeline of Art History). The big idea from the painting reflects dumbness and somberness in how the tomb appears ruined. The image shows that the dampness led to the breakdown of most of the organic matter in the tomb. In this way, it leaves a feeling of dullness and grimness for the destruction of human remains that should be protected (Heilbrunn Timeline of Art History). This visual arts website provides information on the history of transportation from ancient to modern day machines. The site offers important timeline information from 3500 BC wheels on carts were the main source of transport and later years of horses, wheelbarrows and hot air balloons. The 18th century saw the first road vehicle, 19th century cable car, and 20th century airplanes as well as