Language, Identity and Acceptance in Wright’s Autobiography, Black Boy :: Wright Black Boy Essays

Language, Identity and Acceptance in Wright’s Autobiography, Black Boy African American writer James Baldwin said that, â€Å" Language is the most vivid and crucial key to identity: It reveals the private, and connects, or divorces one from the larger public or communal identity.† The stories in Black Boy are original and captivating. It identifies Richard Wright as a writer and a person of incredible substance. The language identifies the books time frame and era. And most importantly shows Richard’s journey through social and personal acceptance. Writing this book the language used was important to Wright. It gave him the power to convey his life story to the reader. Without it his stories could have never been published and his popularity amongst readers would be nonexistent. This book is based on a factual claim. It might be biased because we read only his side of the story. It might also include a bit of fiction but his command of the words and the imagery speaks otherwise. Richard Wright infuses the book with personal stories from his experiences in life. We as the reader might find some of the stories in the book hard to believe but his use of evidence and historical facts lead the reader to deem that this book is in fact the life of Richard Wright. His use of words and his grasp of the English language allows the reader to identify with his victories and his defeats. Using the pathos appeal Wright enables the reader to be part of the story of his life. â€Å" I would hurl words into the darkness for an echo, and if an echo sounded, no matter how faintly, I would send other words to tell, to march, to fight, to create a sense of hunger of life that gnaws in us all, to keep alive in our hearts a sense of the inexpressibly human. Language also identifies the books era. Reading the book one can tell that it was a time of hostility between races. The term â€Å" white man† comes up many times. It is as if Wright is reluctant to use he names of particular people even when he does know them. â€Å" White man† obtain a singular feeling from the reader. Even though most of the time there is usually more than one man he refers to them as the white man. The blacks on the other hand are â€Å"us† or â€Å"ours† .

Our Visual Culture in Arts and Crafts Essay

Ours is a culture of spectacle, which is to say that we thrive on visual entertainment of all sorts (Mulvey, 2002). We love films, television, drama, ads, in addition to the art of the land expressed in art galleries throughout the world. We thrive on these visual entertainers, and so there is a huge industry involved in marketing visual thrills and using them on the people for a purpose. Visual culture is meant to influence the individual that enjoys it, so therefore advertisements add meaning to our lives by informing us about what is new and what is not in the all-important market of goods and services. Experts study the impact of their visual messages to people. In return for their efforts they have come to know that people are influenced by visual messages even if these messages last only a few seconds in an advertisement; and that the mind is like a long-term-memory photographer that may somehow retain everything in the subconscious part of itself. Henceforth are born marketing campaigns selling billions worth of goods and services to humanity. Films, too, cost billions of dollars. They, too, rely on the visual medium to make a living. What is more, films are seen as a necessity of modern life in terms of the culture that they allow ordinary individuals to relate to. Yes, films allow us to feel like we are a part of the culture they represent. Through films, humanity can connect. Connection and communication are the only essential facets of the media (that is, all mediums of communication). Visual art is special not only because it is related to the five senses of humanity; but also because it reveals a culture of science and imagination that we are invited to feel a part of. Every medium of communication is important in the modern world. The Internet plays an important part in the visual culture by bringing the world of visual arts into our homes. It shows us museums as well as the movies, icons of cultural visuals. Visual culture should be a subject of the communication field, as well as psychology and sociology, besides the fine arts. There are various understandings about what constitutes the visual culture, and so there are experts in visual arts that say paintings and similar art forms must not be open to visual-cultural interpretations. In other words, paintings are best left to the human soul to understand and judge (Kamhi, 2004). Visual culture is about quietude, just as much as it is about flourishing through science fiction movies such as the Matrix, and science fiction tv series like the Star Trek. These visual arts and crafts rely on the power of â€Å"effects† (which should also be read as special â€Å"affects†) seeing that these movies rely on the visual medium to produce pictures in the subconscious mind that would hopefully leave a lasting impression on the mind, depending on how powerful the visual message is. A very good medium of communication, such as the Internet encyclopedia by the name of Wikipedia, has a bad reputation because it is written by many experts and people do not always know whether those experts are real or not. Such reality conflicts are also obvious in the visual arts. Star Trek relied on special effects to make a lasting impression on the audience and also by its use of excessive, unique clothes and implements that never appeared real to the audience. We know that Star Wars is a lie, and yet we enjoy it. The reason appears to be that we enjoy unreal kinds of entertainment because they open the mind, allowing us to imagine things through the mind’s eye. All mediums of communication are open to competition and comparisons. Wikipedia may be compared to the Open Course Ware of MIT, for example, because many people find the encyclopedia useful. Wikipedia’s definition for â€Å"visual culture† appears very professional, concrete, correct and real: Visual culture is a field of study that generally includes some combination of cultural tudies, art history, and anthropology, by focusing on aspects of culture that rely on visual images. Among cultural studies theorists working with contemporary culture, this often overlaps with film studies and the study of television, although it can also include video game studies, comics, traditional artistic media, advertising, the Internet and any other medium that has a crucial visual component (â€Å"Visual Culture,† 2007). The above is actually just a part of the definition of the important culture of spectacle. Our generation of men will have literature about our visual culture in the days to come. Earlier generations of humanity did not perhaps have the kind of riches in visual culture that our generation possesses. We have excessive tv and movies that earlier generations did not have because they had not managed to make optimal use of electricity as well as scientific brains. This, indeed, is an important part of the definition of ‘our visual culture. ’ Like Wikipedia, there are visual means of communication that are rejected by certain kinds of people. In the Middle East, for example, it is considered a bad thing to enjoy Western television with girls kissing, beach babes, etc. And so, certain types of visual arts are not acceptable to particular groups of society. To put it another way, no visual culture or any other medium of communication can perhaps fully satisfy all people at the same time. Perhaps only nature can satisfy all people. Nature is an extraordinary feast to the eyes – a free form of visual art available for all and acceptable to all. Besides, nature could be compared to the films we watch and the photography we admire on the covers of golf magazines. Nature is represented by rivers, streams, oceans, mountains, lakes, green spaces, etc. What is a better feast to the eyes? We next explore how and why the visual culture of science fiction movies and tv shows is a visual form of entertainment. A viewer of both Star Trek and the Matrix may believe that one is better than the other, or that none of these visual entertainers are truly entertaining. In order to understand science fiction, it is necessary to know something about the science behind the phenomena being investigated in the film. Day after Tomorrow was a film that explored the possibility of an ice age suddenly hitting humanity when it’s time for global warming to show its true colors. It was a science fiction movie, and yet it was not an excellent representation of visual culture because the director(s) did not pay attention to good cutting/editing of the film. Similarly, Hitchhiker’s Guide to the Galaxy is a famous name, a movie that cannot truly be understood unless one has read a book by the name of Guide to Hitchhiker’s Guide to the Galaxy. Tom Cruise’s episode of the Matrix, on the other hand – a movie about the most handsome man losing his face after he had been in a dream machine – is more interesting because it is filmed beautifully. Beauty is a universal language, and so a viewer does not have to know the ‘secret beyond matter’ to understand the science behind the movie. It was not important to understand the science in this case because beauty was caught on tape. Both Cruise and his girlfriend in the movie are breathtakingly beautiful, and so the movie is a definite hit – one that would leave a lasting impression on the viewer. Then there was an Arnold Matrix with a similar story, and of course, the true Matrix with Keanu Reeves. Both were action-packed, and telling a different story about afterlife, or another life. Yet, Keanu and Arnold were not as handsome as Cruise perhaps, and the latter’s movie left a longer lasting effect on the girls as opposed to the boys. Keanu’s version was a hit especially among boys, although girls enjoyed eyeballing Keanu very much. Genders have differing interpretations of the visual arts. So therefore, it can be imagined that boys enjoyed Keanu’s Matrix more than the girls because boys like violent films – a sociological question to ponder, with reference to the visuals of the culture. The best visual culture of arts and films is made by the minds that work on lasting impression. Our visual culture has the capacity to change and shape people, which is why foreigners refer to Americanization as the standardization/globalization of American films and television shows available in all countries abroad. Those who enjoy Americanization and take comfort in a culture that appears tolerant and good to them, are lovers of the visual arts of the West. For them, movies such as the Matrix (all episodes) and shows such as Star Trek are culture definers. The world understands us better because of our visual arts. Thus, it is very important to concentrate on what we want others to know about us in the future. It is essential to ask: Is our visual culture going to be admired by our descendants? It would be easiest for future generations to understand us by looking at our visual arts preserved in museums, homes, books, and the on the World Wide Web. Improved technology has also made it possible to preserve films and television shows in good packaging and systems such as the DVD’s. We are providing improved quality of visual arts to our culture at all times. What we keep in our records will be taught in schools of tomorrow. Hence, it is very important to leave good messages behind, and in good quality films that easily leave a lasting impression on people. Science is a defining attribute of the modern era. What we leave behind in visual arts in terms of science fiction movies has got to reveal that we, as a society of the twenty first century, were thoroughly drenched in scientific facts and we were exploring the universe by the use of imagination. The latter generation of the twentieth century was already exploring time relativity in Back to the Future series. Besides time traveling, our society is interested in a lot more scientific details, such as volcanoes, trips to Mars, etc. Mission to Mars is a new film of bad-to-good quality, perhaps as well filmed as old Back to the Future series. Matrix is perhaps the most modern specimen. It is an unforgettable story, after all. I believe that Matrix is the paragon of modern science fiction films. But then, this is just a single person’s opinion. What society thinks collectively about a visual arts project is generally considered more acceptable an interpretation of the art form, although this argument may not necessarily be true. In the case of Matrix and its contemporary films, the fact is nevertheless that the episodes about life versus dreams were more important for the general public to enjoy in the era of quantum mechanics. Films such as Back to the Future were good in their own time – right after Einstein. Science is constantly moving ahead, and so we may expect science fiction films to improve further. Damien Broderick’s (2000) â€Å"Tearing Toward the Spike† is truly a work of art as far as the imagination of the author is concerned. Mankind is seeking knowledge at greater depths than ever before. What is the future of humanity? – Broderick’s paper answers the question with various creative scenarios, including a future that resembles a black hole, and a â€Å"‘dinosaur-killer’ asteroid† that strikes humanity in the middle of the day. At the same time, the author invites the reader to imagine any number of scenarios on his or her own. As a matter of fact, Broderick’s paper is an invitation for the reader’s very own stream of consciousness to burst forth. It is a mind opener, as well as an attempt to analyze unlimited possibilities. It is very easy to make a visual art treat using the imagination of the paper. Even so, it may very well be that the evolutionists would read the paper differently from the creationists. This is because the creationists are typically those that would like to remain compatible with their belief that the world would end when the Day of Judgment begins. On the other hand, there is no restriction on the faculty of the imagination in both the theory of creation and that of evolution. Both God and chance allow for unlimited possibilities, after all. What is more, in visual arts, it is best to have competitions of quality as well as theory. If evolutionists and creationists both make science fiction movies, they would most probably add to the spice of life in the modern world of spectacle. A variety of different visual treats is definitely good for the human soul. Besides, the greatest thing about visual arts is that it is possible for anybody in the world to join in and become an artist and/or an entertainer/performer. The quality of the visual medium must be taken care of. At the same time, since visual culture refers specifically to â€Å"culture,† it is an unforgettable truth about our world that certain forms of art are still not acceptable to all people of the world. In Iran, Buddha’s sculptures would be rejected. Similarly, Star Trek may be more entertaining than Matrix depending on what we are concentrating on in our appreciation of the craft of moviemaking. Various perspectives are involved in understanding visual culture. The fact remains, still, that our visual culture is a necessity in our lives, and must be good at all costs.

The Arab Israeli Conflict Of The Middle East Essay

The Arab Israeli conflict was a state of political tension and military disputes between the Arab countries and Israel. Though there are many factors contributing to the conflict such as Arab and Jewish nationalism and religion, Britain played an essential role in the conflict. Through Britain double dealing during the First World War and its misguided strategies and conflicting promises to Arab and Jewish ignited the conflict between Arab and Jews in the Middle East. Britain’s involvement started at the outbreak of war. Britain already had an interest in the Middle East, controlling Egypt and key points at the southern end of the Arabian Peninsula. This control was essential to safeguard the Suez Canal and the route to India which was Britain’s most valued colony. Britain felt that with the stalemate in Europe it was essential to widen the conflict. Britain constructed a complex strategy to undermine the central powers. The British saw the Middle East and the Arabs as an ally, the only hope of success in the war. An idea to tempt the Arabs into a revolt against the ottomans and create a diversion which would tie down the central powers in the Middle East. The British high commissioner in Cairo, sir henry McMahon, negotiated that Hussein would provide a substantial Arab force against the ottomans in return for British support for Arab independence. By September 1918 Hussein and the British under General Allenby had defeated the Turks and entered Damascus. Hussein demandedShow MoreRelatedCauses Of The Arab-Israeli Conflict In The Middle East1820 Words   |  8 PagesIntroduction The Arab-Israeli conflicts in the Middle East have been an on-going issue since the establishment of Israel in 1948. The primary cause of the fighting between Arab-Israeli is the rejection of Israel exists in the Middle East. The first known outburst of Arab-Israeli conflict occurred in 1948. The United Nations stepped in to ensure peace in the Middle East, but that peace ended in 1967 when Gamal Abdel Nasser, the Egyptian President, instigated another war, with the intent to annihilateRead More The Arab-Israeli Conflict: Protecting Democracy in the Middle East3988 Words   |  16 Pagesrenew the spirit of cooperation and harmony in the Middle East. It is a task of mammoth proportions, rife with possibilities for failure, but one which is the responsibility of any government that is to be taken seriously by the international community to undertake. The peace that Israel seeks is often hampered by those who claim that the violence and unrest in the region is solely their fault. Howev er, what people will not tell you is what blame the Arab nations hold for destroying any viability in theRead MoreArab-Israeli Conflicts between 1948 and 19731227 Words   |  5 Pagesperiod of 1948 and 1973 there was quite a bit of animosity and conflict between the Arab world and Israeli’s. This was caused by a struggle for land in the state of what was known as Palestine but to many it is now known as Israel. This conflict in the Middle East caused many wars between Israel and its surrounding Arab states. At the same time both USA and the USSR were trying to spread their ideologies and get a foothold in the Middle East because of strategic position, they would have access to theRead MoreIslamic and Middle East World Conflicts1048 Words   |  4 Pagescurrent conflict in the Middle East and Islamic world stands as the biggest constraint to peace in the region? Discuss with reference to at least two conflicts. Historically, there have been many problems in the Middle East due to foreign occupation. Middle East has always been hot and it is still hot. However, there seems to be no end to the fire. There have been a lot of peace talk in the region, but the conflicts still is still unresolved. In this paper, I will discuss the top three conflicts inRead MoreArab Israeli Conflict 883 Words   |  4 Pages1.1 WHAT IS THE ARAB ISRAELI CONFLICT? The Arab-Israeli conflict is a hotly contested issue both in the Middle East and the broader global community.1 The modern conflict is essentially a dispute over the area known up until 1948 as Palestine, which is considered holy to all three major monotheistic religions.2 The primary parties in the conflict are Israeli (formerly Zionist) Jews and Palestinian Arabs (who are predominately Muslim).3 It is one of the unresolved problems bequeathed to the regionRead MoreArab Israeli Conflict Between Arab Nations And Israel1508 Words   |  7 PagesArab-Israeli Conflict The Arab-Israeli conflict refers to the political tension and military conflicts amongst certain Arab nations and Israel. The conflict began as a struggle over land, or the area now known as Palestine. This conflict began at the end of the nineteenth century with the rise of Zionism and Arab nationalism. Arab nationalism was a reaction response to Zionism in relation to this conflict. While the Arab nation initiated four wars, Israel defended itself and won each time. WhatRead MoreThe Arab-Israeli Conflict Essay1092 Words   |  5 Pages The Arab-Israeli conflict has been ongoing for many years and so far a peaceful solution to the violence has not been reached. The peace process aims to find a just, fair and lasting peace solution to the conflict in the Middle East. The USA in particular has been very active in looking for a peace solution. This is because Israel is their ally. There are several million Jews in the USA and many send money to support Israel. Also the Arabs used oil as a very successfulRead MoreSuper Power Involvement in the Middle East1401 Words   |  6 Pagessuperpowers, namely the USSR and US were in engaged in a war by proxy, which is very easy to identify if you analyze the conflicts in the Middle East from 1948 until, and including, the Yom Kippur War of 1978. The superpowers would employ tactics such as supplying their various ‘allies’ in the Middle East with weapons and finances which would afford them the ability to engage in the many conflicts that took place in that period such as the Suez Crisis, Six Day War and the Yom Kippur War. All of this was doneRead MoreThe Treaty of Camp David1874 Words   |  7 PagesDavid of 1978 a turning point in the History of Arab Israeli conflicts from confrontation to peace making? In considering the Arab Israeli conflicts there were many disputes issues and turning points in the 20th century. Wars broke out such as the 1948-1949 Arab Israeli war in order for Israeli state to emerge . Many other wars followed such as the Suez war the 6 day war all conflicts had major consequences. However the war that changed the Middle East for ever was the War of Yom Kippur. The consequenceRead MoreThe Middle East And European Colonialism1700 Words   |  7 PagesIn the Middle East, European colonialism obliterated Arab sovereignty through its political and economic takeover. After gaining independence, the epicenter of perceived encroachment of Arab autonomy by the West was found in the Jewish state of Israel. Furthermore, the United States’ military support of Israel was also seen as an extension of colonialism. The colonial legacy of the British and the French occupations in the Middle East led to the belief that Israel was another imperial force that

Construction of an Islamic Center near Ground Zero Essay

The approval by the authorities in the United States to build an Islamic cultural center at a location near the spot of the September the eleventh attacks in America resulted in a controversy that touched on the basic rights of Americans protected by the first amendment of the American constitution. The Commission for Landmark Preservation in New York approved the construction of the Islamic center just two blocks away from the site of the World Trade Center because the two buildings torn apart to give way for the construction of the Islamic center were not very distinctive landmarks in Manhattan (Aljazeera). This decision proved to be divisive to the American public because it degenerated quickly into a national debate and a†¦show more content†¦It also touched on the unique history of the ground zero as well. For example, many Americans who opposed the construction of the Islamic center yet they are supporters of freedom of religion. For The people who lost their friends and relatives in the September, the 11 attacks, their wounds were still hurting in them and they could not tolerate anything close to the site because ground zero is the only cemetery they have for their dead relatives (Gladstone). The construction of a Muslim center close to the site represented an abomination to them because it symbolized the triumph of radical Islam in America (McFarland). This emotional dimension of opposing the construction of the mosque provides some validity in some of the arguments for the opponents of the construction of the mosque at a location near the site of the September the eleve nth attacks in lower Manhattan in New York. The first falsehood Perpetuated by the media that resulted in the explosive nature of the debate is that the Islamic center was being built at ground zero, the site of the former World Trade Center building. This was not correct because the area approved for construction of the Islamic center is a building that used to serve as a factory for Burlington coats two blocks away from the site of the World Trade Center (Gladstone). This was a lie perpetuated by the media and some people opposed to the construction of the Islamic center used to exploit and manipulate the emotionsShow MoreRelatedThe Ground Zero Mosque: An Insult to America Essay1040 Words   |  5 Pagesmillions forever and is once more a resurfacing issue. On this horrendous date in time, Islamic terrorists hijacked a pair of commercial airplanes and flew them into the Twin Towers, murdering thousands and causing millions in damage. Nearly a decade later, an Islamic religious gr oup named the Cordoba Initiative is stirring up more trouble and is planning to construct a mosque within only blocks away from ground zero itself. This is an extremely offensive and distasteful decision and should not be allowedRead MoreExploratory Report Example977 Words   |  4 PagesXXXXXXXXX Exploratory Report Stake-Holders: People/Entities The conflict of the Ground Zero mosque has become one of the fiercest religious based debates in recent years. One of the most influential men in the debate is Feisal Abdul Rauf. Rauf is the Imam (leader in prayer) at the current New York City mosque just a few blocks away from the proposed location of the future mosque. He has put a lot of time and money into this proposed mosque and does not plan to give up on it. Another key person inRead MoreOn September 11, 2001 Four Planes Were Hacked By A Group1228 Words   |  5 PagesOn September 11, 2001 four planes were hacked by a group of Islamic extremists called Al Qaeda which resulted in t he deaths of more than 3,000 people and almost 10,000 injuries. The first hijacked plane, Airlines Boeing 767 flew straight into the North Tower, at the famous World Trade Center that ultimately resulted in the immediate deaths of hundreds and leaving a large mass of people trapped at the top of the tower as the bottom had begun to slowly collapse onto itself. 20 minutes later, a littleRead MoreIslamophobia in America Essay2004 Words   |  9 PagesIslam culture especially escalated, in America, after the September 11th, 2001 attack on the three World Trade Centers in New York City, which is believed to have been under the supervision and orders of Islamic terrorists belonging to an infamous group known as Al-Qaeda. The mass media, as always, thrives on conflict. Due to the not-so-detailed reports and the misrepresentations of the Islamic culture, the mass media has caused Islamophobia to be of epidemic status world wide. IslamophobiaRead MoreThe Impact Of 9 / 11 On The United States Of America2100 Words   |  9 Pagesthis event including the powerful influence of Osama Bin Laden and al-Qaeda leading to the physical attacks on American centers of high office and iconic places in America. These chain of events that have changed US history and have had wide spread negative effects on the lives of those Americans. A few things I will address are Osama Bin Laden, al-Qaeda, 1993 world trade center bombing, 1983 and 1998 at-tacks against US embassy. The next is the approach and actual occurrence of the 9/11 terroristRead MoreThe September 11 2001 : Is It A Turning Point For American History?2077 Words   |  9 Pages D.C. At 8:46 a.m., five hijackers crashed American Airlines Flight 11 into the northern facade of the North Tower in the World Trade Center . At 9:03 a.m., United Airlines Flight 175 was crashed into the South Tower. 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In 1968, when the British Government announced its decision (reaffirmed in March 1971) to end the treaty relationships with the Persian Gulf sheikdoms, Bahrain joined theRead MoreBurj Khalifa4062 Words   |  17 PagesIntroduction Burj Khalifa Definition Claiming as the Tallest Structure in the World Breaking other World’s Record Location and its Environment Part of Downtown Dubai Downtown Dubai Evolution, Timeline and Construction Progress Construction Timeline Architecture and Design Construction Highlights Structure and Features Project Costs and Pricing People behind the Shadow of Burj Khalifa Conclusion Recommendation Bibliography ABSTRACT BURJ KHALIFA: THE WORLD’S TALLEST BUILDING INTRODUCTIONRead MoreHistory of Science Technology in Indian Subcontinent5042 Words   |  21 PagesCivilization (3000–1500 BCE). Housed at the National Museum, New Delhi. 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The seizure of a Pan Am jetliner at Karachi airport in September 1986 by suspected Abu Kidal terrorists, in which more than 20 people, mostly of Indian descent, died, was testimony

Attention Deficit Hyperactivity Disorder ( Adhd ) - 961 Words

ADHD can affect a Child’s Success in School Attention Deficit Hyperactivity Disorder (ADHD) has three primary symptoms of: inattention, hyperactivity, and impulsivity. Children with ADHD have difficulties in everyday life, whether it be in school or at home. They tend to be misunderstood by others. Children with ADHD have a much more difficult time learning than traditional students. Children with ADHD struggle to be successful in school. In most schools, the environment is not designed to meet the needs of students with ADHD. Jean Segal, Ph.D. is the Editor-in chief of Help Guide and a Sociologist Psychologist with 40 years of experience as an innovator within the fields of emotions, intelligence, holistic health, and relationships. Melinda Smith, MA is the senior editor of Help Guide. She has a degree in Psychology and over 15 years of experience as a health writer and editor. According to Jeanne Segal and Melinda Smith, â€Å"The classroom environment can be a challenging place for a child with ADD/ADHD. The very tasks these students find the most difficult-sitting still, listening quietly, concentrating-are the ones they are required to do all day long. Perhaps most frustrating of all is that most of these children want to be able to learn and behave like their unaffected peers. Neurological deficits, not unwillingness, keep kids with attention deficit disorder from learning in traditional ways.† Because AD HD bad negative effect, children with ADHD face encounter moreShow MoreRelatedAttention Deficit Hyperactivity Disorder ( Adhd )1710 Words   |  7 Pages Attention-deficit hyperactivity disorder or ADHD which is often referred to as childhood hyperactivity, it s a severe and chronic disorder for children. It is one of the most prevalent childhood disorders, and affects 3% to 5% of the school-age population. Boys outnumber girls three or more to one. Children with ADHD can experience many behavioral difficulties that often manifest in the form of inattention, being easily distracted, being impulsive, and hyperactivity. As a result, children withRead MoreAttention Deficit Hyperactivity Disorder ( Adhd )1744 Words   |  7 PagesI chose to research Attention-Deficit Hyperactivity Disorder, otherwise known as ADHD, in culture and child development for the following reasons. First, it is important as educators that we understand the difference between restlessness and Attention-Deficit Hyperactivity Disorder in children. Secondly, we must be conscious of the origins of ADHD, how to recognize it, the myths and prejudices against it, and kn ow the most appropriate intervention strategies. Educators must also realize that evenRead MoreAttention Deficit Hyperactivity Disorder ( Adhd )1002 Words   |  5 PagesAbstract There are many disorders that are first diagnosed whether it is during infancy, childhood or adolescence. The disorders range from intellectual disabilities, learning disabilities, communication disorders, all the way through to elimination disorders. Attention-deficit and disruptive disorders are the most common. All including AD/HD, conduct disorder, oppositional defiant disorder, and unspecified disruptive disorder. Attention deficit hyperactivity disorder is one of the most commonRead MoreAttention Deficit Hyperactivity Disorder ( Adhd )1495 Words   |  6 Pagesoccasionally forget to do their homework, get fidgety when they lose interest in an activity, or speak out of turn during class time. But inattentiveness, hyperactivity, and impulsivity are all signs of attention deficit hyperactivity disorder (ADHD). ADHD is a neuro-development disorder and can start as early as three years old throughout adulthood. People with ADHD have trouble focusing on tasks and activities, this c an have a negative impact on the individual in different ways. It can make the child feelRead MoreAttention Deficit / Hyperactivity Disorder ( Adhd )1699 Words   |  7 Pageshas had some difficulty sitting still, paying attention and even controlling impulsive behavior once or twice in our life. For some people, however, the problems that occur slim to none in our life occurs in the lives of theirs every day and interfere with every aspect of their life inclusive of home, academic, social and work. . The interaction of core ADHD symptoms with co-morbid problems and neuropsychological deï ¬ cits suggests that individuals with ADHD are likely to experience problems in academicRead MoreAttention Deficit Hyperactivity Disorder (ADHD)1259 Words   |  5 PagesAttention Deficit Hyperactivity Disorder (ADHD) is the most commonly found disorder in children in the United States. Statistics show that the male to female ratio for children with ADHD is eight to one. 4.4 million Children be tween the ages four to seventeen have diagnosed with ADHD (Cheng Tina L et al.). African American children are at a higher risk for having ADHD. Caucasian children are least likely to have ADHD. 2.5 million children receive medication for ADHD, but African American childrenRead MoreAttention Deficit Hyperactivity Disorder ( Adhd )1058 Words   |  5 Pagesfrom disorders such as Attention Deficit Hyperactivity Disorder (or ADHD/ADD.) While much is known about these disorders and how they affect the education of children, there are only a few known methods that consistently help an affected child focus and target in on what they need to learn. Medication for children With Attention Deficit (Hyperactivity) Disorder must be used as an aid to help the affected child to focus and comprehend information being presented to them. Children with Attention DeficitRead MoreAttention Deficit Hyperactivity Disorder ( Adhd )1552 Words   |  7 PagesATTENTION DEFICIT HYPERACTIVITY DISORDER Seth was a second grader at West Elementary. He constantly got reprimanded by his teachers for not paying attention in class. He could not understand the information given to him during the school day. He thought he was stupid and useless. But he was not. His parents got him tested by a doctor for ADHD. He is one of many kids in the United States who have been recognized as having it. Attention Deficit Hyperactivity Disorder is a major issue in the educationRead MoreAttention Deficit Hyperactivity Disorder ( Adhd )978 Words   |  4 Pagesin diagnoses of attention deficit hyperactivity disorder (ADHD) in children since the 21st century. Per the Centers for Disease Control and Prevention the increase has been seen as a difference from, â€Å"7.8% in 2003 to 9.5% in 2007 and to 11.0% in 2011† (p. 4). Many questions arise concerning why the numbers are on the rise, especially when boys are 7.6 percent more likely than girls to receive the diagnosis of ADHD. When should the line be drawn between a disorder, and hyperactivity that comes withRead MoreAttention Deficit Hyperactivity Disorder ( Adhd ) Essay700 Words   |  3 PagesWhat is ADHD? Attention Deficit Hyperactivity Disorder (ADHD) affects almost 10% of American children between 13 and 18 years old, as well as 4% of U.S. adults over 18. Only a licensed mental health professional can provide an ADHD diagnosis, after a thorough evaluation. ADHD has three primary characteristics: Inattention, hyperactivity and impulsivity. Inattentive: Are effortlessly distracted, fail to catch details, are forgetful, and regularly switch activities. Find it difficult to focus

Case Study †Appendicitis Free Essays

I. DEFINITION/PREVALENCE Acute disease of the GI tract may be caused by the pathogen itself or by a bacterial or other toxin. Acute inflammatory disorders such as appendicitis and peritonitis result from contamination of damaged or normally sterile tissue by a client’s own endogenous or resident bacteria (Lemone and Burke, 2008, page 766). We will write a custom essay sample on Case Study – Appendicitis or any similar topic only for you Order Now Appendicitis is the inflammation of the vermiform (wormlike) appendix; the appendix is a small fingerlike appendage about 10 cm (4 in) long, attached to the cecum just below the ileocecal valve, which is the beginning of the large intestine. It is usually located in the right iliac region, at an area designated as McBurney’s point. McBurney’s point, located midway between the umbilicus and the anterior iliac crest in the right lower quadrant. It is the usual site for localized pain and rebound tenderness due to appendicitis during later stages of appendicitis. The function of the appendix is not fully understood, although it regularly fills and empties digested food. Some scientists have recently proposed that the appendix may harbor and protect  bacteria  that are beneficial in the function of the human colon. Appendicitis  is the most common cause of acute inflammation in the right lower quadrant of the abdominal cavity. The lower quadrant pain is usually accompanied by a low-grade fever, nausea, and often vomiting. Loss of appetite is common. In up to 50% of presenting cases, local tenderness is elicited at Mc Burney’s point applied located at halfway between the umbilicus and the anterior spine of the Ilium. Rebound tenderness (ex. Production or intensification of pain when pressure is released) may be present. The extent of tenderness and muscle spasm and the existence of the constipation or diarrhea depend not so much on the severity of the appendiceal infection as on the location of the appendix. If the appendix curls around behind the cecum, pain and tenderness may be felt in the lumbar region. Rovsing’s sign may be elicited by palpating the left lower quadrant. If the appendix has ruptured, the pain become more diffuse, abdominal distention develops as a result of paralytic ileus, and the patient’s condition worsens. The disease is more prevalent in countries in which people consume a diet low in fiber and high in refined carbohydrates. It is the most common reason for emergency abdominal surgery, affecting 10% of the population. Although appendicitis affects a person at any age, the peak incidence is between the ages of 20 and 30 years old in which the vast majority of clients are most common in adolescents and young and slightly more common in males than females. About 7% of the population will have appendicitis at some time in their lives (Lemone and Burke, 2008 page 766). The major complication of appendicitis is perforation of the appendix, which can lead to peritonitis, abscess formation (collection of purulent material), or portal Pyle phlebitis, which is septic thrombosis of the portal vein caused by vegetative emboli that arise from septic intestines. Perforation generally occurs 24 hours after the onset of pain symptoms include a fever of 37. 7 degree Celsius or 100 degree Fahrenheit or greater, a toxic appearance and continued abdominal pain or tenderness. II. TYPES/CLASSIFICATION Appendicitis can be classified as simple, gangrenous, or perforated, depending on the stage of the process. In simple appendicitis, the appendix is inflamed but intact. When areas of tissue necrosis and microscopic perforations are present in the appendix, the disorder is called gangrenous appendicitis. A perforated appendix shows evidence of gross perforation and contamination of the peritoneal cavity (LeMone Burke, 2008 page 766). Peritonitis can be primary or secondary. Primary peritonitis is an acute bacterial infection that is not associated with perforated viscus, or organ. Bacterial infection is the usual cause and may be associated with an infection by the same organism somewhere else in the body, which reaches the peritoneum via the vascular system. Tuberculosis peritonitis, which originates from tuberculosis elsewhere in the body, is a type of primary peritonitis. Clients with alcoholic cirrhosis and ascites, in the absence of a perforated organ, often manifest peritonitis, which may be due to leakage of bacteria through the wall of the intestine. Secondary peritonitis is usually caused by bacterial invasion as a result of perforation, or rupture of an abdominal viscus. It can also result from severe chemical reactions to: pancreatic enzymes, digestive juices, or biles released into the peritoneal cavity (Gould Dyer, 2011). III. DEMOGRAPHIC PROFILE Patient’s name is Mr. Ruptured Acute Appendicitis, 24 years old, male, residing at 820 General Kalentong, Daang Bakal, Mandaluyong City. He is the second child among 3 siblings, a Roman Catholic, single, a 3rd year college Information Technology student. IV. FAMILY MEDICAL HISTORY (Family Genogram)COD: TB COD: TB A: 83 -S, -D A: 83 -S, -D Not Recalled Not Recalled c c A: 20 +S, +D A: 20 S, +D A: 24 +S, +D A: 24 +S, +D A: 27 -S, -D Skin allergy A: 27 -S, -D Skin allergy A: 42 +S, +D A: 42 +S, +D A: 64 +S, +D HPN, Stroke A: 64 +S, +D HPN, Stroke c c A: 46 -S, +D Asthma A: 46 -S, +D Asthma A: 51 -S, +D A: 51 -S, +D patient patient LEGEND: LEGEND: male male married married deceased male deceased male S- smoker D- drinker COD- cause of death S- smoker D- drinker COD- cause of death female female deceas ed female deceased female V. PAST MEDICAL HISTORY He was first hospitalized last 2006 due to dengue at the same hospital: Mandaluyong City Medical Center (MCMC). He has no other further illnesses except the typical fever, cough and cold. Other than that, he has no allergies, hypertension, or diabetes mellitus. VI. HISTORY OF PRESENT ILLNESS 1 week prior to admission patient experienced abdominal pain all over abdomen. He consulted at ER MCMC signed out AUPD (Acute Peptic Ulcer Disease) and was given Omeprazole HNBB (Buscopan). Whole abdominal ultrasound done and revealed tiny cholecystolethiasis. He was given Diclofenal and HNBB tab and eventually discharged. Few days prior to consultation, the patient still experienced abdominal pain. He consulted at Emergency Room and was opted for surgical intervention – EXPLORATORY LAPAROTOMY APPENDECTOMY under the service of Dr. Abram Del Valle, M. D. VII. GORDON’S PHYSICAL ASSESSMENT i. Health Maintenance – Perception Pattern Before admission: The patient used to smoke cigarette 3 sticks per day. And he also drinks alcohol daily specifically beer of more than 2 bottles per session. He was not using drugs and he has no allergies at all. During time of care: The patient is not smoking cigarette or drinking alcohol. ii. Nutritional – Metabolic Pattern Before admission: The patient was on a high protein diet because he was used to go to the gym 2-3 times a week. He was also taking vitamins (CENTRUM). He has normal appetite and has no difficulty swallowing. He usually eats 3 times a day (breakfast, lunch and dinner) and most of the time he also has his snacks. He also usually drinks 2-3 liters of water a day. e During time of care: The patient is on NPO (nothing per orem) for 5 days due to post-operative appendectomy and he was on his 2nd day of NPO status when we cared for him. He has also NGT lavage connected. ii. Elimination Pattern Before admission: The patient’s normal bowel movement was 3 BM a day and has no difficulty in bladder habits. His last bowel movement was last July 17, 2012. He usually urinates 6-7 times a day without difficulty. During time of care: The patient has absence of bowel movement and even flatus and has no bowel sounds upon auscultation. He has foley catheter and with urine output of 480 cc per shi ft. iv. Activity and Exercise Before admission: The patient could do his activities independently without assistance. He usually goes to gym 2-3 times a week. During time of care: The patient’s functional level or self-care ability level is 2 which mean he requires help from another person for assistance. v. Sleep/Rest Pattern Before admission: The patient usually sleeps at 4 or 5 am and wakes up at 8 or 9 am. He has no difficulty in sleeping and he feels rested after sleep. During time of care: The patient has regular sleeping habits. He sleeps at 10 am, wakes up at 6 am with uninterrupted sleep. vi. Cognitive – Perceptual Pattern Before admission: The patient was alert and coherent, has normal speech, with mild level of anxiety, has normal hearing, and with impaired vision of his left eye due to cataract. During time of care: The patient is alert and coherent. He has normal speech (Filipino as his spoken language), he has moderate level of anxiety, has normal hearing, and with impaired vision of his left eye due to cataract. He also complained of acute pain and described it as a cramping pain. Pain management (Tramadol) was given. vii. Role – Relationship Pattern Before admission: The patient was a student and single. His support system was his family, relatives friends. During time of care: The patient’s support system is his mother who is always at his bed side assisting him in whatever he needs. Upon asking his mother if she has any concerns regarding hospitalization, she said that she is more concern about the fast recovery of her son. viii. Sexuality – Reproductive System Before admission and during the time of care: The patient still didn’t have his testicular exam. ix. Coping – Stress Tolerance/Self – Perception/Self – Concept Pattern The patient’s major concern regarding his hospitalization is s all about self-care. Due to the contraptions attached to him, he cannot independently do his activities. His major loss was his stepfather when he died of kidney failure. His rated his outlook on future as 5, 1 being poor and 10 being very optimistic. He further explained why he rated 5 because he is not sure if when he finished college he can be able to find a job suited for him. x. Value – Belief Pattern Our patient is a Roman Catholic and he always goes to church every Sunday together with his family. VIII. GROWTH AND DEVELOPMENT DEVELOPMENTAL TASK| THEORIST| STATUS| Intimacy vs. Isolation * Develops commitments to others and to a life work (career)(Daniels, et. al. , 2010). | Erikson| The patient had a relationship with his opposite sex but he said that they just broke up a week before he was hospitalized due to some personal and private reasons. Currently, he is in 3rd year college, an IT student. | Genital * Emergence of sexual interests and development of relationships with potential sexual partners (Daniels, et. al. , 2010). | Freud| As what had written above, the patient had a relationship with his opposite sex but because of some reasons they decided to end up their relationship. Formal Operations * Able to see relationships and to reason in the abstract (Daniels, et. al. , 2010). | Piaget| He perceived that relationships (any kind of relationship) are important especially at his age. He can also reason out in an abstract way. He can express his opinions intellectually and precisely. | Early Adulthood * Select a partner, learn to live with a partner, s tart a family, manage a home, establish self in a career/occupation, assume civic responsibility, and become a part of a social group (Daniels, et. al. , 2010). Havighurst| According to our patient, he didn’t expected that something like that will happen to them (referring to his girlfriend). He was really expecting that they are really meant for each other and that she (his gf) will be his future wife. He is also establishing himself to a future career, that’s why he is studying in preparation for his future. During our time of care also, his ‘barkadas’ visited him and he said that they were his ‘tropa’. | Postconventional * Individual understands the morality of having democratically established laws (Daniels, et. al. , 2010). Kohlberg| Upon asking the patient if he is familiar with the democratically established laws in the Philippines, he immediately responded with a yes. He also said that these laws help us, Filipinos, to have safe and se cure country though there may come a time that we may experience something unexpectedly. | IX. PHYSICAL ASSESSMENT * Vital Signs TIME| Initial 8AM (07/24/12)| 10 AM| 12 NN| 8 AM (07/25/12)| 12 NN| Last 8AM(07/26/12)| T| 36. 3| 37. 3| 37. 4| 36. 4| 37. 3| 36| P| 83| 84| 71| 75| 81| 68| R| 23| 25| 21| 19| 19| 20| BP| 120/80| 120/80| 120/80| 120/80| 120/80| 110/80| Sequence: BY SYSTEMS NORMAL FINDINGS| BOOK FINDINGS| PATIENT FINDINGS| SIGNIFICANCE| I. NEUROLOCIGAL SYSTEM Alert and coherent; with normal body temperature of 36. 3 °C – 37. 6 °C| * Fever (usually 38 °C although hypothermia may be present w/ severe sepsis); chills * Thirst * Pain| * Complained of pain in the incision site (lower longitudinal midline of the abdomen)| Pain results from the increased pressure of fluid on the nerves, especially in enclosed areas, and by the local irritation of nerves by chemical mediators such as bradykinins (Gould, et al. 2011). | II. RESPIRATORY Normal respiration with a rate of 12-20 breaths per minute| * Tachypnea; shallow respirations| * RR: 23 bpm w/ shallow respiration| Acute pain usually initiates physiologic stress response with increased respiratory rate (Gould Dyer, 2011). | III. INTEGUMENTARY Pink or brown and in uniform color, no edema, no lesions, moistSkin temperature is normally warmIntact skinWhen pinched, skin springs back to previous state| * Dry lips and mucous membranes * Swollen tongue * Poor skin turgor| * Dry lips and mucous membranes * Skin turgor:3-5 seconds * Presence of surgical incision at lower longitudinal midline of the abdomen * Skin is warm to touch and is reddened| Dry mucous membrane and poor skin turgor are signs of dehydration (Gulanick, et al. 1994). Redness may indicate inflammation (Weber Kelly, 2007). Redness and warmth are caused by increased blood flow into the damaged area (Gould Dyer, 2011). | IV. CARDIOVASCULAR Normal pulse rate of 60-100 bpm| * Tachycardia * Diaphoresis * Pallor * Hypotension * Tissue edema| * Pulse rate: 83 bpm| Acute pain usually initiates a physiologic stress response with increased heart rate (Gould Dyer, 2011). | V. MUSCOLOSKELETAL Ability to do Activities of Daily Living (ADL)| * Difficulty ambulating * Weakness| * Difficulty ambulating due to post-op condition * Weakness| Constant pain frequently affects daily activities and may become a primary focus in the life of an individual (Gould Dyer, 2011). | VI. GENITO-URINARY Normal urine output of 30cc/hrColor: Amber, transparent, clear| * Decreased urinary output * Dark color urine| * Dark color urine * Urine output: 480 mL/shift * Specific gravity: 1. 30| Decreasing output of concentrated urine with increasing specific gravity suggests dehydration/need for increased fluids (Doenges, et al. , 2006). | VII. GASTROINTESTINAL Abdominal skin may be paler than the general skin tone because this skin is so seldom exposed to the natural elementsAbdomen is free of lesions or rashesA series of intermittent, soft clicks and gurgles are heard at a rate of 5-30 per minuteNormally no tenderness or pain is elicited or reported by the clientNo rebound tenderness is presentAbdo men is non-tender and soft. There is no guarding| * Loss of appetite * Nausea vomiting(usually projectile) * Constipation of recent onset * Diarrhea(occasional) * Sudden, severe, generalized abdominal pain * Abdominal distention; rigidity * Decreased/absence of bowel sounds * Inability to pass stool/flatus * Muscle guarding (abdomen) * Psoas’ Sign (flexion of or pain on hyperextension of the hip due to contact between an inflammatory process the psoas muscle) * Obturator Sign (the internal rotation of the right leg with the leg flexed to 90 degrees at the hip and knee and a resultant tightening of the internal obturator muscle may ause abdominal discomfort) * Rovsing’s Sign (pressure on the left lower quadrant of the abdomen causes pain in the right lower quadrant) * Rebound tenderness (a sign of inflammation of the peritoneum in which pain is elicited by the sudden release of the fingertips pressing on the abdomen) | * Board-like abdomen * Sudden, severe, generalized abdominal pain * Absence of bowel sounds in all four quadrants * Absence of flatus/stool * Presence of surgical incision| Signs indicating the onset of peritonitis include a rigid â€Å"board-like† abdomen (Gould Dyer, 2011). Pain recurs as a steady, severe abdominal pain as peritonitis develops (Gould Dyer, 2011). Absence of bowel sounds may be associated with peritonitis or paralytic ileus (Weber Kelly, 2007). When inflammation persists, nerve conduction is impaired, and peristalsis decreases, leading to obstruction of the intestines (paralytic ileus) (Gould Dyer, 2011). | X. DIAGNOSTIC TESTS DIAGNOSTIC TEST| NORMAL| RESULT| SIGNIFICANCE| WHOLE ABDOMINAL ULTRASOUND (July 21, 2012) | The organs examined appear normal (Cosgrove, et al. , 2008). | Liver is not enlarged. It has homogenous echopattern with smooth border. The intrahepatic ducts are not dilated. No evident focal mass lesion seen. CD measures 3. 9mm. Gallbladder is normal in size and wall thickness. There are multiple tiny echogenic shadowing foci seen within the gallbladder lumen. Pancreas spleen are normal in size echopattern. No focal mass lesion seen. Both kidneys are normal in size echopattern. Right kidney measures 10. 1Ãâ€"4. 2Ãâ€"5. 46cm with cortical thickness of 1. 7cm while the left kidney measures 10. 5Ãâ€"4. 8Ãâ€"4. 1cm with thickness of 19cm. No evident caliectasis, lithiasis, seen bilaterally. Urinary bladder is unfilled. Impression:Tiny cholecystolithiasesNormal liver, pancreas, spleen, kidneys by UTZUnfilled urinary bladderNot dilated biliary tree | Abdominal ultrasound is the most effective test for diagnosing acute appendicitis (LeMone Burke, 2007). | HEMATOLOGY REPORT/COUNT (July 21, 2012)| RBC: 4. 2-5. 6 M/uLPlatelets: 150-400 x 10/LWBC: 3. 8-11. 0 K/mm3Hemoglobin: 135-180g/LHematocrit: 0. 45-0. 52DifferentialNeutrophils: 0. 50-0. 81Lymphocytes: 0. 14-0. 44Monocytes:0. 02-0. 06Eosinophils: 0. 01-0. 05Basophils:0. 00-0. 01| WBC Count: 12. 6 K/mm3RBC: 4. 1 M/uL (normal)Hematocrit: 0. 45 (normal)Hemoglobin: 153g/L (normal)Differential Count:Neutrophils 0. 90Lymphocytes 0. 10 (normal)| Elevated WBC is seen in acute infection (LeMone Burke, 2007). Neutrophils: elevated in bacterial infection (LeMone Burke, 2007). | URINALYSIS (July 21, 2012)| Color: Light straw to amber yellowAppearance: ClearOdor: AromaticpH: 4. 5-8. 0Specific gravity: 1. 005-1. 030Protein: 2-8mg/dLGl ucose: NegativeKetones: NegativeRBCs: RareWBCs: 3-4Casts: Occasional hyaline| Color: Dark YellowTransparency: TurbidUrine pH: 6. 0 Specific gravity: 1. 30Sugar: NegativeProtein: +4Microscopic examPus cells 4-6/HPFRBC 1-2/HPFCrystals: Amorphous Sulfate Moderate| A dark yellow to brownish color is seen with deficient fluid volume (LeMone Burke, 2007). Hazy or cloudy urine indicates bacteria, pus, RBCs, WBCs, phosphates, prostatic fluid spermatozoa, or urates (LeMone Burke, 2007). | CLINICAL CHEMISTRY (July 21, 2012)| Sodium (Na): 135-142 mmol/LPotassium (K): 3. 8-5 mmol/L| Sodium: 132 mmol/LPotassium: 4. 02 mmol/L| Sodium is decreased in SIADH vomiting (LeMone Burke, 2007). | XI. ANATOMY PHYSIOLOGY OF APPENDIX (LARGE INTESTINE) The large intestine, which is about 1. 5 m (5 ft) long and 6. 5 cm (2. 5 in. ) in diameter, extends from the ileum to the anus. It is attached to the posterior abdominal wall by its mesocolon, which is a double layer of peritoneum. Structurally, the four major regions of the large intestine are the cecum, colon, rectum, and anal canal. The opening from the ileum into the large intestine is guarded by a fold of mucous membrane called the ileocecal sphincter (valve), which allows materials from the small intestine to pass into the large intestine. Hanging inferior to the ileocecal valve is the cecum, a small pouch about 6 cm (2. 4 in. ) long. Attached to the cecum is a twisted, coiled tube, measuring about 8 cm (3 in. ) in length, called the appendix or vermiform appendix (vermiform = worm-shaped; appendix = appendage). The mesentery of the appendix, called the mesoappendix, attaches the appendix to the inferior part of the mesentery of the ileum. The open end of the cecum merges with a long tube called colon, which is divided into ascending, transverse, descending colon are retroperitoneal; the transverse and sigmoid colon ascends on the right side of the abdomen, reaches the inferior surface of the liver, and turns abruptly to the left to form the right colic (hepatic) flexure. The colon continues across the abdomen to the left side as the transverse colon. It curves beneath the inferior end of the spleen on the left side as the left colic (splentic) flexure and passes inferiorly to the level of the iliac crest as the descending colon. The sigmoid colon begins near the left iliac crest, projects medially to the midline, and terminates as the rectum at about the level of the third sacral vertebra. The rectum, the last 20 cm (8 in. ) of the GI tract, lies anterior to the sacrum and coccyx. The terminal 2-3 cm (1 in. ) of the rectum is called the anal canal. The mucous membrane of the anal canal is arranged longitudinal folds called anal columns that contain a network of arteries and veins. The opening of the anal canal to the exterior, called the anus, is guarded by an internal anal sphincter of smooth muscle (involuntary) and an external anal sphincter of the skeletal muscle (voluntary). Normally these sphincters keep the anus closed except during the elimination of feces (Tortora Derrickson, 2006). XII. PATHOPHYSIOLOGY NARRATIVE Appendicitis, inflammation of the vermiform appendix, is a common cause of acute abdominal pain. It is the most common reason for emergency abdominal surgery, affecting 10% of the population (Tierney et al. , 2005). Appendicitis can occur at any age, but is more common in adolescents and young adults and slightly more common in males than females (LeMone Burke, 2007). The development of appendicitis usually follows a pattern that correlates with the clinical signs, although variations may occur because of the altered location of the appendix or underlying factors (Gould Dyer, 2011). Obstruction of the proximal lumen of the appendix is apparent in most acutely inflamed appendices. The obstruction is often caused by fecalith, or hard mass of feces. Other obstructive causes include a calculus or stone, a foreign body, inflammation, a tumor, parasites (e. g. , pinworms), or edema of lymphoid tissue (LeMone Burke, 2007). Following obstruction, the appendix becomes distended with fluid secreted by its mucosa and microorganisms proliferate. Pressure within the lumen of the appendix increases, impairing its blood supply because blood vessels in the wall are compressed thus the appendiceal wall becomes inflamed and purulent exudate forms. Within 24 to 36 hours, the increasing congestion and pressure within the appendix leads to ischemia and necrosis of the wall, resulting in increased permeability. Bacteria and toxins escape through the wall into the surrounding are. This breakout of bacteria leads to abscess formation or localized peritonitis. An abscess may develop when the adjacent omentum temporarily walls off the inflamed area by adhering to the appendiceal surface. In some cases, the inflammation and pain subside temporarily but then recur. Localized infection or peritonitis develops around the appendix and may spread along the peritoneal membranes. Increasing pressure inside the appendix causes increased necrosis and gangrene in the wall (infection in necrotic tissue). The wall of the appendix appears blackish. The appendix ruptures or perforates, releasing its contents into the peritoneal cavity. This leads to generalized peritonitis and would lead to septicemia and into septic shock and will result to death (Gould Dyer, 2011). XIII. PATHOPHYSIOLOGY DIAGRAM Risk Factors Non-modifiable: * Age (Adolescents young adults) * Gender (Male) Modifiable: * Fecalith * Calculus/Stone * Foreign body * Inflammation * Tumor * Parasites Edema of lymphoid tissue Obstruction of the appendiceal lumen Obstruction of the appendiceal lumen Buildup of fluid inside the appendix Buildup of fluid inside the appendix Proliferation of microorganisms Proliferation of microorganisms Abdominal pain Abdominal pain Increased pressure within the lumen of appendix Increased pressure within the lumen of appendix Compression of blood vessels Compression of blo od vessels * Fever * Obturator Sign * Psoas Sign * Rovsing’s Sign * Rebound tenderness * Fever * Obturator Sign * Psoas Sign * Rovsing’s Sign * Rebound tenderness Decreased blood flow into the appendix Decreased blood flow into the appendix Inflammation of appendiceal wall Inflammation of appendiceal wall (July 21, 2012) Hematology Count * WBC count: 12. 6 K/mm * Neutrophils: 0. 90 Urinalysis * Transparency: turbid (July 21, 2012) Hematology Count * WBC count: 12. 6 K/mm * Neutrophils: 0. 90 Urinalysis * Transparency: turbid Ischemia necrosis of the wall Ischemia necrosis of the wall Increased permeability Increased permeability Bacteria and toxins escape through the wall Bacteria and toxins escape through the wall Abscess formation/localized bacterial peritonitis Abscess formation/localized bacterial peritonitis Proliferation of localized peritonitis around the appendix and peritoneal membranes Proliferation of localized peritonitis around the appendix and peritoneal membranes Increased pressure inside the appendix Increased pressure inside the appendix * Sudden, severe, generalized abdominal pain * Abdominal distention rigid â€Å"boardlike† abdomen * Absence of bowel sounds/(-) flatus/(-) BM (July 24, 2012) * Sudden, severe, generalized abdominal pain * Abdominal distention rigid â€Å"boardlike† abdomen * Absence of bowel sounds/(-) flatus/(-) BM July 24, 2012) Increased necrosis and gangrene in the wall Increased necrosis and gangrene in the wall Appendectomy with NGT lavage (July 22, 2012) Appendectomy with NGT lavage (July 22, 2012) Perforation of the appendix Perforation of the appendix Intestinal bacteria leak out into peritoneal cavity Intestinal bacteria leak out into peritoneal cavity * Low-grade fever leukocytosis * Tachycardia * Hypotension * Vomiting * Low-grade fever leukocytosis * Tachycardia * Hypotension * Vomiting Generalized peritonitis Generalized peritonitis XIV. NURSING PROCESS Problem #1: ABDOMINAL PAIN – July 24, 2012 * Subjective Cues: * â€Å"Nurse wait lang, ang sakit kasi parang nagcacramps,† patient verbalized while having a conversation with him. How does it feel like: Abdominal cramping Precipitating factor: â€Å"Kapag nililinisan pero kadalasan bigla-bigla na lang sumasakit† (â€Å"Whenever wound cleaning is performed but oftentimes it just suddenly happened†) Relieving factor: Pain reliever (but not all the time pain reliever is being given) Does it radiate to the other parts of the body (back, legs, chest, etc): No Duration of pain: â€Å"Paiba-iba din eh. Minsan sobrang tagal mga 2-3 minutes, minsan naman mga ilang Segundo lang† (â€Å"It differs, sometimes it’s too long (2-3 minutes) and sometimes it just happened for a second†) * Patient rated the pain as 8/10 where 0 signifies no pain and 10 signifies unbearable pain. * Objective Cues: * Facial grimace * Guarding of the incision site * Rigid (board-like) abdomen * Abdominal distention * Location of pain: Surgical site * RR: 25 bpm * Nursing Diagnosis Acute Pain related to inflammation of the tissues secondary to post-op surgical incision. Inflammation or nerve damage gives rise to changes in sensory processing at peripheral and central level with a resultant sensitization. In relation, prostaglandins are chemotactic substances drawing leukocytes to the inflamed tissue. It plays a vasoactive role; it is also a pain and fever inducer (Lemone and Burke, 2007). Acute Pain related to infection inflammation of the peritoneal membranes secondary to peritonitis The peritoneum consists of a large sterile expanse of highly vascular tissue that covers the viscera and lines of abdominal cavity. This peritoneal structure provides a mean of rapid dissemination of irritants or bacteria throughout the abdominal cavity. Abdominal distention is evident, and the typical rigid, board-like abdomen develops as reflex abdominal muscle spasm occurs in response to involvement of the parietal peritoneum (Gould Dyer, 2011). * Goal/NOC: Pain Control Outcomes Short Term: After 30 minutes of nursing intervention the patient will report a decrease in pain from pain scale of 8/10 to 4-5/10. Long Term: After 8 hours of nursing intervention the patient will demonstrate an understanding about the proper way of controlling pain as evidenced by proper splinting and deep breathing exercise and will report a decrease or most probably will be free from pain from pain scale of 4-5/10 to 1-2/10. * NIC: Pain Management Independent: * Assessed pain including its character, location, severity, and duration. Both preoperatively and postoperatively, the client’s pain provides important clues about the diagnosis and possible complications. Abdominal distention and acute inflammation contribute to the pain associated with peritonitis. Surgery further disrupts abdominal muscles and other tissues, causing pain (LeMone Burke, 2007). * Monitored vital signs every 2 hours. Vital Signs, especially respiratory rate (RR), are usually altered in acute pain. (Sparks and Taylor, 2005). * Kept the client at rest in semi-Fowler’s position. Gravity localizes inflammatory exudate into lower abdomen or pelvis, relieving abdominal tension, which is accentuated by supine position (Doenges et al. , 2006). * Provided diversional activities (texting, sound trip, etc). Refocuses attention, promotes relaxation, and may enhance coping abilities and diverts attention from pain (Doenges et al. , 2006). * Taught post-op health teaching (e. g. , proper splinting deep breathing exercises). The use of non-invasive pain relief measures can increase the release of endorphins and enhance the therapeutic effects of pain relief medications (LeMone Burke, 2007). * Encouraged early ambulation. Promotes normalization of organ function; stimulates peristalsis and passing of flatus, reducing abdominal discomfort (Doenges, et al. , 2006). Give hot and cold compress. Hot, moist compresses have a penetrating effect. The warm rushes blood to the affected area to promote healing. Cold compresses may reduce total edema and promote some numbing, thereby promoting comfort. (Doenges et al. , 2006). Dependent: * Administered analgesic as prescribed (TRAMADOL 50 mg/IV Q 8 ° x 3 doses) Time given: 8 AM. Post-operatively, analgesics are provided to maintain comfort and enhan ce mobility (LeMone Burke, 2007). * Kept on NPO. Decreases discomfort of early intestinal peristalsis and gastric irritation/vomiting (Doenges et al. 2006). * Evaluation Short Term: Goal partially met. After 30 minutes of nursing intervention the patient reported of a decrease in pain from a pain scale of 8/10 to 6/10 in which 4-5/10 was the expected outcome. Long Term: Goal met. After 8 hours of nursing intervention the patient displayed control of pain as evidence by deep breathing exercise and proper splinting. He also reported of a decrease in pain with a pain scale of 2/10 from 6/10. Pain reliever – TRAMADOL was given @ 8 am via IV. Problem #2: ABSENCE OF FLATUS– July 24, 2012 * Subjective Cues: â€Å"Nurse wait lang, ang sakit kasi parang nagcacramps (referring to abdominal cramping),† patient verbalized while having a conversation with him. * Pain scale of 8/10 * Objective Cues: * (-) Flatulence * (-) BM (Last BM was July 17, 2012) * Absence of bowel sou nds upon auscultation of all four quadrants * Nursing Diagnosis Dysfunctional gastrointestinal motility related to inflammatory process of peritonitis secondary to absence of flatulence. The inflammatory process of peritonitis often draws large amounts of fluid into the abdominal cavity and the bowel. In addition, peristaltic activity of the bowel is slowed or halted by the inflammation, causing paralytic ileus, impaired propulsion of forward movement of bowel contents (LeMone Burke, 2007). * Goal/NOC: Ambulation Outcomes Short Term: After 8 hours of nursing intervention the client will report/experience flatus and will understand and demonstrate the need for early ambulation following abdominal surgery. Long Term: After 2 days of nursing intervention the client will report/experience either flatus or bowel movement or both. * NIC: Impaction Management; Positioning Independent: * Assessed abdomen including all four quadrants noting character to determine increased or decreased in motility; Assessed for further abdominal tenderness auscultated for any abdominal sounds. To help identify the cause of the alteration and guide development of nursing intervention (Sabol Carlson, 2007). * Monitored and recorded (intake) and output every hour or 2 hours. Intake and output records provide valuable information about fluid volume status (LeMone Burke, 2007). * Encouraged early ambulation. Promotes normalization of organ function; stimulates peristalsis and passing of flatus, reducing abdominal discomfort (Doenges, et al. , 2006). * Assisted in moving from side to side or up in bed from time to time. Frequent repositioning helps in proper oxygenation and usually prevents complications like pressure ulcers, deep vein thrombosis, etc. (Gulanick, et. al. , 1994). Dependent: * Administered antacid as ordered (RANITIDINE 50g/IV Q 12 °. Antacids either directly neutralize acidity, increasing the  pH, or reversibly reduce or block the secretion of acid by gastric cells to reduce acidity in the stomach (Gabriely, et al. 2008). * Evaluation Short Term: Goal partially met. After 8 hours of nursing intervention the patient didn’t experience flatus or even bowel movement but was able to have an understanding with regards to early ambulation as evidenced by letting his mother assist him in moving up in bed going to the chair but refused to walk because of complaint of ha ving a lot of contraptions attached to him which causes him to have difficulty in moving. Long Term: Goal met. After 3 days of nursing intervention the patient reported of a flatus for 3 times. Problem #3: RISK FOR DEHYDRATION – July 24, 2012 * Subjective Cue: * â€Å"Nanghihina na ako kasi limang araw ako hindi pwede kumain pati tubig bawal din kaya nagnunuyo na yung labi ko,† as verbalized by the patient. * Objective Cues: * NPO for 5 days * Dry mucous membrane * Dry lips * Capillary refill= 2 seconds * Skin turgor= 3-5 seconds * Urine output/shift= 480 mL * Urine color: Dark Yellow * Urine specific gravity: 1. 030 (Normal value: 1. 005-1. 030) * Absence of bowel sounds of all the four quadrants * (-) Flatus, (-) BM * BP: 120/80 mmHg * PP: 83 bpm * Nursing Diagnosis Risk for deficient fluid volume related to postoperative restriction secondary to NPO for 5 days Inflammation of the peritoneum with sequestration fluid and NPO status can lead to dehydration and electrolyte imbalance (Doenges, et al. , 2008). * Goal/NOC: Knowledge: Treatment Regimen; Hydration; Oral Hygiene; Tissue Integrity: Skin Mucous Membranes Outcomes Short Term: After 30 minutes of nursing intervention patient will have an understanding with regards to maintaining fluid balance as evidenced by willingness of following the prescribed regimen given by the medical staffs. Long Term: After 3 days of nursing intervention the patient will be able to maintain adequate fluid balance as evidenced by moist mucous membrane, good skin turgor, stable vital signs, and individually adequate urine output. * NIC: Fluid Management; Fluid Monitoring; Vital Signs Monitoring Independent: * Monitored BP Pulse. Variations help identify fluctuating intravascular volumes, or changes in vital signs associated with immune response to inflammation (Doenges, et al. , 2006). * Inspected mucous membranes; assessed skin turgor and capillary refill. Indicators of adequacy of peripheral circulation and cellular hydration (Doenges, et al. 2006). * Monitored intake and output; noted urine color/concentration, specific gravity. Decreasing urine output of concentrated urine with increasing specific gravity suggests dehydration/need for increased fluids (Doenges, et al. , 2006). * Auscultated bowel sounds. Noted passing of flatus, bowel movement. Indicators of return of peristalsis, readiness to begin oral intake (Doenges, et al. , 2006). * Provide clear liquids in small amounts when oral intake is resumed, and progress diet is tolerated. Reduces risk of gastric irritation/vomiting to minimize fluid loss (Doenges, et al. 2006). * Stressed the importance of having him on a NPO status and provided the necessary information with regards to his condition and the medications being administered (e. g. , IVF). It provides the patient a full understanding with regards to his condition thus encouraging him to participate and work hand in hand with the staff (Gulanick, et al. , 1994). * Gave frequent mouth care with special attention to protection of the lips. Dehydration results in drying and painful cracking of the lips and mouth (Doenges, et al. , 2006). Dependent: * Maintained gastric suction as indicated. Although not frequently needed, an NG tube may be inserted preoperatively and maintained in immediate postoperatively phase to decompress the bowel, promote intestinal rest, and prevent vomiting (Doenges, et al. , 2006). * Administered IV fluids (D5LR 1L x 8 ° or 30 gtts/min) and electrolytes (D5 Balanced Multiple Maintenance Solution w/ 5% dextrose 1L x 8 ° or 30 gtts/min). The peritoneum reacts to irritation/infection by producing large amounts of intestinal fluid, possibly reducing the circulating blood volume, resulting in dehydration and relative electrolyte imbalances (Doenges, et al. , 2006). * Evaluation Short Term: Goal met. After 30 minutes of nursing intervention the patient was able to have a full understanding with regards to maintaining fluid balance as evidenced by verbalizing, â€Å"So kaya pala hindi pa ako pwede kumain ngaun para maiwasan mairritate ang tiyan ko. † Long Term: Goal met. After 3 days of nursing intervention the patient was able to maintain adequate fluid balance as evidenced by moist mucous membrane, good skin turgor (1-2 seconds), stable vital signs (please see page __ ), and adequate urine output of 620 mL with an appearance of amber yellow. Problem #4: RISK FOR INFECTION – July 24, 2012 Subjective Cues: â€Å"Nurse, sobrang kailangan ba talaga ang paghuhugas ng kamay bago linisan o hawakan sugat niya? †, asked by the mother. * Objective Cues: * Post-operative condition – presence of surgical incision * Surgical site is warm to touch and reddened * Temp: 36. 3 °C * Nursing Diagnosis Risk for infection related to inadequate prim ary defenses secondary to post-operative surgical incision It is risk to be invaded by pathogens especially if surgical site is near at the perineal area, pathogens can also develop by poor personal hygiene and poor wound cleaning (Doenges, et al. 2006). * Goal/NOC: Risk Control (For Infection) Outcomes Short Term: After 30 minutes of nursing intervention the patient will be able to have partial understanding about infection control and will verbalize understanding of and willingness to follow up prescribed regimen. Long Term: After 3 days of  nursing intervention  the  patient will be free of sign and symptom r/t infection. * NIC: Incision Site Care; Infection Control; Wound Care Independent: * Monitored vital signs. Noted onset of fever, chills, diaphoresis, changes in mentation, and reports of increasing abdominal pain. Suggestive of presence of infection/developing sepsis, abscess, peritonitis (Doenges, et al. , 2006). * Inspected incision and dressings. Noted characteristics of drainage from wound/drains, presence of erythema. Provides for early detection of developing infectious process, and/or monitors resolution of preexisting peritonitis (Doenges, et al. , 2006). * Instructed proper hand washing. Practiced aseptic wound care. Reduces risk for infection (Doenges, et al. , 2006). * Encouraged adequate nutritional intake after the NPO status of the patient and when the patient is allowed to eat. Adequate intake of protein, Vitamin C and minerals is essential to promote tissue and wound healing (Sparks and Taylor, 2005). Dependent: * Administered antibiotics (CEFUROXIME 750mg TID Q 8 ° x 2 doses METRONIDAZOLE 500g/IV Q 8 ° x 2 doses) as ordered. Therapeutic antibiotics are given if the appendix is ruptured or abscessed or peritonitis has developed (Doenges, et al. , 2006). * Prepare for/assist with incision and drainage (ID) if indicated. May be necessary to drain contents of localized abscess (Doenges, et al. , 2006). * Evaluation Short Term: Goal met. After 30 minutes of nursing intervention the patient was able to have an understanding about infection control as evidenced by verbalizing, â€Å"Para maiwasan ang pagkaroon ng impeksyon kailangan kong maghugas ng kamay palagi at kinakailangan din ang araw-araw na paglilinis ng sugat ko kahit na sa tuwing nililinisan ito makirot sa pakiramdam. † Long Term: Goal met. After 3 days of  nursing intervention  the  patient was free of sign and symptom r/t infection. Problem #5: INABILITY TO PERFORM ACTIVITY/IES OF DAILY LIVING (ADL) – JULY 24, 2012 * Subjective Cues: â€Å"Hirap talaga ako gumalaw, maglakadlakad, o kahit man lang umupo dahil sa mga nakakabit na ito sa akin,† as verbalized by the patient. â€Å"Nakakapanghina pa kasi masakit nga yung tahi tapos madalas din nagcacramps ang tiyan ko,† he added. * Objective Cues: * Presence of surgical incision * Presence of contraptions (urinary catheter, NGT lavage IV fluid @ left hand) * Nursing Diagnosis Impaired physical mobility related to body weakness, presence of surgical incision, pain, presence of contraptions attached Physical immobility can be usually associated with post-operative conditions (Gulanick, et al. 1994). * Goal/NOC: Activity Tolerance Outcomes Short Term: After 30-45 minutes of nursing intervention the patient will be able to have a clear understanding with the use of identified techniques to enhance activity tolerance and to apply it as well as evidenced by participating in ROM exercises, lower leg ankle exercise, ambulation, or even moving up in bed. Long Term: After 2-3 days of nursing intervention the patient will be able to continually participate in a simple form of activity and will report an improvement with regards to his activities. * NIC: Exercise Therapy: Balance Independent: * Performed passive ROM exercises. ROM exercises and good body mechanics strengthen abdominal muscles and flexors of spine (Gulanick, et al. , 1994). * Encouraged lower leg and ankle exercises. Evaluated for edema, erythema of lower extremities, and calf pain or tenderness. These exercises stimulate venous return, decrease venous stasis, and reduce risk of thrombus formation (Gulanick, et al. , 1994). * Noted emotional and behavioral responses to immobility. Provided diversional activities. Forced immobility may heighten restlessness and irritability. The Cardiovascular System iframe class="wp-embedded-content" sandbox="allow-scripts" security="restricted" style="position: absolute; clip: rect(1px, 1px, 1px, 1px);" src="https://phdessay.com/the-cardiovascular-system-intrinsic-conduction-system/embed/#?secret=fKNLnNlg3O" data-secret="fKNLnNlg3O" width="500" height="282" title="#8220;The Cardiovascular System#8221; #8212; Free Essays - PhDessay.com" frameborder="0" marginwidth="0" marginheight="0" scrolling="no"/iframe Diversional activity aids in refocusing attention and enhances coping with actual and perceived limitations (Gulanick, et al. , 1994). * Assisted with activity, progressive ambulation, and therapeutic exercises. Activity depends on individual situation. It should begin as early as possible and usually progresses slowly, based on client tolerance (Gulanick, et al. , 1994). * Assisted in moving from side to side or up in bed from time to time. Frequent repositioning helps in proper oxygenation and usually prevents complications like pressure ulcers, deep vein thrombosis, etc. Gulanick, et al. , 1994). * Noted client reports of weakness, fatigue, pain and difficulty accomplishing tasks. Symptoms may be result of/or contribute to intolerance of activity (Gulanick, et al. , 1994). Dependent: * Administered pain medication (TRAMADOL 50 mg/IV Q 8 ° x 3 doses, time given: 8 AM) as prescribed and on a regular schedule. Client’s anticipation of pain can increase muscle tension. Medica tions can help relax the client, enhance comfort, and improve motivation to increase activity (Gulanick, et al. , 1994). * Evaluation Short Term: Goal partially met. After 30-45 minutes of nursing intervention the patient was able to have a clear understanding with the use of identified techniques to enhance activity tolerance and was able to use all of the techniques except for the ambulation. He refused to walk because he complained of pain whenever the catheter tube slipped into his legs. Long Term: Goal partially met. After 2-3 days of nursing intervention the patient was able to continually participate in all of the identified techniques but still refused to participate in ambulation. He also reported of an improvement with regards to his activities as evidence by his verbalization, â€Å"Medyo natotolerate ko na rin yung mga activities kahit pautay-utay muna. Hindi ko lang talaga muna kaya maglakad pero pagnaalis na siguro yung catheter baka kayanin ko na. † XV. BIBLIOGRAPHY * Cosgrove DO, Meire HB, Lim A, Eckersley RJ. (2008). Grainger Allisonn’s Diagnostic Radiology: A Textbook of Medical Imaging (5th edition). New York, NY: Churchill Livingstone * Doenges M. , Moorhouse, M. ; Murr, A. (2006). Nursing Care Plans Guidelines for Individualizing Client Care across the Life Span (7th Edition). F. A. Davis Company, Philadelphia * Doenges, M. , Moorhouse, M. ; Murr, A. (2006). Nurse’s Pocket Guide Diagnoses, Prioritized Interventions, and Rationales (11th Edition). F. A. Davis Company, Philadelphia * Gabriely I, Leu, J. P. , Barky, N. (2008). Clinical problem-solving, back to basics. New England Journal of Medicine * Gould, B. ; Dyer, R. (2011). Pathophysiology for the Health Professions (4th Edition). Saunders Elsevier Inc. * Gulanick, M. Klopp, A. , Galanes, S. , Gradishar, D. ; Puzas, M. (1994). Nursing Care Plans Nursing Diagnosis and Intervention (3rd Edition). Mosby-Year Book, Inc. * LeMone P. ; Burke, K. (2007). Principles of Medical-Surgical Nursing: Critical Thinking in Client Care (4th Edition). Pearson International Edition * LeMone P. ; Burke, K. (2008). Principles of Medical-Surgical Nursing: Critical Thinking in Client Care (5th Edition). Pearson Internation al Edition * Mosby’s Pocket Dictionary of Medicine, Nursing ; Allied Heath (4th Edition) 2002, Mosby Inc. Palma G. ; Oseda A. (2009). G;A Notes Clinical Pocket Guide for Medical and Allied Health Professionals (2nd edition). G;A Notes Publishing Co. , Philippines * Sabol, V. K. ; Carlson, K. K. (2007). Diarrhea: Applying research to bedside practice. AACN Advanced Critical Care * Tortora G. ; Derrickson B. (2006). Principles of Anatomy and Physiology 11th edition. Biological Sciences Textbooks, Inc. * Weber J. ; Kelley J. (2007). Health Assessment in Nursing (3rd Edition). Lippincott Williams ; Wilkins How to cite Case Study – Appendicitis, Free Case study samples

New Management Style and Policies

Question: Discuss about the Report for New Management Style and Policies. Answer: Executive summary This paper seeks to analyze the importance of adopting a new management style and policies by Nike after finding itself in a reputational crisis after the sweatshop scandal. For a large corporation such as Nike any scandal will definitely affect the perception and trust that the consumers of its products have. We will use qualitative analysis in this paper and also analyse the various initiatives that Nike has come up with to restore stakeholders confidence and use qualitative analysis in our methodology. Introduction NIKE, Inc., is a design company based Oregon, Nike is among the leading companies involved in design, manufacture, distribution and marketing of shoes , equipment and apparel for sporting and physical activities all over the world. Nike has subsidiaries such as Cole Haan, which is involved in manufacturing and distribution of luxury items such as handbags, shoes and coats another subsidiary is Converse Inc., which also is involved in the design of accessories and distribution of athletic footwear, apparel and accessories(Aras Crowther, 2009). There is also a subsidiary called Hurley International LLC, which designs apparel and accessories for action sports and youth lifestyle and Umbro Ltd., which is a leading football brand company based in the UK. This paper focuses on the the management style and unethical issues that Nike has been involved in and why. Research methodology The paper covers ethical and unethical practices that Nike Inc. has been involved in. Data collection will be from past literature about Nike as well as the graphs and financial results of Nike in previous years. The research uses qualitative analysis of data concerning Nike Inc. the data will be obtained from journals, Nikes financial statements to analyze Nikes policies as well as the measures that they have put in place for improving CSR in the regions that Nike operates in. as a result, data collection will not take a long time since all Nikes information can be easily accessed in various mediums such as the internet Ethical and enethical practices by Nike In 1992, Nike had developed a code of conduct and a year before the report, had signed its adherence to the Global Compact which was launched by the UN Secretary General, Kofi Annan. Following this agreement Nike agreed to respect principles such as freedom of association and protection of human rights. By joining this initiative, Nike acquired a commitment to both consumers and with international organizations(Carbasho, 2010). So when reports were issued that Nike had engaged in unethical issues there was a serious reputational crisis. This was the labor practices in Bangladesh known as the Sweartshop scandal. This showed not only the social impact of a multinational company in the countries where it stands, but also the high cost that may involve not closely monitor all activity of Nike operated. Consumers reacted and Nike had to get going to keep the credibility of your brand. As a textile leader Bright business career in the industry began in the seventies when its founder, Phil Knight, director devised a revolutionary new model of sneakers that caused a sensation among athletes. Soon, the firm managed to gain a foothold in the textile sector reaching sufficient capacity to expand its product offerings. The market share of Nike has grown steadily to achieve the level it enjoys today. Today, Nike is at the top of the sports equipment industry with approximately 37% market share. It is also the most production jobs have moved outside North America. According Setem, a federation specializing in issues of cooperation and development NGOs, this American company makes 99% of its production in the Third World. For many companies such as Nike, Developing nations are attractive for factories due to the fact that they offer labor that is cheap in an environment that has free social legislation. Big companies preffer to work with local factories in order to develop a certain product, the main reason behind this is so that they can leave everything relating to emplo yees, , salaries, and working conditions in the hands of native producers(Simpson Taylor, 2013). The inadequate transparency that describe this production method has caused Nikeand other large multinationals, be closely watched by the critical eye human rights organizations that are integrated into the anti-globalization movement. Nike social responsibility Consequently, Niketried to address the problem by arranging various activities improve social work and dignity in the countries the factories were set up. Nike also decided to launch a communication campaign whose goal was to get people and moreso consumers end up associating and relating the brand to values of justice, dignity and equality. Nikeformulated a new code of conduct which outlined their business principles which endorsed its serious improvement purposes: (DeWinter-Schmitt, 2007). Moreso, the code would ensure continuity of its commitment to social values and also required that all its working partners adhere to thes e code., Nike is mainly committed to: 1. Respecting employees rights , this includes the right to free association and collective bargaining. 2. Ensure minimal negative impact on the environment in general. 3. Guaranteeing a safe and healthy workplace to the workers. 4. Prioritize on the health and welfare of all workers. Suppliers and transparency Nike also gave a very significant when publishing the list with the names and locations of its 700 suppliers and subcontractors plants worldwide step.This activity had never done before in the history of the textile sector and has come to be a milestone that unions and labor rights associations consider decisive. Nike said in a statement that any damage caused by competition following the publication of this list would not harm the potential benefits that the brand could acquire(Business as usual? The mobilization of the anti-sweatshop movement and the social construction of corporate identity, 2008). The report coincided with the publication of the second CSR report. role management function and how it is impacted by politics and the social environment; Effective management aims at ensuring that the company achieves its set objectives. Management function is affected by politics and social environment, for example in the case of Nike, the company was forced to adopt a new style in which it would manufacture its products while ensuring that they adhere to safeguarding the workers interests including provision of a good working environment. The politics of how multinationals violate human rights in developing countries played a key role in ensuring that the management observes this aspect without negatively impacting on the bottom line(Ferrell, Fraedrich, Ferrell, 2010). Politics are behind the managements decision to change on the ways they were doing production. Also, Nikes management has promoted its plan of using soccer as a movement to enhance social change. This is inline with the managements focus on the social environment . For example, An example of a program the company partners with is Grassroots football . This is a community program that directly addresses an extreme social need through awareness especially in deveoping countries. The report notes that during the supplier audits supervised by inspectors of the FLA, four areas of breach of code of conduct were detected: freedom of association, wages, working hours and harassment in their factories. However, improvements were seen in the areas of child and environmental work(Simpson Taylor, 2013). Looking ahead, Nike confirmed in the document their commitment to advance in three different direction.It is increasingly common to find a responsible CSR within the structure of Nike or see codes of conduct drafted and enforceable also extensible to suppliers(Morsing Beckmann, 2006). Companies are becoming interested in training their employees on human rights as well as working on improving their systems testing and evaluation work in subcontracting factories. It is clear that these large multinational companies remain leaders in their respective areas despite having chosen a committed CSR policy.Already it is seen that the fact of adopting labor principles in line with the new social demands is not at odds with the pursuit of profit.Turning pointIn October 2000 a reporter for the BBC, Paul Kenyon, traveled to Cambodia to investigate working conditions in factories. Subsequently, a report with the Nike Gap No sweat name issued in which the harsh working conditions in subcontracted factories are kept awake by these companies(Morsing Beckmann, 2006). Children under fifteen years working in endless shifts and sexual abuse by officials of the factory were some of the practices that the BBC brought to light. The impact of the scandal made both Nikeand Gap closed down factories in Cambodia. As a result, the country lost 10 million dollars in contracts and hundreds of natives were fired from their job. Nikes Management Most of the texts have served as a basis for designing this course, they use different terms: policy, strategy and tactics. In general the term "politics" and its different meanings, set standards for the management of Nike and its behavior in the market, and sometimes cover a period of ten years(Ferrell, Fraedrich, Ferrell, 2010). Covering the objectives of Nike as well as methods for their behavior. Nike is a strong company when it comes to sustainable and innovative business (Sustainable Business and Innovation, ). This approach was integrated consistently with Nikes business strategies of , this was aimed at generating greater income for Nike and a more sustainable business model to cater for the communities, consumers, factory workers e.t.c. Politics and social environment determine how the management formulates their policies; this is because the policies should not go outside the policies of the government(Visser, 2011). The management style ensures that Sustainability and innovation is key to innovation and growth of the products as well as revenues of Nikeaccording to Mark Parker, CEO of NIKE, Inc. politics and social environment made Nike change how they were going to operate going forward in terms of Making the business sustainable and beneficial to customers, and have a low impact on environment, the factories workers will enjoy a good environment in production and employees growth and shareholders value who will be rewarded from the management style. The management report announces progress Nikeregarding the five-year objectives that were established in 2007. Nike has made considerable progress in many aspects, for example the execution of training in efficient management which is also known as (Lean Management) in factories that have been contracted, use of environmentally preferred products and reduction of waste and toxics and increasing in all high performance considered Design of materials.The management has also moved towards removing th e most challenging aspects of progress regarding the purpose of Nike, for example, the how to deal with overtime in contract involving the workers. Nike and management has the objectives in some to reduce the complexities which is a change in strategy in how to manage Nike(Micheletti, Fllesdal, Stolle, 2004). Efficient Management (Lean Management) and human resource management. One of the management strategies is to train factory workers with an aim of creating and implementing efficient manufacturing in Nike hence there is need to have a good human resource management programme.. efficient management decision-making principles are critical as they bring the worker closer through skills, understanding quality and teamwork understanding. References Aras, G. Crowther, D. (2009). Global perspectives on corporate governance and CSR. Farnham: Gower. Business as usual? The mobilization of the anti-sweatshop movement and the social construction of corporate identity. (2008). Carbasho, T. (2010). Nike. Santa Barbara, Calif.: Greenwood. CSR handbook. (2001). [Washington, D.C.]. DeWinter-Schmitt, R. (2007). Business as usual?. Ferrell, O., Fraedrich, J., Ferrell, L. (2010). Business ethics. Mason, OH: South-Western Cengage Learning. Green, S. Nike. Micheletti, M., Fllesdal, A., Stolle, D. (2004). Politics, products, and markets. New Brunswick, N.J.: Transaction Publishers. Morsing, M. Beckmann, S. (2006). Strategic CSR communication. Copenhagen: DJF Publishing. Reviews, C. (2013). Studyguide for business ethics 2009 update. [Place of publication not identified]: Cram101 Incorporated. Simpson, J. Taylor, J. (2013). Corporate governance, ethics, and CSR. London: Kogan Page. Sutherland, A. (2012). Nike. London: Wayland. Visser, W. (2011). The age of responsibility. Chichester, West Sussex: John Wiley Sons.