What Is a Trade School How Can You Apply

What Is a Trade School How Can You Apply SAT / ACT Prep Online Guides and Tips If you want to advance your skills and education but are unsure if a traditional four-year college is for you, you may want to consider a trade school. Attending a vocational school can be an excellent option for those who want to get the necessary training to secure a good job quickly. In this article, I'll explain the benefits and potential disadvantages of trade schools. Also, I'll thoroughly describe the differences between trade schools, community colleges, and four-year colleges. What Is a Trade School? A trade school, sometimes referred to as a vocational school, technical school, or vocational college, is a posts of trade schools include UEI, American Career College, and Chamberlain University. Trade schools can be public or private, but many are for-profit businesses. At a trade school, you can get a degree in fields like information technology, nursing and health sciences, automotive technician training, and medical assisting. Program lengths vary, but typically, they can range from anywhere from eight months to two years. Unlike a four-year college, you don’t graduate from a trade school with a bachelor’s degree. Usually, upon completion of the program, you'll receive a diploma or trade certificate acknowledging you successfully finished. For some programs you can earn an associate degree, which is the degree you get from a two-year college. What Can You Do With a Degree From a Trade School? After completing a trade school program, you can get a job directly related to the field you studied in your vocational school program. For example, once you complete a dental assisting program, you can get a job as a dental assistant. If you complete a program in plumbing, you can get a position as a plumber. Again, these schools are designed to prepare you for a job in a specific field. Here are some of the jobs you can do with a degree from a trade school: Electrician Dental hygienist Plumber Paralegal Nurse Graphic Designer Welder Computer technician Aircraft mechanic Cosmetologist Chef Marine mechanic Construction manager Massage therapist Pharmacy technician The Differences Between Vocational Schools, Community Colleges, and Universities When you're deciding your path, it's important that you know the major differences between trade schools, community colleges, and four-year colleges. I'll outline the biggest differences between each type of school for you here. Trade Schools Trade school programs are the shortest; they run from less than a year to up to two years. As opposed to community colleges and four-year colleges, many vocational schools are for-profit businesses. The focus of trade schools is on giving students hands-on experience directly related to a specific job. At the end of a program, you can get a diploma or certificate, prepare for a licensing exam, or become an apprentice or journeyman in a skilled trade. Admission is mostly open enrollment. There's really no extracurricular involvement or on-campus culture at trade schools. Students just attend their classes and get their professional training. Community Colleges Community colleges award associate degrees at the end of two years. Most community colleges are public, but there are private ones, which are usually referred to as junior colleges. Like trade schools, some community colleges give diplomas or certificates to students who complete a program to practice in a specific field like cosmetology or nursing. Admission is mostly open enrollment: high school graduates or students 18 or older can attend. Community colleges tend to be the cheapest of all the college options. The average tuition and fees for a year at a public two-year college for in-district students is $3,570, and the average at a public four-year college for in-state students is $9,970. The average cost to complete a trade school degree (1-2 years) is $34,740. Socially, there are more options for students at community colleges than there are for students at trade schools. However, there are fewer options compared to students at four-year colleges. Community colleges often have sports teams, clubs, and on-campus residents, but many community college students commute and are only at school for their classes. Also, you have the option of transferring from a two-year community college to a four-year college. Many students start at a community college and then transfer to get a four-year college degree. If you take this option, make sure the courses you take are transferable and that you're doing the necessary work to make yourself eligible to transfer. Bronx Community College Four-Year Colleges Four-year colleges can be public or private, and the vast majority are non-profit. After successfully finishing a program at a four-year college, you get a bachelor's degree. This is the most versatile and highest degree you can get compared to degrees at trade schools and community colleges. On average, those with bachelor's degrees make more money than those with associate degrees or trade school diplomas. Furthermore, bachelor's degrees are required to go on to graduate school or professional schools like law school, medical school, or dental school. Even though four-year colleges do have pre-professional majors and programs, the focus is more on acquiring academic knowledge. Socially, four-year colleges offer the most opportunities for students. There are varsity sports, intramural sports, campus clubs, fraternities, sororities, guest speakers, campus traditions, and a greater percentage of students who live on or near campus. Benefits of Attending a Trade School Over a Four-Year College Going to a vocational school does offer some undeniable benefits. The most obvious benefit of going to a trade school is that trade schools require less time to complete. Almost all trade school programs can be finished in less than two years. Meanwhile, getting a degree from a community college normally takes two years, and getting a traditional four-year college degree usually takes at least four years to complete, and many students need a fifth or sixth year to get their degrees. Less time in school allows you to get more job experience and progress faster in your career. Furthermore, if you're not in school, you won't have to pay for those additional years of college tuition and may have to take out fewer student loans. Another advantage of trade schools is the hands-on preparation you’ll receive for a specific job. Many four-year colleges and programs at four-year colleges focus more on scholarly learning than on job preparation. For example, if you graduate with a degree in philosophy or theater, you may have difficulty finding a job that’s directly related to your major. At a trade school, the focus is on learning the skills that you’ll be using in your job when you graduate. Similarly, because the goal at a vocational school is to acquire the skills for a certain job, it may be easier to initially find a job in that field. Also, many trade school programs are geared toward fields in which there is high demand for workers. Additionally, there are lucrative jobs you can get with a trade school degree. According to the Bureau of Labor Statistics, the median pay for dental hygienists was $74,070 in 2017. Meanwhile, the median starting salary for four-year college graduates was $50,516 for students from the class of 2016. Finally, if you go to a trade school, you don’t have to stress about the traditional college application process. Because the application requirements are much less strict at a trade school, if you decide to go to one, you won’t have to spend the time or money associated with four-year college applications. You won't have to take the SAT/ACT. You won’t have to stress about your grades. You won’t have to worry about joining clubs just to enhance your college applications. A trade school may be a good idea for you. Disadvantages of Attending a Trade School While vocational schools do offer some benefits, there are significant drawbacks, especially when compared to traditional 4-year colleges. Even though there are financial benefits to going to a trade school, college graduates, on average, make more money than trade school grads. According to College Scorecard, the salary after attending, which is the median income for students receiving federal financial aid 10 years after graduating, for American Career College in Los Angeles is $31,800. Comparatively, the salary after attending for UCLA is $60,700. Even after accounting for the additional time spent in school, the average UCLA graduate is going to come out well ahead financially in the long run. Also, four-year colleges tend to offer more generous financial aid. After financial aid, the average cost for West Coast University in Anaheim, California is $47,939. Meanwhile, the average cost for an in-state student at CSU Long Beach, a California State University, is $9,733. Furthermore, if you go to a vocational school, you’ll miss out on the traditional college experience. At trade schools, there’s no real on-campus culture, and there's limited social interaction. At a four-year college, you can join clubs, attend campus parties, go to sporting events, join Greek life, and live in dorms with your peers. For many people, the college experience gives them wonderful memories and helps them form long-lasting friendships. Much of the learning you do at a traditional college takes place outside of the classroom. You can attend lectures by famous politicians and prominent academics, and you're able to socially interact with students from all over the world. At a trade school, the focus is on the job preparation you receive inside the classroom, and that's basically the extent of your education. Additionally, traditional colleges offer a more broad, well-rounded education. Again, at a trade school, the education you receive is almost exclusively focused on preparing you for a specific job. At a traditional college, you’ll have general education requirements that will expose you to a variety of different subjects, and even in many majors, you’ll learn about a wide variety of topics. In college, I was an American Studies major, which is an interdisciplinary major that focuses on the United States. I was able to take classes in sociology, education, religion, history, psychology, and political science that counted towards my degree. Outside of my major, I was able to take classes in numerous subjects like human biology, anthropology, statistics, and Spanish. Traditional colleges pride themselves on not just preparing you for a specific job, but also teaching you critical thinking skills and making you an informed citizen who will be able to have a positive impact on society outside of your profession. Finally, there's more job flexibility with a traditional college degree. Trade schools prepare you for very specific jobs, but there are a wide variety of jobs you can get with a bachelor's degree, regardless of your major. If you study medical assisting at a trade school, your program will only prepare you to be a medical assistant. If you end up deciding that you want to do something else or can't find a job as a medical assistant, your vocational school degree won't be of much value. On the other hand, a degree from a four-year college offers you many more job opportunities. There are sales, education, and consulting jobs that are open to four-year college graduates from a wide variety of majors. Furthermore, you can pursue graduate school and professional schools like medical school and law school with a four-year college degree. On average, with more education and advanced degrees, you'll make more money and have more job security. Know about your options to make a wise decision. Should You Go to a Trade School or a Four-Year College? There are a few factors to consider when deciding whether to go to a trade school or a four-year college. Generally, I encourage all students who are capable to go to a four-year college. You’ll give yourself the most opportunities by graduating from a four-year school, and you’ll likely have a more fun, enriching experience at a traditional four-year college. Also, by going to a four-year school, you’ll have more earning potential and job flexibility. A trade school is a good option if you can’t spend the time to get a four-year degree or you’re very sure that you want to do a job that you can prepare for at a vocational school. Sometimes, family or financial situations make it too challenging for students to spend four years in school, so they opt to complete a much shorter program at a trade school. Also, some students just don't like traditional schooling. They struggle to do well in school because they detest reading and writing papers. They prefer doing something more active and don't want to spend at least four years in college to end up with a desk job. If you know you want to be an automotive technician, you may benefit more from completing a trade school program than going to a four-year college. You’ll get hands-on experience and be able to start your career in a short period of time. Keep in mind that if you don’t have the grades or test scores to go to a four-year college, you have options other than a vocational school. If you want to go to a four-year college, but you’re worried that you don’t have the qualifications to get admitted, check out the colleges with the highest acceptance rates. You still may be able to get in with sub-par grades and test scores. Also, you can go to a community college and then transfer to a four-year college. Most community colleges are open enrollment, so you don’t have to worry about being admitted. If you want to fix cars, maybe you should go to a trade school. How to Find the Right Vocational School for You Once you've decided to attend a trade school, your next step is deciding which school is best for you. There are three main steps to doing this: #1: Make Sure the Trade School Offers the Program You Want Nothing else about the school matters if it doesn't have the program you want, so this is your first step. If you're interested in a specific program/certificate, make sure the school offers exactly what you're looking for so there are no surprises once you graduate. You can also ask admissions counselors at the school which jobs the program will qualify you for. #2: Make Sure the Trade School Has a Good Reputation It's imperative the school you attend have a good reputation so people who hire you will have confidence in the program you completed. Your school might have specific accreditation which you should research, and you should also read online reviews and speak to current and former students to see if they would recommend the school and program. Unfortunately, there are many vocational schools that exist mostly as diploma mills and will take a lot of your money without giving you a good education in return. Doing your research early on will help you avoid this. #3: Make Sure You Can Manage the Costs and Schedule Finally, you also need to make sure you can afford tuition costs (or be able to take out the necessary financial aid), and that the times the classes are offered works with your schedule. The school should also be able to estimate how many hours a week you should be devoting to the program, and you should make sure you're able to manage that workload or look into part-time options. How to Apply to a Trade School For the majority of trade schools, the application process is relatively simple. Most schools have a basic online application on their websites, or you can contact the school for admissions information. Also, there tend to be no application deadlines. You can apply at any time, but you may need to wait for the beginning of your program of interest before you can enroll. Additionally, after you fill out the application, you may have to interview or speak with an admissions representative. These conversations are meant to be informational and help guide you to the program that would be best for you. Trade schools aren’t considered selective, and most are open enrollment. For the majority of schools and programs, you don’t have to take the SAT/ACT, and you don’t need to write an essay. Furthermore, trade schools won’t require recommendations or consider your extracurricular activities when determining admission. What's Next? Now that you're familiar with trade schools and the differences between trade schools and other types of colleges, there are a few articles you may want to check out. If you're considering going to a four-year college, learn more about the college application timeline and if it matters where you go to college. If you're interested in community colleges, find out how to apply. Want to improve your SAT score by 160 points or your ACT score by 4 points? We've written a guide for each test about the top 5 strategies you must be using to have a shot at improving your score. Download it for free now:

Discuss and evaluate how teams function Essay Example | Topics and Well Written Essays - 2250 words

Discuss and evaluate how teams function - Essay Example Secondly, team members are interdependent which signifies their reliance on each other, which is the hallmark of teamwork (Thompson, 2008, p. 2). Thirdly, team members are bounded to each other and are relatively stable over a period of time. By boundedness is meant a finite and identifiable membership the composition of which is known to all members as well as outsiders; by stability is meant that there is tenure of membership. Fourthly, team members are empowered to manage their own work and exercise their discretion over the internal processes. They do not need constant permission or approval from the team leader or manager. Finally, teams operate within the context of a larger social system. Teams work alongside other teams and draw upon resources outside their team, from the larger social system (Thompson, 2008, p 3). Team characteristics may be summarized as follows (Zayed & Kamel, 2005, p.2): A team can involve as few as two people. A team is not a mere aggregate of individual s. More than that, it is an integrated unit that functions in a coordinated and complementary manner. A team’s success depends on the interdependent and collective efforts of various team members, not just a few individuals; each member makes a significant contribution to the team effort. Team members are likely to have significant impacts on one another as they work together. When tasks require multiple skills, experience and sound judgment, teams usually outperform the sum total of the work of separate individuals. Teams are found to be more flexible and responsive to changes in the environment and other unexpected events, compared to traditional organizational hierarchical structures or other forms of permanent groupings (Zayed & Kamel, 2005, p.1; Thompson, 2008, p. 6). Factors that make a team work Zayed & Kamel (2005, p.3) specify four requirements for teams to function well: (1) Team members must have an interdependent relationship with each other in the performance of their team activities. (2) This interdependence dictates that group members must interact through conversation or work activities. (3) A team is characterized by a condition of mutual influence between team members. (4) Teams have a common purpose such as accomplishing work, completing a project, or preparing a report. Aside from internal factors possessed by the effective team, there are external factors that have made the development of the self-managed team not only apropos but necessary. The first of these is the degree of specialization required in addressing an increasingly globalized environment. The globalization of the economy enables more organizations to form and, with the increasing complexity of productive activity, assume more specialized functions. This gives rise to a need for specialists in many fields, experts with indepth knowledge and training who are particularly equipped to assess and render competent decisions within their fields of expertise, more than a gene ral manager or team leader (Dyer & Dyer, 2010). The second factor is competition, where the global market is increasingly dominated by a few large firms who enjoy economies of scale and large profits. For these firms, teamwork is becomes a source of competitive advantage in coordinating the activities of the

Differences In The Treatment In The Financial Statements For Capital Essay

Differences In The Treatment In The Financial Statements For Capital And Operating Leases - Essay Example A capital lease is considered an acquisition of ownership once the lease is paid out. The lessee must record the lease as an asset. The four criteria that must be considered by accountant to record a lease as a capital lease are: The lease transfers ownership of the property to the lessee The lease contains a bargain purchase option The leas is equal to 75% or more of the economic life of the leased property The present value of the lease payments equals or exceeds 90% of the fair market value of the leased property (Weygand & Kieso & Kimmel, 2003, pg. 658). Weygandt, J., Kieso, D., Kimmel, P. (2002). Accounting Principles (6th ed.). New York: John Wiley & Sons. 2. I think that capital leases are better investment options than operating leases. I compare the difference between an operating leases and a capital leases to the difference between been a renter and a homeowner. Companies that incur in operating leases contracts are throwing money away because they will pay thousands of do llars and will never own the equipment. Sometimes due to the nature of the project it is better to use operating leases. For example if a project has a completion elapsed time of 6 months, it is cheaper to obtain equipment using short operating lease contracts. 3. When you think about the criteria of having a leases for the duration of at least 75% of the useful life of equipment it makes sense that capital lease transfer ownership. The person that pays the lease will pay the owner of the equipment the majority of the value of the asset. I think the use of capital leases is a good way to add value to the balance sheets of a company. The equipment will increase the total assets account of the company. Since the balance sheet is based on the basic accounting equation it must balance itself out, thus there is need of a liability to be included in the balance sheet to offset the asset entry. 4. The four criteria you mentioned in your response are right on target. The first criterion of ownership establishes that a capital lease will lead to ownership of the equipment by the lessee once the contract is complete. A capital lease is similar to a contract to buy a home because the homeowner does not actually fully own the home until is completely paid. If the homeowner fails to pay his monthly payment for more than three consecutive months the bank could foreclose on the home and take back the house. The fair value criterion also completely justifies the ownership privileges in a capital lease. 5. Weekly Summary During week two of the course I learned a lot about accounting theory. The classroom discussion was very informative. I now clearly understand the difference between an operating lease and a capital lease. The week two individual paper cover some very specific accounting topics dealing with some unusual transactions. I use to believe that the inventory reflected in the balance sheet was based on historical cost only. I learned this week that companies make adj ustment to lower the inventory when the current replacement cost is lower. Another interesting accounting topic I learned during my research for the week two paper was that accountants can capitalize interest on construction projects. 6. The total inventory of the company at the end of 2009 was 282,000 units. Using LIFO the valuation of the inventory is illustrated below 10000 15 150000 22000 18 396000 250000 20 5000000 282000 19.67 5546000 The average cost per unit of the company at the end of the year was $19.67 per unit. If the company decides to purchase the 40,000 units at $17 before the end of the year the valuation of the inventory is illustrated below 10000 15 150000 22000 18 396000 250000 20 5000000 40000 17 680000 322000 19.34 6226000 The decision of

Principles of Acid Base Balance

Principles of Acid Base Balance The purpose of this handout is to educate the student on basic principles of acid base balance. To give a systematic approach to interpretation and understanding of arterial blood gases and appropriate care for the patient who is having a blood gas taken. It is intended that the student will learn from this package but also be encouraged to source other material to broaden their understanding of acid base balance. It is intended that this learning packet will complement their experiences with help of an understanding mentor, who will assist them with questions raised both within themselves and within the book. An arterial blood gas measures the acidity of the blood, the levels of carbon dioxide and levels of oxygen. The blood is taken from an artery prior to the blood distributing the oxygen from blood cells to the body tissues. The values the gas will show are: Partial pressure of oxygen (PaO2) this measures the pressure of oxygen dissolved in the blood Edwards (2009) say this can indicate how good respiratory system is functioning. This can indicate oxygen saturation and how well oxygen can move from the lungs to the blood Partial pressure of carbon dioxide (PaCO2) this measures how much CO2 is dissolved in the blood and how well it can move from the blood to the lungs (and out of the body). Foxall (2008) explains that co2 mixed with water turns in to carbonic acid that the lung must excrete to prevent an acidosis. Bicarbonate (HCO3) Bicarbonate is the form in which a large amount of acid is removed from the cells Schilling (2008) says about 70% is removed from tissues and bicarbonate can be measured as either actual or standard bicarbonate. The standard which is the more important value is obtained by using a PCo2 of 5.6 kPa as a reference for the amount of CO2 in the body. Base excess (B.E.) Springhouse (2008) explains that the base excess indicates the amount of excess or lack of bicarbonate in the circulatory system it can be a negative number indicating too much acid or a positive number indicating too much base. It normal range is -2 to +2 Introduction Skinner (2005) and Adam (2009) concur in that arterial blood gas analysis is an essential part of diagnosis and management a patients ventilation therapy and their acid base balance. Skinner continues to say the usefulness of this intervention is dependent on the ability of the health professional to analyse and interpret the individual aspects of the gas. The intention of this learning packet is to introduce the learner to the individual aspects of a blood gas, and there meaning. Additionally it hopes to show how to bring these values together to formulate a decision on the patients condition and suggest options for treatment. Common reasons for blood gas analysis are: To diagnose and assess existing lung function. To review treatment for lung disease and evaluate its effectiveness. To assess if extra oxygen is required for a patient or if further support is required (CPAP, BIPAP or PPV). To measure the acid base level in patients where it is compromised. Patient would include renal patients, patient with heart failure, severe infected patients uncontrolled diabetes or individuals who have taken an overdose. Preparing the patient. Explain to the patient that they are having a blood test from their artery. It is likely to be taken from a radial artery. Nettina (2005) Describes a test to assess the puncture site prior to puncture called the Allens test procedure. This will evaluate the blood circulation in the hand and whether it is appropriate to use the radial artery for puncture. The site will be cleaned with alcohol and allergy status permitting anaesthetic agents will be applied to reduce discomfort, and increase possibility of success. Dougherty (2008) suggests that the patient should be encouraged to breathe normally through the procedure and the doctor may ask for cessation of supplementary oxygen prior, to give a better understanding of the patients present condition. After the syringe is full, place gauze over the puncture site and apply pressure until bleeding has stopped. This may be some time if the patient is on blood thinners or has coagulopathy. Once bleeding has stopped apply a dry dressing but monitor for any further bleeding. After the procedure there is a possibility of bruising although the longer pressure is kept on the puncture site the lower the risk. Some light headedness or nausea may occur during or after the blood draw. On rare occasions the needle may damage the artery or a nerve causing it to become blocked. As a result care must be taken with the wrist once blood draw has taken place. How it feels Dougherty explains that collecting arterial blood from a patient is a procedure that is often painful. It is more painful than the routine venous phlebotomy your patient may be used to. There are a number of reasons for this, arteries are often deeper than veins and surrounded by nerves. Ideally the patient is given a local anaesthetic and the patient feels just a sting as the needle punctures the skin. Otherwise there is a sharp pain as the needle enters the artery. If the procedure becomes protracted either by the practitioner having difficulty finding the artery or the artery is narrow the pain may more than brief. It is important to note that both pain and fear would cause the arteries to narrow so reassurance is important and if the practitioner continues to have difficulty you must advocate on the patients behalf since fear would impact on future successful arterial blood gas collection. Questions What other sites could a patient have blood gases taken from? Can only arterial blood be used for blood gases? What values would be markedly different in a venous sample blood gas. Why would a patient emotional response make blood draw difficult how can we reduce the affects of this to cause a positive outcome What medications or disease process would make a patients bleeding time prolonged after sampling? Further reading Royal Marsden clinical procedures manual 2008, Dougherty etal Overview The measurement of a blood gas will show a pH value. PH is a value the can range from 1 to 14 and is a measure of acidity or alkalinity of a substance. Springhouse(2008)explains in the blood stream the pH value is inversely proportional to the number of hydrogen ions in the blood. The fewer ions the higher the number (alkalosis) and vica versa, more ions would mean a lower number (acidosis). A solution with a pH of 1 is acidic and a solution of pH 13 would be alkalotic. A solution of pH 7 is called neutral since it is in the middle, it is neither acidic nor alkalotic, and water has a pH of 7. Adams (2009) explains that the normal PH of the body ranges from 7.35 to 7.45. In order for normal metabolism to take place the body must maintain this fine balance at all times. He clarifies that if the pH level rises the blood is said to be alkalotic or acidic if it drops below 7. Hall (2009) says the ability of the body to function normally is impaired if the pH moves from these parameters. Hall also concludes that in acidosis the bodys response to medication is muted, cardiac function is impaired since contractility and vascular response to catecholamines is reduced. If the patients pH is raised then oxygenation is effected which interferes with neurological and muscle function. Adams points out that severe changes in pH that is above 7.8 or below 6.8 will interfere with basic cell function and respiration and if not corrected will result in death. Below is a discussion on how the body regulates this delicate balance. We will elaborate on the processes the renal and respiratory systems use to buffer the bodys processes to keep this fine balance. The respiratory buffer system Hinds (2008) explain that carbon dioxide (CO2) is a normal by product of cellular metabolism. Carbon dioxide is carried in the blood to the lungs where excess CO2 combines with water (H2O) to form carbonic acid (H2CO2) in the blood. The blood pH will change according to the level of this acid in the blood. This fluctuation triggers either a rise or fall in respiration until the level of CO2 is returned to the patients base line. Hinds explain that this system is fairly rapid and can be triggered in a short space of time a few minutes in most cases. The renal buffer system Henessey (2007) simplifies the metabolic system explaining that the kidneys also maintain acid base balance by the excretion or retention of bicarbonate (HCO3). As the pH rises HCO3 is excreted and in return as the pH decreases HCO3 is retained. Although an effective system the renal system is slow to respond to imbalances, requiring hours or days to attend altered pH. Questions If neutral pH is 7 why does the body require a mean of 7.4 a slightly alkalotic environment to operate? The notes above indicate the bodys response to catecholamines is muted what are these and why are they important? Normal values pH 7.35 to 7.45 PO2 11 to 13.3 kPa PaCO2 4.8 to 6.0 kPa HCO3 21 to 28 mmol/l Acid Base Disorders Respiratory acidosis. Henessy (2007) discussion on respiratory acidosis is defined as a pH less than 7.35 with a Pco2 greater than 6.0 kPa. This type acidosis is caused by a build up of CO2 which combines with water in the body to produce carbonic acid thus lowering the pH of blood. Driscoll (1997) says any condition that results in a reduction in ventilation can cause this type of acidosis. Head trauma, which has inflicted damage to the respiratory centre leading to respiratory depression. Sedatives, narcotics, neuromuscular blocking agents or anaesthesia, which can cause central nervous system depression. Impaired respiratory muscle function related to spinal cord injury or neuromuscular disease. Poor lung function such pneumothorax, pneumonia, atelectasis or bronchial obstruction. Hypo inflation due to pain chest injury or abdominal distension. Hasan (2009) simplifies the presentation of the signs and symptoms of respiratory acidosis are centred within the respiratory, cardiovascular and nervous systems. These symptoms can range from shallow breathing or dyspnoea to headaches or altered consciousness and irritability. If left unchecked these symptoms deteriorate towards drowsiness and coma. Increasing ventilation support will correct this type of acidosis. The specifics of how this will be done is dependant on the mode of insult to the respiratory system. Edwards (2009) suggests ventilator support could be oxygen via a face mask, non invasive ventilation (N.I.V.) or positive pressure ventilation (P.P.V.). If medications are inhibiting respiratory function then reversal agents can be deployed whilst supporting the patients respiratory needs. Pneumothorax and pain are problems that can be reversed promptly once the patients condition allows. Marino (1997) say that if the patients symptoms or condition, cannot easily be resolved then it may be appropriate to ventilate the patient mechanically. Commonly patients with respiratory acidosis are hypo ventilating, as a result they will benefit from supplemental oxygen but this only improves the quality of respiration; it does not in fact remedy the problem. Respiratory Alkalosis Respiratory alkalosis is defined as a pH greater than 7.45 with a PaCO2 less than 4.8 kPa. Any condition that causes hyper inflation can result in respiratory alkalosis. These conditions include, Pain Anxiety fear or panic Medications which stimulate the respiratory system Lesions in the brain affecting the respiratory centre Increased metabolic demands such as fever sepsis or pregnancy. Alkalosis will present cardiovascular or central nervous system disorder. Springhouse (2008) illustrates that presentations can be dysrhythmias and palpitations to numbness and confusion. Additional symptoms are dry mouth, blurred vision and titanic spasms of the arms and legs. To resolve the alkalosis the cause of the hyper ventilation must be attended to. These patients are at risk of suddenly deteriorating, they have tachypnea and must be supported to reduce fatigue. If they become tired their own ability to ventilate adequately will be impaired leading to respiratory failure. Questions What would be the signs and symptoms of a patient with a respiratory caused imbalance? Which kind of medications can cause an acidotic condition and what would be the reversal agents? In respiratory alkalosis why do patients suffer with tetany? What are the signs and symptoms of respiratory failure? Metabolic acidosis Metabolic acidosis is defined as a bicarbonate level less than 21mEq/L with a pH of less than 7.35. Schilling (2008) explains metabolic acidosis is caused either by a deficit of base in the blood stream or an excess of acids other than CO2. Excessive bowel action such as diarrhoea and intestinal fistulas may cause decreased levels of base. Increased acids can be caused by a number of factors such as: Renal failure Diabetic ketoacidosis Anaerobic Metabolism Starvation Salicylate intoxication Hall (2009) Signs and symptoms of metabolic acidosis are varied affecting numerous systems. The nervous system presents with headaches, dizziness leading to confusion or later coma. Dysrhythmias are common as conduction pathways are affected and low blood pressure due to desensitivity to catecholamines such as epinephrine. Marino (1997) elaborates to say the respiratory system will attempt to correct imbalances by breathing out more CO2. Kussmaul respirations these are deep and laboured breaths. In the gastro intestinal tract nausea and vomiting is noted as well as warm flushed skin. The Hinds (2008) says treatment of the metabolic acidosis is to resolve the cause, this invariably means an initial review of body systems and their function. By assessing each function and its efficiency, underperfused or hypoxic tissue beds can be identified. Hypoxemia can lead to generalised anaerobic metabolism, but hypoxia of a specific tissue bed will produce metabolic acids even if oxygenation (PaO2) is normal. To reverse this acidosis perfusion must be restored which in turn will cease the anaerobic metabolism. Hinds warns that other causes of metabolic acidosis should be addressed after the possibility of hypoxia and poorly perfused tissue beds have been resolved or ruled out. Metabolic alkalosis Metabolic alkalosis is defined as a bicarbonate level of 28mEq/L with pH greater than 7.45. Metabolic alkalosis obviously is the reverse of the previous condition deriving from an excess of base or a deficit of acid. Adam (2009) suggests that excessive base comes from ingestion of antacids, excess use of bicarbonate or lactate in dialysis. Low amounts of acid come from overuse of diuretics, gastric suction or protracted vomiting. It presents through neurological signs and symptoms varying from light headedness to seizures and coma or musculoskeletal symptoms of weakness, muscle cramps and tetany. Other associated signs might be nausea and vomiting and respiratory depression. This is a relatively uncommon presentation and presents a challenge in treatment. Bicarbonate can be stimulated thought the kidneys by drugs such as Acetazolamide but it is a protracted therapy. Severe cases I.V. administration of acids may be used Questions Which other value is closely linked with the metabolic state of the body? What does it signify? What signs and symptoms would a patient show who presented with a metabolic acidosis? In a very severe alkalosis state what I.V. acids could be administered? Steps to Arterial Blood gas interpretation There are simply 3 steps to interpreting a blood gas result and each must be done in order to prevent confusion and misdiagnosing your patient. The components are pH PaCO2 and HCO3 below are three steps and following are examples to assist you in interpreting them. Step One Review the pH initially is this normal or abnormal? If the pH is above 7.45 it is alkalotic if it is below 7.35 then it is acidotic. Step Two If the blood sample pH is altered then we must consider how this is being affected. Initially assess the PaCO2 this value will move in the opposite direction to the pH when there is a insult to the respiratory system. That is as the pH falls out of normal values the PaCO2 rises from its normal limits. The reverse is true if the PaCO2 falls then the pH will rise. Step Three The third step is to assess the HCO3 value. If there is an altered metabolic function the HCO3 will alter in a similar direction to the pH. As the HCO3 value rises so will the pH and as one decreases so will the other. Examples: Using the table above and your knowledge you have gained try and diagnose the problems below. Example 1 Mr Brown is a 72 year old man admitted with recent chest infection to the assessment unit. He is quite short of breath and has a strong cough his blood gas show the following information Patient: John Brown D.O.B.01:01:38 PH 7.30 PaCO2 8 HCO3 25 Step one, assess the pH is it normal? It is not, it is low therefore it is acidotic. Step two, assess the PaCO2 is it normal? It is not, it is raised which is the opposite direction of the movement of the pH. Step three, assess the HCO3, is that normal? Yes it is within its normal range. Reviewing the grid it can be seen the pH being low, the PaCO2 raised and the HCO3 normal shows a respiratory acidosis. Example 2 Maria 29, who has a long history indigestion and reflux, has come to the drop in clinic with vomiting unresponsive to her usual medications and cramp in her hands. A routine blood gas shows the information below. Patient: Maria Goode D.O.B.: 01:01:1981 pH 7.51 PaCO2 5.5 HCO3 35 Assess the pH, is it normal? It is high indicating alkalosis Assess the PaCO2 is it normal? It is normal Assess the HCO3 is it normal? It is raised, moving in the same direction as the pH. Looking at the chart above a raised pH and a raised HCO3 would indicate a metabolic alkalosis state Discussion on compensation So far we have only looked at a simple blood gas scenarios, with only one system failing. As Hasan (2009) indicates that often if one system fails or falls out of normal range altering the pH the second system will activate and work harder to compensate to bring the pH back in to normal limits. This activity is called compensation. Foxall (2008) describes that when a patient develops an imbalance over a period of time the body will naturally attempt to compensate. The lungs and the kidneys are the primary response mechanisms and so the body will try to resolve any metabolic or respiratory imbalance to return the pH to normal There are varying degrees of compensation initially uncompensated, an altered pH with only one value out of normal range. Partially compensated blood gas, an altered pH value with both values out of normal range. Compensated blood gas, a normal pH value with possibly both values out of range. Previous examples we looked at were simple uncompensated blood gases. Now lets look at more advanced gases such as partial compensation. To review these gases as before break the interpretation down in to three simple steps Assess the pH, is the gas acidotic or alkalotic Assess the PaCO2; is the PaCO2 a normal value? As reviewed before respiratory imbalances will move the pH in the opposite direction to which the PaCO2 moves when causing a primary imbalance. If the PaCO2 is moving in the same direction that is either increasing, or decreasing in value, then this would be a compensatory behaviour and it would indicate the primary insult is coming from the kidneys (metabolic). In a compensatory environment a decreasing PaCO2 would show the lungs are buffering by excreting excess acid by blowing off Co2 in order to equalise the balance of acids and return the pH to normal. Conversely a raised pH and raised PaCO2 would indicate a buffering response by the lungs which would reduce acid excretion in an effort to return to homeostasis. In summary, if there is evidence of compensation, but the pH has not yet arrived back into normal limits then it is only partial respiratory compensation. Assess the HCO3. In our original uncompensated examples the pH and the HCO3 moved in the same direction when the primary insult was metabolic. Following our discussion above in compensatory behaviours the values will work counter to their normal presentation. So if the pH is decreasing when the HCO3 is increasing or decreasing when the pH is increasing this is a compensatory action therefore the primary insult is a respiratory one. The kidneys will hold on to or release HCO3 in response to the abnormal pH to equalise the acid in the body to return the bodys pH to normal The essential difference between these two states is that they are on a journey towards normal from possibly uncompensated , to partially compensated, to fully compensated environment (normal pH). The body is always trying to correct the imbalance however successful, but the body will never over compensate. As can be seen from the above table the pH in fully compensated states is normal. Knowing which side of 7.40 will help in determine the original imbalance that is now compensated. More technical questions Example 1 A patient enters the AE who is known to the renal team. He has been having dialysis 3 times a week for a year but missed his last appointment. He is complaining of being unwell. A Routine blood gas show the following results Using the same 3 steps we have used before: Patient : George Philip D.O.B. : 01:01:50 pH 7.31 PaCO2 3.9 HCO3 18 Is the pH normal? The answer is no it is low therefore it is acidotic Is the PaCO2 Normal? No this is also low. If the PaCO2 was causing the primary insult we would expect it to move in an opposite direction to the pH in this case it is not. We must conclude therefore that the primary insult is metabolic and the paCo2 is out of range in a compenstatory role. The lung are excreting CO2 to reduce the PaCO2 whereby return equilibrium and return the pH to normal. Is the HCO3 normal? It is not it is low moving in the same direction as the pH. Therefore confirming what has already been said that the primary problem is metabolic. If you review the tables above it can be seen that the primary problem is metabolic but the full diagnosis would be a partially compensated metabolic acidosis Example 2 A lady walks in to her local surgery complaining of shortness of breath she is a long term smoker. A routine blood gas shows the following results Patient: Jane OBrien D.O.B. : 01:01:62 pH 7.35 PaCO2 7.2 HCO3 29Assess the pH is it normal? Yes it is, but the low side of neutral Assess the PaCO2 is it normal? No it is raised an acidotic condition. If this is the primary problem we would expect the pH to move in opposite direction to the PaCO2. Assess the HCO3 is it normal? No it is also high which is representative of an alkalotic state. Although the pH is normal both elements are out of range showing there is full compensation being achieved. The pH is lower than 7.40 which shows it is moving in the opposite direction as the HCO3 which show the initial insult was respiratory and that the kidneys are compensating by retaining bicarbonate Her arterial blood gas would be interpreted as fully compensated respiratory acidosis Example 3 A 42 year old man on the surgical unit with history of bowel obstruction has had N.G. on free drainage has become unwell. Routine labs were sent and the blood gas below: Patient: Tom Jones D.O.B. : 01:01:47 pH 7.44 PaCO2 7.1 HCO3 34 Is the pH normal? Yes Raised within normal limits Is the PaCO2 normal? No this value is also raised, so therefore even if this is a fully compensated state it was a metabolic imbalance in origin. Is the HCO3 normal? No this is raised with two value out of range and the pH with in normal limits this is fully compensated gas with the pH raised in normal limits and the HCO3 raised this was an initially a metabolic alkalosis This is a fully compensated metabolic alkalosis. Example 4 David has arrived from a nursing home with altered consciousness into the AE department. His initial labs showed a raised white cell count and this blood gas was taken Patient: David Hawcroft D.O.B. : 01:01:72 pH 7.32 PaCO2 8.2 HCO3 32 Is the pH normal? No it is low therefore it is acidotic. Is the PaCO2 with in normal limits? No it is raised which indicates that respiratory system is causing the primary insult. Assess the HCO3 is that normal? No this is raised also indicating that because it is moving in an opposite direction to the pH it must be in compensation, confirming the insult is respiratory in nature. Since both elements are out of normal limits there is evidence of compensation but since thepH is not achieved normal values it is considered only partial compensation, so this gas is a partially compensated respiratory acidosis Primarily this book has been to discuss the relationship between respiratory and renal systems is maintaining the bodys acid base balance. Arterial blood gases are used also to interpret blood oxygenation using the Po2 value. This value indicates the partial pressure of oxygen, the ability of oxygen to bind to haemoglobin and transfer to tissues, this ability can be affected by the acid state of the body. Below is a discussion on the Oxyhemoglobin Dissociation Curve which is a graph that plots the behaviour of oxygen in the blood comparing saturation against partial pressure and how acid base can affect it. Oxyhemoglobin Dissociation Curve The Oxyhemoglobin curve is a tool used to show the relationship between oxygen saturation and Pao2. Marino (1997)points out that the strength at which oxygen binds to the haemoglobin can vary depending on the disease state of the body. This in turn can affect the oxygenation of tissue beds or end organ perfusion. Adam(2009) simplifies the principle explaining that oxygen can bind too tightly which would which would inhibit of transfer of oxygen to tissues that needed oxygen or alternatively not bind tightly enough an oxygen is lost before it reaches these target cells. This relationship between the affinity of oxygen and the saturation is illustrated below with the Oxyhemoglobin curve. As mentioned above there are a number of conditions or states than can affect this relationship essentially moving the graph left or right. A fever, acidosis or elevated PCo2 levels can cause reduced adhesion of the O2 molecule therefore the graph and its values appear to move to the right (A right shift). Where as if the body is alkalotic, hypothermic or a low PCo2 the graph will shift to the left which would indicate the blood is failing to release the oxygen through increased affinity The curve can be used to assess Pao2 if the oxygen saturation is known. Shown in the illustration is a person with a saturation of 82%. If the curve has not shifted then that persons Pao2 would be 51mm Hg. A value of 80mmHg could indicate hypoxemia. Correction of the patients oxygen level may be facilitated by improving oxygen delivery and resolving conditions affecting the curve. Revision Questions What number indicates extreme acid on the pH scale? What is the range for pH in the blood? The kidneys compensate for acid base imbalances by excreting what substance? Which A.B.G value indicates an excess or insufficiency of sodium bicarbonate? What two values are compared on the Oxyhemoglobin curve? Interpretation revision pH 7.33 PaCO2 8.0kPa HCO3 31 pH 7.49 PaCO2 5.9 kPa HCO3 34 pH7.37 PaCO2 5.3 kPa HCO3 25 pH 7.44 PaCO2 4.0 kPa HCO3 16 pH 7.27 paCO2 5.5 kPa HCO3 15 Further reading Mays DA (1995). Turn ABGs into childs play R.N. 58:1: 36-40 Foxall Kesley (2008) Arterial Blood Gas Analysis: an easy learning guide M K Publishing Keswick Cumbria U.K.

Promoting diversity within a health and social setting Essay

In this report I am going to outline The Mental Health Act alongside this, the procedures and codes of practise and how both of these aim to promote diversity and assessing the effectiveness of these measures in place. The Mental Health Act aims to safeguard the vulnerable, by ensuring they are treated fairly and equally by services and given permission to health care, for example hospital treatment if required. The term mental illness or a personality disorder is used to describe someone with a mental disorder. The key principles of the act include keeping the service users best interest at heart and if unwise decisions are made by the user, the least restrictive option should be made. The mental health acts helps to promote diversity, because it ensures that the individual themselves will not be taken advantage of and their choices are met with full understanding before a decision has been made. This also makes sure that the person who holds the right to overrule the decision making follows under the act closely. The codes of practise aim to provide rules and regulations on how professionals should behave in a health and social care service. Most importantly, they provide specific standards of practise for each situation. For example, there is a code of practise for nursing and midwifery, known as ‘the nursing and midwifery council’. Another example of how codes of practise provide specific rules for each situation is the including standards of practise specially tailored for social care workers. This is known as the ‘General Social Care Council.’ The standards of practise must comply with the employers and employees responsibilities non- discriminatory practise. These responsibilities include staff promoting choices about service users and the care they receive; promoting a sense of self – concept for each service user; promoting diversity by considering their preferences, the service user’s individual needs and their wishes being taken into consideration of every aspect of their care. These responsibilities help to promote diversity, because it prevents victimisation and respects individual’s different views, with providing equality for all and promoting non – discriminatory practise. Overall, this piece of legislation is effective, because it aims to promote diversity by providing important legislation with lawful regulations that helps to meet service user’s needs. For example, the mental health act ensures the individual focused on if necessary, will be ensured to have informed and respectful decisions made based on their needs and preferences. Codes of practise are effective for aiming to promote diversity, because they provide standards of practise for individual situations, which all consequently aim to promote diversity and help staff and carers to use non – discriminatory practices that respect all individual service user’s needs while also aiming to promote and respect differences within each individual.

What Everybody Is Saying About Current Definition Argument Essay Topics

What Everybody Is Saying About Current Definition Argument Essay Topics The primary goal of writing an argumentative essay is to understand how to convince individuals to modify their perception of things they strongly believe in. There are respective patterns that writers can use if writing an argumentative essay even though there is not any particular model of organization. It's important to select the word which provides you enough to research and write about. If you need assistance with a definition essay, or just do not have a sufficient amount of time to write it all on your own, no worries! Even when you're stating your viewpoint, make sure you do not come off as biased. To begin with, remember that it's structured and worded in a manner that attracts the entire attention of your readers. To reach a compelling subject, you will need to center on a single issue as opposed to using several thoughts which are inclined to confuse the reader. You've got to investigate and support your description whilst assuming your reader already knows the implied meaning of that specific word, term, or subject. After you've decided on the topic question, it would be recommended to browse through the web to discover some plausible responses. The word looks interesting enough so as an intelligent student you opt to look this up in the dictionary. The very first step it to go for an intriguing word or a phrase you'd like to do a little bit of research about. The solution is quite simple. The Demise of Current Definition Argument Essay Topics Young writers may try simple on-line citation generators which are ordinarily at no charge. It's important to select debatable argumentative essay topics as you need opposing points you can counter to your own points. Argumentative writings is a particular sort of a paper. Making up a topic all on your own is quite mind-torturing. Also though you'll have a lot of details here, the section is not as technical. So be sure you select a subject, which has values in it. It's possible to go for an intriguing topic from any area of science. When you are finished with your essay, you must not merely check it for spelling and grammatical errors, but nevertheless, it also has to be checked for logical fallacies. Typically, a definition essay isn't complicated to write. Having selected a great topic to argue about, at this point you need to make an argumentative essay outline. A definitive essay outline also acts as a map of sorts because it already is made up of an essay parts arranged in line with the order of their look. It's necessary to continue to keep your reader always interested. Simply, you should endeavor to make them interested in furthering their discussion by themselves even as soon as they are finished with the reading the writing. If you must compose your whole essay in 1 day, do your very best to give yourself breaks so you don't burn out. Our essay writing service will aid you with any assignment. Obviously, here, you'll discover a wide selection of topics and essay ideas. There are an endless number of words that may be defined in the period of an essay. In such a paper, you have to compose a personal yet academic definition of a particular word or subject. When writing a crucial composition, it's highly recommended to pick contradictive topics. To begin with, if you're writing definition essay you want to pick out a topic which will be interesting. A definition essay can appear simple, but in fact, it's not. To generate the topics you merely must choose definition essay in the sort of essay and place some keywords when you have any on your mind. According towikihowyour definition essay has to be thorough.

Comparing Power and Freedom in Invisible Man and Notes...

Comparing Power and Freedom in Invisible Man and Notes From Underground The quest for power is an endless one for humanity. Countless tales of greed, strife, and triumph stem from this common ambition. Similarly, men universally seek freedom, a privilege entitling an individual to make independent decisions and express personal opinion. Exploration of the connection between these two abstract concepts remains a topic of interest, especially in the works of Ralph Ellisons Invisible Man and Fyodor Dostoevskys Notes From Underground. Two distinct definitions of power exist: one deals with societally defined power, generally represented by wealth, leadership, and authority over the lives of others. The other defines a†¦show more content†¦the mocking birds fluttered their tails and sang... (34). The dreamy world of perfection he sees manifests a huge sense of hope in the young Invisible Man. In his wide-eyed wonder, he initially characterizes Dr. Bledsoe as the example of everything [he] hoped to be: Influential with wealthy men all over the c ountry; consulted in matters concerning the race; a leader of his people...he had achieved power and authority... (101). Invisible Mans deep admiration for Dr. Bledsoe marks his yearning to be influential and powerful in society, and his belief that he can attain such a goal. Invisible Man continues to place Dr. Bledsoe on a pedestal, believing that his destiny lies in the path of graduating and assuming the same level of authority. But his perspective gradually shifts with time. When Invisible Man returns to the institution late with Mr. Norton after an excursion to Golden Day, Dr. Bledsoe reveals a side of himself underneath the humble gratitude and respect he shows white men, saying: Im still the king down here. I dont care how much it appears otherwise. Power doesnt have to show off. 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