Case Vignettes in Acid-Base Balance Essay Example for Free

Case Vignettes in Acid-Base Balance Essay Choose three of the four vignettes and BRIEFLY answer the questions that follow. Normal Levels of Substances in the Arterial Blood: pH 7.40 + 0.05 pCO2 (partial pressure of carbon dioxide) 40 mm Hg pO2 (partial pressure of oxygen) 90 100 mm Hg Hemoglobin O2 saturation 94 100 % [HCO3-] 24 meq / liter Vignette #1: A 14-year-old girl with cystic fibrosis has complained of an increased cough productive of green sputum over the last week. She also complained of being increasingly short of breath, and she is noticeably wheezing on physical examination. Arterial blood was drawn and sampled, revealing the following values: pH 7.30 pCO2 50 mm Hg pO2 55 mm Hg Hemoglobin O2 saturation 45 % [HCO3-] 24 meq / liter Questions: 1. How would you classify this girls acid-base status? 2. How does cystic fibrosis cause this acid-base imbalance? 3. How would the kidneys try to compensate for the girls acid-base imbalance? 4. List some other causes of this type of acid-base disturbance. Vignette #2:  A 76-year-old man complained to his wife of severe sub-sternal chest pains that radiated down the inside of his left arm. Shortly afterward, he collapsed on the living room floor. Paramedics arriving at his house just minutes later found him unresponsive, not breathing, and without a pulse. CPR and electroconvulsive shock were required to start his heart beating  again. Upon arrival at the Emergency Room, the man started to regain consciousness, complaining of severe shortness of breath (dyspnea) and continued chest pain. On physical examination, his vital signs were as follows: Systemic blood 85 mm Hg / 50 mm pressure Hg Heart rate 175 beats / minute Respiratory rate 32 breaths / minute Temperature 99.2o F His breathing was labored, his pulses were rapid and weak everywhere, and his skin was cold and clammy. An ECG was done, revealing significant Q waves in most of the leads. Blood testing revealed markedly elevated creatine phosphokinase (CPK) levels of cardiac muscle origin. Arterial blood was sampled and revealed the following: pH 7.22 pCO2 30 mm Hg pO2 70 mm Hg Hemoglobin O2 saturation 88 % [HCO3-] 2 meq / liter Questions: 5. What is the diagnosis? What evidence supports your diagnosis? 6. How would you classify his acid-base status? What specifically caused this acidbase disturbance? 7. How has his body started to compensate for this acid-base disturbance? 8. List some other causes of this type of acid-base disturbance. Vignette #3: An elderly gentleman is in a coma after suffering a severe stroke. He is in the intensive care unit and has been placed on a ventilator. Arterial blood gas measurements from the patient reveal the following: pH 7.50 pCO2 30 mm Hg pO2 100 mm Hg Hemoglobin O2 saturation 98% [HCO3-] 24 meq / liter Questions: 9. How would you classify this patients acid-base status? 10. How does this patients hyperventilation pattern raise the pH of the blood? 11. How might the kidneys respond to this acid-base disturbance? 12. List some other causes of this type of acid-base disturbance.

The Deer :: essays research papers

It was the middle of summer in a small town called Harvey, in the city of Marquette, Michigan. The road (driveway) to my families cabin is really long it takes about a half-hour just to get to the cabin. Our camp is a very little, quaint, one bedroom in the middle of the woods. There is a creek the flows around our land, which is about 8 acres. About a half a mile away there is a rundown cabin that we call "Jack's house". My dad always said that there was an old man Jack, who lived there. He would tell us that Jack would watch us at night while we were asleep. Supposedly there was a rumor that he ate humans and animals for survival.He even told us that there were bears all surrounding us, but I never actually saw one. We usually go there on weekends during the summer for a vacation away from the city, but sometimes we end up staying longer. There isn't really much to do out there, so if we don't go to town, we go to Presque Isle Island near our camp. It is located in Marquette, Michigan, on Lake Superior, which is one of the coldest and biggest of the five Great Lakes. There are large rocks out there that we climb called Black Rocks. Besides the rocks there are a couple of parks with swings and slides, and a nature path that has a few site lookouts. It is so peaceful out there that all you can hear are the sounds of nature. As I pulled up in my car, I stopped and began to get out to go for a walk on the nature trail. As I looked up, I saw the deer. There was something about the way his helpless eyes gazed at me. I slowly started to approach him. It looked as if he had no hope for his life left. His hair was very thin but rough around his neck and legs. There was dried up blood above his left eye it seemed as if he were in a harmful fight with another deer recently. I slowly and calmly continued to walk towards him trying, as much as possible, not to frighten him in any way." It's ok, I won't hurt you. I want to try to help you live and be healthy." I said.As I got closer to him I could see felt covering two bumps on the top of his head.

Of Mice And Men And Social Characters Essay

In this essay I will examine three characters that can be considered as social misfits. I will talk about crooks, lennie and Curley’s wife as my three social characters. The reason that I have chosen these characters is because, Lennie is simple minded, crooks is black and Curley’s wife is a woman, these reasons will explain why each of these characters doesn’t fit into the environment. I will explain why Steinbeck has included the above characters in the novel. At last I will finish my essay by giving my conclusion. I have chosen crooks as a social misfit because he is the only black man on the ranch and back in the 1930’s, black people were treated differently to white people because of their skin colour. In my opinion crooks is a lonely person because again he is black, no one wants to talk to him or play card with him because he is black. â€Å"They play cards in there and I can’t play because I’m black!† Generally the level of the racism is so high. For instance, different characters have said a word â€Å"nigger† several times throughout the novel and this in my opinion is very racist towards black people. â€Å"If I say something, why it’s just a nigger talking†. Every one judges him by looking at his skin colour but he is possibly the most intelligent man on the ranch because he can read. â€Å"He had books too, California civil code for 1905†. With this knowledge he is discriminated and has to sleep alone behind the stables. Steinbeck has included crooks in this novel because he wanted to demonstrate how black people were treated differently. Not because white people don’t like black people’s personality, no; it’s just because of their skin colour. Crook is one of those fortunate black men who are very talented but he can’t fit into the environment because of his skin colour. I have chosen Lennie as one of my social misfit character because he in fact is mentally disabled. Lennie’s brain can only think about rabbits or mice, â€Å"don’t you think of nothing but rabbits.† He is very different to other characters because they can have serious conversations but Lennie can’t, but if he wants to talk to people he will either talk about tending rabbits or their dream of having a small farm, â€Å"the rabbits that we’re gonna get, and I get to tend them.† Lennie’s mind is just like a child because he only thinks about tending rabbits like a child would do, â€Å"I remember about tending rabbits George.† â€Å"Don’t you think of nothing but rabbits?† Steinbeck has include Lennie in this novel to show some of the Americans were narrow minded and most of them where uneducated. Curley’s wife can be considered as one of my social misfit characters because she is the only woman on the ranch. Steinbeck is trying to demonstrate about a woman back in 1930s, and how they were treated. You can see Curley’s wife was treated as a sexual object. For example, she is sometimes called a â€Å"tart† by the man or she couldn’t talk to any one except Curley, â€Å"you can talk to people, but I can’t talk to nobody but Curley .else he gets mad.† I personally feel sorry for Curley’s wife because she was not allowed to talk to any one except her husband and in my opinion she is a very lonely person. Curley’s wife and crooks are quite similar. No one wants to talk to crooks because he is black, no one wants to talk to Curley’s wife because she is a woman and in those day’s women’s and black people were treated differently so both of them were abused because of what they are. In my opinion Steinbeck has include Curley’s wife in the novel of mice and men because he wanted to demonstrate the position of the women and how they were treated. I think in 1930s there were fewer women in America than men’s in and those women’s were viewed as a sexual object by men’s. My conclusion is that every one of these three characters can be considered as a social misfit but in my opinion crooks is more likely not to be fit into the environment because he is black and in 1930s there were few black people in community in America. Crooks can’t have a conversation with people because he has a coloured skin that’s why he is very lonely. In my opinion it would have been boring if everyone on the ranch was white. By putting crooks in this novel everyone can see that black community weren’t in demand as white community.

Do Early Childhood Programs Really Work - 795 Words

Do early childhood programs really work? People conducted numerous researches to find out the truth and determine what factors influence the positive or negative outcomes. One thing should be said, if these programs are still in use than they are productive. It was proven that early childhood development has an impact of the whole life of a person that is why there is so much attention around this issue. Besides positive outcomes of a child receiving services in early childhood, paid by the government, there are also social-economic benefits. For example, investing in the Head Start program, which helps families with low income, the authorities would probably gain less criminal records in the future. Or if a child with special needs starts receiving necessary services on time, he will have more chances to graduate high school, find a job, and pay taxes to the revenue. As a result, it would be payback. It is harsh to discuss early intervention from this angle, but special education is a business. And, I should say, successful, because by implementing any kind of special programs for children, they hire more people, create new professions and position, which improves the status of labor market. The resources say programs with better-trained caregivers appear to be more effective (RAND, 2005). Today we can see how many colleges are offering Bachelor’s, Master’s in special education and related services in phycology, speech, physical, and occupational therapies, audiologists andShow MoreRelatedMy Career Path For A Teacher Essay1211 Words   |  5 Pagesworking on obtaining a degree in Early Childhood Education. I haven’t decided whether I want to teach the younger kids or if I want to teach the older ones. After years of developing a passion of teaching, I’ve decided to take on the career of teaching. There are many degrees that you can obtain to become a teacher. 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