Reflective Nursing in ctitical care Account of an intubation Essay

Reflective Nursing in ctitical care Account of an intubation - Essay Example That is to say, nursing has a more active role to play in the health care delivery system than the past and nursing, as a profession is 'accountable' today. The patient in this case was admitted for an acute exacerbation of COPD with the complications of Atelectasis and Cor pulmonale. Chronic obstructive pulmonary disease (COPD), also known as chronic obstructive lung disease (COLD), is a term used to describe progressive lung diseases, which include emphysema, chronic bronchitis and chronic asthma.The common symptoms of COPD are progressive limitations of the airflow into and out of the lungs and shortness of breath. Emphysema and chronic bronchitis are closely related and patients with COPD may have both, which affects lung function, preventing the lungs from bringing oxygen to the body and getting rid of carbon dioxide. Atelectasis is a condition where there is a collapse of part or all of a lung by blockage of the bronchus or bronchioles or by very shallow breathing. Atelectasis can be both acute and chronic. Acute atelectasis is the recent collapse of the lung and is primarily notable only for airlessness. In chronic atelectasis, the affected area is often characterized by a complex mixture of airlessness, infection, bronchiectasis, and fibrosis. The most common cause of atelectasis is an obstruction of a large bronchus. Smaller airways also become blocked. The obstruction is caused by a plug of mucus, a tumor, or an inhaled foreign object inside the bronchus. Alternatively, the bronchus is also blocked by a tumor, enlarged lymph nodes, or a significant amount of pleural effusion or pneumothorax in the pleural space. When an airway becomes blocked, the air in the alveoli beyond the blockage is absorbed into the bloodstream, causing the alveoli to shrink and retract. The collapsed lung tissue commonly fills with blood cells, serum, and mucus and becomes infected. Acute atelectasis is a postoperative complication, especially after chest or abdominal surgery. Cor pulmonale is the failure of the right side of the heart caused by prolonged high blood pressure in the pulmonary artery and right ventricle of the heart.The left side of the heart exerts a higher level of blood pressure to pump blood to the body.Whereas, the right side pumps blood through the lungs with a lower pressure. Thus, any condition that leads to prolonged high blood pressure in the arteries or veins of the lungs causes a condition called pulmonary hypertension.This pulmonary hypertension is not tolerated by the right ventricle of the heart and thus fails to properly pump against these abnormally high pressures leading to cor pulmonale.Chronic lung diseases like COPD or other conditions like Obstructive sleep apnea,Central sleep apnea,Cystic fibrosis causing prolonged low blood oxygen can lead to cor pulmonale.The symptoms include shortness of breath,wheezing, coughing, swelling of the feet or ankles,exercise intolerance,chest discomfort, cyanosis,distension of the neck veins indicating high right-heart pressures,abnormal fluid collection in the abdomen, enlargement of the liver,swelling of the ankles and abnormal heart sounds.

McGraw Hill publishing Research Paper Example | Topics and Well Written Essays - 750 words

McGraw Hill publishing - Research Paper Example In the year 1902, John Hill founded the Hill Publishing company. The two men formed an alliance in the year 1909 and formed an alliance to create the McGraw Hill book publishing company. (McGraw Hill-a â€Å"brief history†) The company has three divisions namely, McGraw Hill Education, Financial Services and Information and media. The McGraw hill education division publishes books for primary, secondary, post secondary and professional education. The information and media business provides industry intelligence, analytics and business solutions for better decision making. The group has the following divisions namely Aviation week, Broadcasting, Business week group, JD Power associates, McGraw Hill construction and Platts group. McGraw Hill companies reported a second quarter Earnings per share of $0.52. The revenue of the company has decreased by about 12.4% to $164.1 million dollars, as compared to last year. The revenue in the education segment has decreased by about 17.2% to $555.2 million dollars in the second quarter. The total operating profit declined by about 70.1% amounting to an amount of $21 million dollars. The foreign exchange rates reduced the net revenue by about $10.1 million in this year. The revenue for the Information and Media segment has dropped by about 11.5% to $ 236.2 million in the second quarter. The foreign exchange rates did not have a great impact on the revenues but it led to a decline of $ 2.5 million in the operating profits. The company declared that due to the current economic slowdown the revenue expectations of the company has been reduced by about one percentage and the company expects the revenues to further decrease. The new guidance for earnings per diluted share has been modified and the new forecast for guidance has now been fixed at $2.2 to $2.25. (McGraw Hill-c â€Å"Investor Relations†). The company is headquartered in New York, USA. It also has