AB 109 and Institutional Corrections Essay Example | Topics and Well Written Essays - 1250 words

AB 109 and Institutional Corrections - Essay Example The bill provided guidelines to be used in decongesting the state prisons and at the same time increase capacity within county prisons. California has 33 state prisons which initially had exceeded its capacity by more than 100%. The main goal of the California department of corrections and rehabilitation was to ensure public safety by preventing crime and realizing social responsibilities (Misczynski, 2011). The adult department had three major departments which was the male department, female department and the parole department. The number of parole violators and recidivist prisoners was adding to the overgrowing population among prisoners. The population prevents effective service delivery and prevents effective healthcare delivery (Lofstrom et al. 2012). The increased population prompted the state prisons this release offenders before their time elapses. The county prisons had limited jurisdiction over felony offenders and parole violators. The assembly bill (AB 109), was enacted to expand the jurisdiction of county court to enable them deal with cases that were initially assigned to the state courts. This was an effort by the state of California to change the manner in which adult correctional facilities were managed. The decongestion programs aimed at reducing the number of inmate in state detention facilities and accommodate them in the country facilities. According to Lofstrom et al. (2012) the bill was a move by the California to decongest the 33 state prisons by approximately 137.5%. The bill was an effort of by a taskforce which recommended the decongestion. In 2011 the recommendations by the task force were implemented. The assembly bill also allowed low- felony offenders to serve their jail term in country prisons rather than the state prisons. The state prisons where to regulate the inmate population. No inmate was to be transferred to the county prisons upon the implementation of the bill. In that sense no prison would be released prior to his

World History Bringing it All Together Essay Example | Topics and Well Written Essays - 500 words

World History Bringing it All Together - Essay Example Witness, for example, the impact of gunpowder; not only its role in the early Mongol invasions of Japan, but the ripple effect it created throughout history as that technology spawned not only primary improvements in the substance itself, but also tactical warfare revolutions into the medieval baronies and even later. This is only one example of a single new technology changing society and civilization forever. Discussion 2 - Inequality. Certainly when viewed from today's perspective, the institutionalized social and gender inequality during this time is repugnant. Man's inhumanity to man has always been a shocking part of history, and the socialized stigma of being a woman, or a Jew, or a slave certainly recognized no individual human right in the modern sense. That said, however, I want to note that it was upon these unequal foundations that civilization was built. Accepting the status quo was the very mindset that allowed those enslaved by the Romans to build the empire. Without the technological development of the Romans, built on the backs of those slaves, we wouldn't have running water.

Theoretical Perspectives On A Family

Theoretical Perspectives On A Family Theories have been useful as a tool for creating explanations for patterns of behaviour in families (Doherty et al:, 1993). Functionalism gives an extremely optimistic view of family life. Langs evidence on child abuse, violence against women and divorce statistics indicates that functionalists neglect the dysfunctional aspects of the nuclear family. Functionalism focused excessively on the nuclear family form and insufficiently on other family forms. Marxist and Functionalist theories of the family tend to assume that the nuclear family is the dominant family form and therefore neglect diversity. Both structural approaches to the family Marxism and Functionalism can be deterministic, and this can make their analyses inaccurate and maybe over-generalised. Feminists, interactionists and the radical psychiatrists of the 1960s (Laing, Leach and Cooper) have all helped to correct these weaknesses.  Postmodernism has helpfully emphasised diversity, but it can be argued that it goes too far, ignoring the evidence of structural trends and dominant norms in our society(Doherty et al:, 1993). Functionalist approach presents the most positive view of theory. Types of Family The nuclear family is traditionally known to be made of the parents and their siblings and this is the most basic family arrangement. While the nuclear family is made- up father, mother and their offspring, extended family refers to aunts, grandparents, cousins and uncles. I would like to think that most societies have a concept of extended family. The relative structure, functions and importance vary according to the particular culture. Traditionally, extended family is referred to as kinship network of economics and social ties made-up of the nuclear family plus other relatives. The economic and social importance of extended family can most readily be seen when family members are living together. Even when extended families do not live together, nuclear families may rely on extended kin to help with basic day to day activities and may also co-dependent on extender family for economically and emotionally support. Contemporary family is ..In any particular time and place, families have always been more varied than the prevailing image of what the ideal family should be. Although family types are even more diverse than in the past, most contemporary families are still variations on the traditional nuclear family pattern. Family structure Lone parent Single parent can be caused by death of a spouse, divorce, and separation. This may lead to single parents being overwhelmed with their loss and the responsibilities. Most single parents are women, who may face somewhat lower income and will often rely on child support and government subsides. When parents divorce or are widowed children often experience loss and a disruption of routine. Children may also need a lot of attention, affection, and reassurance (Meyerhoff, 2010). Reconstituted family As we tend to think of families consists of a mother, father and their children, the reality is that there is a lot of divorces and remarriages occurring in our society such that a large number of families are actually stepfamilies. In remarried families, parenting is shared among different sets of parents and different household. Children will tend to visit in and out of households for visitations. Issues with children not accepting parenting from their stepparents can be an issue and this can be hard on children as well as the parents. Strong sense of loss can recur in remarried families due to the families not feeling intact, which may sometimes cause emotional scars, conflicting loyalties. Remarried families can be complex. Each additional member of the family system allows for another relationship or another with every other member of the family. The family is made up of biological parents, grandparents, siblings, stepparents, stepsiblings, half siblings and step-grandparents (M eyerhoff, 2010). With this many relationships between so many people there is potential for stress, but there is equally an increased potential for a large support network if everyone cooperates and communicates well. Hence reward can be tremendous. Adoption family Adoption family structure is complex but potentially rewarding . Changes in family structure Family structure has changed significantly in recent years, with increasing divorce rates and single-parent households (Field, 2003). Evolving definitions of family include people who may not be kin, but who act as family for some individuals, Rothausen (1999). Bogan (1991) uses the term wider families to refer to the concept and opines that such families result from individuals lifestyles and may not involve the sharing of a household. This concept of family describes a group of people who are invested in one another due to bonds of dependence, obligation or duty, love caring or cooperation (Rothausen, 1999). In the same way Weeks, Heapy and Donovan (2001) refer to same -sex families which are founded on bonds of individual choice, as families of choice. There is also a great deal of cultural variability in how the term family is defined. Changes to the family structure is also happening through ethnic difference which is also influenced by religion within the society In many Asian countries, a normal family may include three or more generations living in one household (Rothausen, Kanye, 2005). And as life expectancy continues to rise the number of multigenerational families may increase (Levade et al, 2000). The dynamics of family have changed, with couples having children later on following economic stability and careers. A lot of women are pursuing careers thereby starting family in the late 30s. Families might only have one child, this could lead to the child being spoiled (through parents trying to over compensate) and lonely. With new legalisation allowing same-sex couples to adopt families in place, the traditional family structure has changed to contemporary. Discussion Family friendly government policies are helping families by providing childcare, pre and after school care benefits (tax credit), vouchers, extended maternity and paternity leave, flexible work / life balance, Finn (2010). This is allowing families to spend more time together there by forming strong bonds, which is essential for a better relationship between family members. The stronger the relationship the more family became a haven in this heartless world. The family is a social institution. Due to diversity, different cultures have different concepts of family values. Same families can be oppressive (oppress individual development), restrictive, inhibitive and repressive. This can lead to families masking undercurrents and patterns of abuse, violence and potentially exploitation. Finn (2010) states that majority of abuse is within family unit and close relatives. Hence for the abused people family might not be a haven. An example of abuse by family is baby P incident (whereby a little boy lost his life through abuse by family members and extended family members). Baby Ps abuse occurrence and pattern was masked by the same family members who abused him, therefore family was not a haven for baby P. More often abused people sometimes become anti-social because of their lake of trust and also often became withdrawn such that they are un-productive. Abused people may often confide in people outside the family unit and are most like to beco me estranged to their biological family and they will forge relationship with people who they will consider as family. They often get support from outside the family unit. The will make family of choice based on friendship and this family of choice might be their haven in the heartless world, Lasch (1977). Support from family members differ between same -sex and opposite sex couple. The research by Kurdeck (2001) found that gays and lesbians received very little support from their families of origin as compared to the heterosexual couples, Bravewoman et al (1998). For the gays and lesbians who do not have support from their family of origin family is not a haven of. They might face the pressure from society and family to conform to what is traditional. This can lead to unrest, but family is a haven for the gays and lesbians who have strong family ties. Lawrence Stone (1977) argued that, the new family ideal prescribed domestic privacy and strong emotional attachments between spouses and between parents and children. Todays life style has lead to longevity, meaning parent and child relationship can last fifty years or more. Family remains a central attachment in most peoples lives, thereby family acting as a haven in this heartless world. Summary The change in the perception of family in recent times is through people choosing a family life in whatever shape or form and that people still desire a family life and family is still a required lifestyle option for the majority of people, Finn (2010). Therefore there will always be a variation in family units. Families will come in different shape and sizes and such differentiation is expected. So family will vary from time to time and place to place. For the majority of people the family is a haven in this heartless world, for family is a source of great joy and warmth. Whatever your particular family situation it will have tremendous influence upon your childrens happiness, development and future. A strong relationship with extended families can be just as rewarding as close ties inside the nuclear family. However building those bonds inside the extended family can be a little more difficult because, obviously everyone does not live under the same roof. For young children, living in a big family can be a lot of fun. The traditional family will continue to exist along other alternative family and everyone has a right to choose which family they belong too and the one that suit their situation and circumstances. Hence family life in whatever chosen shape is still the desired and required lifestyle option for the majority of people.

Seventh Heaven :: Alice Hoffman Magical Realism Essays

Seventh Heaven Seventh Heaven by Alice Hoffman was published by G.P. Putnam's Sons in 1991. Many characteristics of magical realism were expressed in an excerpt from this novel. From reading this, I have learnt that magic appears to me as being real. My comprehending of this novel was more because or realism. Alice Hoffman's attitude in this book seemed to be that she set it as an example of magical realism and she made the readers curious about what was going to happen next. Hoffman made this book enjoyable so that readers would want to read this book. She had a good attitude toward what she was writing about and how the book was presented. The book consisted of many magical elements. Some of the magical elements in this book were that the crow in Mrs. Olivera's chimney might find a pack of matches, rub them the wrong way, and poof up goes the house in flames (17). I feel that this is something that would never happen. I think it is impossible for a crow to light a match and catch a house on fire. Another magical element was the fact that no one in the neighborhood could tell the houses apart when they were first built and carve out of the potato farms. (10). I don't think that many people would get confused about what house was theirs and what block that it was on. Everyone should know what is theirs. Realistic elements in this book stood out better than the magical elements because I felt that most of the book seemed like everyday life. Realistic elements were that the guys in the neighborhood wanted to get together and renovate Mrs. Olivera's house and to sell it to someone instead of it setting there looking run down (18-19). I think that guys in the community would fix a house to try to help the neighborhood look nice and to keep people from getting hurt. The purpose of the magical elements is to keep the reader tuned into the book. The author tries her best to make the reader experience textualization. She does this by making the book have plenty of realistic elements and throwing in magical element to make the experience different. Magical elements stood out to me the most were when the women in the neighborhood made a big deal about Nora being divorced and how Donna Durgin had never met a divorced person in her entire life (82). Seventh Heaven :: Alice Hoffman Magical Realism Essays Seventh Heaven Seventh Heaven by Alice Hoffman was published by G.P. Putnam's Sons in 1991. Many characteristics of magical realism were expressed in an excerpt from this novel. From reading this, I have learnt that magic appears to me as being real. My comprehending of this novel was more because or realism. Alice Hoffman's attitude in this book seemed to be that she set it as an example of magical realism and she made the readers curious about what was going to happen next. Hoffman made this book enjoyable so that readers would want to read this book. She had a good attitude toward what she was writing about and how the book was presented. The book consisted of many magical elements. Some of the magical elements in this book were that the crow in Mrs. Olivera's chimney might find a pack of matches, rub them the wrong way, and poof up goes the house in flames (17). I feel that this is something that would never happen. I think it is impossible for a crow to light a match and catch a house on fire. Another magical element was the fact that no one in the neighborhood could tell the houses apart when they were first built and carve out of the potato farms. (10). I don't think that many people would get confused about what house was theirs and what block that it was on. Everyone should know what is theirs. Realistic elements in this book stood out better than the magical elements because I felt that most of the book seemed like everyday life. Realistic elements were that the guys in the neighborhood wanted to get together and renovate Mrs. Olivera's house and to sell it to someone instead of it setting there looking run down (18-19). I think that guys in the community would fix a house to try to help the neighborhood look nice and to keep people from getting hurt. The purpose of the magical elements is to keep the reader tuned into the book. The author tries her best to make the reader experience textualization. She does this by making the book have plenty of realistic elements and throwing in magical element to make the experience different. Magical elements stood out to me the most were when the women in the neighborhood made a big deal about Nora being divorced and how Donna Durgin had never met a divorced person in her entire life (82).

Care of Elderly Persons in American and Hispanic Culture

In the United states, particularly in its more urbanized regions, there is a clear discrimination against the elderly, particularly in its more urbanized regions. This ageism is also apparent in mass media. In American movies, for instance, elderly persons in â€Å"homes† (homes for the aged) are a frequent sight. The nursing home is a potent demonstration of American society's cultural attitude towards its elderly.In American culture, it is acceptable for a child to talk in a straightforward and frank manner to elderly people, sometimes to the point of rudeness. However, most Hispanic children are taught to talk to elders with respect and reverence.Elders often have the last say in the household. From early childhood, Hispanic children are taught to respect older persons, because respect for elders connotes respect for oneself.Today many elderly persons in the United States are isolated from their families, although this kind of treatment of the elderly in the United States w as not always so. In the 17th and 18th centuries, the elderly used to be more respected, perhaps also because of the low life expectancy in those times, so that there were only very few elderly people, making their contributions to society much more valuable.However, the increased life expectancy of modern United States society has dramatically increased the proportion of the elderly in modern societies such as in America, which in turn has led to the increasing irrelevance of the elderly from an economic and practical view. Now American culture reveres youth, but at the same time looks down on old age.Many aging persons in America grow old and become afraid that their family will eventually put them in a home, and that they will have no choice but to concede. Between 17 to 20 percent of all deaths in the United States happen in nursing homes (although this number would be higher if not for the common practice of moving nursing home residents to the hospital almost immediately befor e death.In American culture, independence is highly valued, sometimes to the point of alienation. In contrast, Hispanic culture may be seen by Americans as more â€Å"clingy.† Hispanic culture is very family oriented. Hispanics typically have strong family ties and are more likely to support extended family members, including their elderly.Hispanic culture emphasizes respect for elders, and this is reflected in how their elders are treated. Many Hispanic households have the traditional structure of housing three generations. Many elderly Hispanics are also poor and cannot live independently, but they are welcomed to stay in their children's homes.However, with increasing urbanization, even Hispanic society is increasingly going the route of Americans in this regard.Nursing homes have a â€Å"presence† in American culture that is lacking in Hispanic culture; most Hispanic people assume that they would eventually be taking care of their elderly parents. This is not to sa y that ageism is exclusive to America.It is true that in most cultures a form of ageism exists, but in many Asian and Hispanic countries, this is more of a positive ageism, where elders are given more respect and are listened to and revered (although this seems to be changing with the rise of urbanization worldwide).

Patients With Neurologic Dysfunction Health And Social Care Essay

Keshin Himura is a 42-year-old patient diagnosed with pituitary prolactinoma, a benign tumour that arises from the pituitary secretory organ, ensuing in a lessening in libido and powerlessness and increased milk production of the chest. The patient besides has ailments of concern and sleepiness and the presence of ocular field alterations and papilledema preoperatively.What postoperative attention should the nurse provide the patient?The nurse should supply the undermentioned postoperative attention to the patient: Evaluate joke physiological reaction and ability to get down Offer semisoft diet Perform neurologic cheques Monitor critical marks Maintain neurologic flow chart Reorient patient when necessary to individual, clip and topographic point If with ictuss, carefully proctor and and protect from hurt Check motor map at intervals Assess for centripetal perturbations Evaluate addressThe patient ‘s household asks the nurse how will they cognize that the jobs the patient had before surgery have stopped ; what is the nurse ‘s best response?Through observation, carry oning series of trial that will be provided by the doctor ( e.g. MRI, CT scans ) to look into if the tumours are already diminished, because presence of tumour will still suppress the marks and symptoms of the upset. The primary aim of the surgical intercession is to take or destruct the full tumour without increasing the neurologic shortage and to alleviate symptoms by decompression. And if there is no grounds of tumour, the normal degrees of endocrine would return in usual, the patient will no longer see the symptoms of the disease.What direction schemes should the nurse anticipate will be ordered to care for diabetes insipidus if it occurs?The aim of the therapy is: To replace ADH To guarantee equal fluid replacing To rectify the implicit in intracranial job ( pituitary prolactinoma ) A unstable want trial is ordered by the doctor to corroborate for the diagnosing of diabetes insipidus by: keep backing fluids by 8 to 12 hours Patient is weighed often during the trial Plasma and urine osmolality surveies are performed at the beginning and terminal of the trial. The inability to increase the specific gravitation and osmolality of the piss is an indicant of Diabetes insipidus Pharmacologic Therapy Administer Desmopressin ( DDAVP ) intranasally, BID as ordered Nursing Management Establish baseline informations ( weight, BP, I/O spiel ) , Monitor BP and weight often throughout therapy and study sudden alterations to physician Monitor I/O and specific gravitation and serum osmolality as ordered If patient has Coronary arteria disease, utilize this drug with cautiousness as this drug causes vasoconstriction Avoid concentrated fluids as this addition piss volumeWhat discharge instructions should the nurse provide the patient and household?Most patients will pass at least one dark in the intensive attention unit ( ICU ) and so typically 2 or 3 extra darks on a regular ( non-ICU ) ward after surgery The patient will probably hold some incisional hurting and mild to chair concern for which he will be given pain medicine. A CT scan or MRI will be ordered before discharge Ask patient to return 2-3weeks after surgery Inform patient to return 2-3months after 1st check-up Inform household to watch out for marks of DI ( intense thirst, frequent micturition ) . Refer instantlyManagement of Patients with Neurologic DysfunctionA ACase Study 2Hiehachi Nishima, a 22-year-old patient who weighs 150 lbs, nowadayss to the exigency section ( ED ) after being thrown from his Equus caballus and go throughing out for a few proceedingss ; he regained consciousness. The friend who was besides siting a Equus caballus called the squad. The patient presented with a GCS of 15, and the neuro test was within normal bounds ( WNL ) . The ED physician wrote the orders for a CT scan without contrast of the caput, CBC, nephritic and metabolic profile, PT, PTT, and INR. The nurse sent the labs and had the IV of NS at keep-open rate per ED protocol hanging. The nurse was expecting radiology to name for the patient to travel for the CT when the patient had an epileptic call, became unconscious, stiffened his full organic structure, and so had violent musculus contractions. The re spirations are really shallow, and the lips and nail bed became bluish. The patient lost control of vesica and intestine. The patient spot his lingua and blood is coming from the oral cavity. The radiology section calls and is ready for the patient.List in the right order the actions that should be taken by the nurse.Before and during a ictus, the patient is assessed and the undermentioned points are documented: The fortunes before the ictus The happening of aura The first thing the patient does in the ictus – where motions or stiffness Begins, conjugate regard place, place of caput The type of motions in the portion of the organic structure involved The countries of the organic structure involved The size of the students and whether the eyes are unfastened Whether the eyes or the caput are turned to one side The presence or absence of automatisms Incontinence of piss or stool Unconsciousness and its continuance Any obvious palsy or failing of weaponries or legs after the ictus Inability to talk after the ictus Motions at the terminal of the ictus Whether or non the patient slumbers or non afterwards Cognitive position after the ictus In add-on to supplying informations about the ictus, nursing attention is directed at forestalling hurt and back uping the patient non merely physically but besides psychologically. Consequences such as anxiousness, embarrassment, weariness, and depression can be lay waste toing to the patient. After the patient has a ictus, the nurse ‘s function is to document the events taking to and happening during and after the ictus to forestall complications.Explain what type of ictus the patient is holding, and depict the three stages of the patient ‘s ictus and the specific nursing attention for each phase.The patient had a tonic-clonic ( gran mal ) ictus. There are three stages viz. the aura, the quinine water and the clonic stage. In the aura stage is the premonition of an epileptic onslaught. It characterized by episodes of Deja vu or Jamais vu. The client may besides hold auditory, olfactory, or even ocular hallucinations, unnatural gustatory sensations, and prickling esthesiss. Physical symptoms include giddiness, concern, dizziness, sickness, numbness. Though in this instance, the client did non demo marks of the aura stage. *Nsg Mgt: Provide privateness and protect the patient from funny looker-ons Patients who have an aura may hold clip to seek a safe, private topographic point Ease the patient to the floor, if possible Loosen constricting vesture Push aside any furniture that may wound the patient during a ictus If an aura precedes the ictus, insert an unwritten air passage to cut down the possibility of the patient ‘s seize with teething the lingua The following is the tonic stage. It is normally the shortest portion of the ictus, enduring non more than merely a few seconds. In this instance, it is when the patient had an epileptic call, became unconscious and stiffened his full organic structure. *Nsg Mgt: Protect the caput with a tablet to forestall hurt from striking a difficult surface If the patient is in bed, take pillows and raise side tracks The last is the clonic stage. It is when the client had violent musculus contractions, really shallow respirations, the lips and nail beds became bluish, lost control of vesica and intestine and seize with teeth his lingua. *Nsg Mgt: Do non try to prise unfastened jaws that are clenched in a cramp or to infix anything. Broken dentition and hurt to the lips and lingua may ensue from such an action. No effort should be made to keep the patient during the ictus because muscular contractions are strong and restraint can do hurt If possible, place the patient on one side with caput flexed frontward, which allows the lingua to fall frontward and facilitates drainage of spit and mucous secretion. If suction is available, utilize if necessary to clear secernments.The ED physician orders the followers: Valium ( Valium ) 10 milligram every 10 to 15 proceedingss prn for ictuss ( maximal dosage of 30 milligram ) . Once seizures halt, administer Dilantin ( diphenylhydantoin ) 10 mg/kg IVPB. ECG monitoring continuously, VS, GCS, neuro cheques every 30 proceedingss. Explain what meds the nurse should supply, in what order, and how they should be administered.The nurse should supply Valium injection ( Valium ) 10 milligram IM PRN every 10 to 15 mins. ( max 30mg ) for his ictus to relief the musculus cramp. For the long term alleviation, administer Dilantin ( diphenylhydantoin ) 10 mg/kg IVPB lading dose STAT, one time the ictuss stop. Dilantin ( diphenylhydantoin ) is an anti-seizure medicine ( anticonvulsant ) , parti cularly to forestall tonic-clonic ( expansive mal ) ictuss and complex partial ictuss ( psychomotor ictuss ) .We use piggyback to administrate different IV drugs at different times. Dilantin can do crossness to the venas and can do serious tissue and/or nervus harm if it infiltrates. So we should administrate it with normal saline. Pull up the drugs in a syringe and attach it to the piggyback port on the IV tube cassette, which is run at the same time with the primary IV fluid ( normal saline ) . Run it easy and maintain an oculus on the ECG proctor. This ECG monitoring should be done continuously to assist place irregular pulses. For the critical marks, Glasgow coma graduated table and neuro V/S, it should be look into every 30 proceedingss to supply dependable, nonsubjective manner of entering the witting province of a individual for initial every bit good as subsequent appraisal.Group AssignmentsHave each member reference nursing direction related to caring for an unconscious pat ient. Preventing Urinary Retention Palpate vesica at intervals to find whether urinary keeping is present If patient is non invalidating, an indwelling catheter is inserted and connected to a closed drainage system as ordered Observe for febrility and cloudy piss for infection Observe the country around the urethral opening for any drainage Equally shortly as consciousness is regained, a bladder-training plan initiated Promote Bowel Function Assess venters for dilatation by listening for intestine sounds ( irregular rippling sounds should be heard every 5-20sec ) Measuring the girth of the venters with a tape step. Proctor for the figure and consistence of intestine motions Perform rectal scrutiny for marks of faecal impaction as ordered. Stool softeners may be prescribed and can be administered with tubing eatings Glycerin suppository may be indicated to ease intestine emptying May require clyster every other twenty-four hours to empty lower colon Maintain Skin and Joint Integrity Monitor force per unit area countries for possible ulcerations Establish a regular agenda of turning to avoid force per unit area, which can do breakdown and mortification of the tegument This provides kinaesthetic, proprioceptive and vestibular stimulation Avoid dragging and drawing the patient up in the bed, because this creates a shearing force and clash on the tegument surface Maintain correct organic structure place Passive exercising of the appendages is of import to forestall contractures Splints or foam boots may be used to forestall foot bead and force per unit area of bedding on the toes Trochanter axial rotations may be used to back up the hip articulations and maintain the legs in proper alliance Supplying Mouth Care Inspect oral cavity for waterlessness, redness, and crusting Cleanse and rinse oral cavity carefully to take secernments and crusts and to maintain the mucose membranes moist Administer petroleum jelly on the lips to forestall drying, checking and incrustations. If patient has an endotracheal tubing, the tubing should be moved to the opposite side of the oral cavity and lips Perform everyday tooth brushing every 8hrs to diminish ventilator-associated pneumonia Keeping the Airway Promote the caput of bed to 30 grades to forestall aspiration. Topographic point the client in sidelong place to let the jaw and lingua to fall frontward to advance drainage of secernments. Suction for secernments as needed Maintain unwritten hygiene Chest physical therapy and postural drainage to advance pneumonic hygiene Auscultate the patient ‘s thorax every 8 hours to measure for any deviated breath sounds. If the patient has a mechanical ventilator, maintain the patency of the endotracheal tubing or tracheotomy, supply unwritten attention, monitor arterial blood gas measurings and keeping ventilator scenes. Protecting the Patient Raise side rails up every bit ever to forestall hurt Ensure the patient ‘s self-respect during altered LOC, talking to the client during nursing attention activities. Keeping Fluid Balance and Managing Nutritional Needs Assess tegument turgor and mucose membrane for waterlessness Monitor for consumption and end product and find the demands for catheterisation Continuing Corneal Integrity Patient ‘s eyes may be cleansed with cotton balls moistened with unfertile normal saline to take any discharge. For unreal cryings ( prescription by the doctor ) , may present every 2 hours. Keeping Body Temperature The environment can be adjusted ( depending on the patient ‘s status ) to advance normal organic structure temperature. If body temperature is elevated, a minimal sum of bedclothes is used. For geriatric patients and does n't hold any elevated temperature, a heater environment is needed. Supplying Centripetal Stimulation Communicate with patient, and promote the household members to make it so. Orient the patient to clip, day of the month, and topographic point one time for every 8 hours. Have each group member develop a nursing diagnosing related to a patient with an altered degree of consciousness. Identify possible jobs and complications related to the nursing diagnosing.Nursing DiagnosisPotential Problems and Complications1. Ineffective airway clearance related to altered degree of consciousness Aspiration 2. Hazard for impaired tegument unity related to prolonged stationariness Bed sore Pressure ulceration 3. Impaired Urinary riddance: keeping related to impairment in neurologic detection and control Bladder dilatation Infection Formation of rocks 4. Impaired tissue unity of cornea related to decrease or remove corneal physiological reaction Periorbital hydrops Ulcers Corneal scratchs 5. Deficient fluid volume related to inability to take fluids by oral cavity Dehydration Cerebral hydrops 6. Interrupted household processes related to alterations in the cognitive and physical position of their loved 1 Crisis Severe anxiousness, denial, choler, compunction, heartache, and rapprochement 7. Hazard for hurt related to decreased LOC Fallss 8. Ineffective thermoregulation related to damage to hypothalamic centre Hyperthermia 9. Impaired unwritten mucose membrane related to talk external respiration, absence of guttural physiological reaction and altered fluid intake Dryness Inflammation Crusting 10. Bowel incontinency related to impairment neurologic detection and control Abdominal dilatation Diarrhea Frequent loose stools As a group, place possible complications that may originate in the postoperative stage of cranial surgery. Increased ICP Monro-Kellie hypothesis provinces that, because of the limited infinite for enlargement within the skull, an addition in any one of the constituents causes a alteration in the volume of the others.because encephalon tissue has limited infinite to spread out, compensation typically is accomplished by displacing or switching CSF, increasing the soaking up or decreasing the production of CSF, or diminishing intellectual volume ensuing to an addition ICP. Bleeding and hypovolaemic daze An accretion of blood under the bone flap ( epidural, subdural, or intracerebral haematoma ) may present a menace to life. A coagulum must be suspected in any patient who does non rouse as expected or whose conditions deteriorates. Fluid and electrolyte perturbations IV solutions and blood constituent therapy for patients with intracranial conditions must be administered easy. If they are administered excessively quickly, they can increase ICP. The measure of fluids administered may be restricted to minimise the possibility of intellectual hydrops. Infection The hazard of infection is great when ICP is monitored with an intraventricular catheter and increases with the continuance of the monitoring. Seizures Underliing cause is an electrical perturbation in the nervus cells in one subdivision of the encephalon. An unnatural motor, sensory, autonomic, or physical activity that consequence from sudden inordinate discharge from intellectual nerve cells. Have each group member place a type of ictus. Describe clinical manifestations, diagnosing, and intervention of each.Generalized Seizures:This are seizures that chiefly involves electrical charges in the whole encephalon, its clinical manifestations includes loss of consciousness for a short or long period of clip.Types of SeizureClinical Manifestationâ€Å" Grand Mal † or Generalized tonic-clonicUnconsciousness Paroxysms Muscle rigidnessAbsenceShort loss of unconsciousnessMyoclonicIrregular jerked meat motionsClonicInsistent jerked meat motionsTonicMuscle stiffness and rigidnessAtonicLoss of musculus tone Diagnosis: Physical scrutiny peculiarly neurologic scrutiny Electroencephalogram For impermanent and reversible causes of ictuss: Blood chemical science Blood sugar Complete Blood Count Cerebrospinal fluid analysis Kidney map trial Liver map trials Trial to find the cause and location: EEG ( electroencephalograph ) to mensurate the electrical activity in the encephalon Head CT or MRI scan Lumbar puncture-spinal pat Treatment: When a ictus occurs, protect the individual from hurt, make the environment safe for you and the patient. Protect the patient ‘s caput Loosen tight vesture Put the patient into a side-lying place if vomiting occurs Stay with patient until she or he is to the full recovered Monitor the patient ‘s critical marks Medicines such as antiepileptics may be given as ordered to cut down the figure of future ictuss. The DO N'T ‘s During Seizures: Do n't keep the patient Do n't put anything between the patient ‘s dentition during a ictus Do n't travel the patient unless he or she is in danger or near something risky Do n't seek to halt the patient from convulsing.Partial Seizures:This are seizures that chiefly involves electrical charges in one portion of the encephalon, its clinical manifestations includes unnatural musculus motions, automatisms, unnatural esthesiss, hallucinations, sickness, perspiration, dilated students, rapid bosom rate and pulsation rate, alterations in vision.Types of SeizureClinical ManifestationSimple( consciousness is integral ) Jerky motions Muscle rigidness, cramp Unusual esthesis Memory and emotional perturbationComplex( consciousness is impaired ) Automatisms: lip slap, masticating, walking and insistent involuntary and coordinated motions Diagnosis: CT scan Magnetic resonance imaging Electroencephalogram EEG-video recordings Treatment: Vagus Nerve Stimulation in which a little battery is implanted in the chest wall which will plan to present short explosions of energy to the encephalon. Corpus Callosotomy is a type of surgical intercession that will cut the connexions between the two sides of the encephalon that will forestall bead attacks.. Multiple sub-pial transection which is a surgical technique that will cut a certain connexion between nervus cells.