I will be developing a Ostomy care teaching plan for client L.J, who is 24 days post operative following a colostomy. This teaching plan will be specific to L.J, taking into account his learning needs, his motivation and readiness to learn and any environmental factors that might influence his learning. The teaching plan will also include visuals for the client, active participation and an evaluation of the goals.
While working with client L.J, I was able to complete a full assessment of the clients characteristics that could potentially affect his learning. L.J is a 77 year old male who is alert, oriented to person, place and time. L.J has a Chinese and Cantonese background and speaks very limited English. L.J is able to understand questions and information provided to him in small portions and done slow, giving him time to understand the information in English. L.J wears glasses to read, he is able to read in English, Chinese and Cantonese. He is also able to ask questions, and answers using broken up English. L.J is very attentive to his health, he uses a holistic approach for pain, such as meditation to overcome pain. He is a soft spoken and a calm individual, who also prefers a quite environment. L.J is ready to learn, he is very eager to understand any new information that involves his care. L.J is very much motivated by his wife and son, they encourage his interest in his care and assist in translating any information he is unable to correctly understand.
Before beginning the teaching plan, I have asked client L.J his understanding of the Ostomy and the care it needs. I have identified that there is insufficient knowledge, this will help me have a better understanding of how much information to include. Client L.J’s learning need is help him have a better understanding of what the ostomy is and how it works, how it is effected by his diet, how to care for the skin, what to look for and how to clean and change the ostomy bag. The goals for the teaching plan, is firstly for client L.J to understand what the ostomy is, how it works and how his diet affects it.
The goal is for the client to successfully explain this information back to me in easy English terms that will be used for him. The Second goal is for the client is to successfully demonstrate back to me how properly care for the skin and how to clean the bag after demonstrating it. I will spend approximately 30 minutes over two days, as to not overwhelm the client with too much information. The first day will be to provide information about the ostomy, also leaving reading material with him. The second day will be to demonstrate proper care and cleaning. I have selected a visual including demonstration and reading materials as my method for teachings, having him follow it in Chinese while I explain in English. To achieve my first goal I will use a pamphlet in both English and Chinese to provide the information.
I will begin first by showing him a picture of the type of surgery he had, explaining to him that it is called a colostomy, it is an opening in the abdomen and they brought up a little section of the colon to top of your skin. While pointing to it I will explain, the opening here is called a stoma, and it lets stool (poop) come out of the body. I will ask the client if they understood, and ask him to explain to me what colostomy is. Second I will explain to him that he will not have control over his bowel movements, his stool (poop) will be the normal or thick (formed) consistency. To avoid having very hard poop, being constipated, eat a lot of fibre, a lot of vegetables, fruits and whole wheat and drink a lot of water, this is important to be healthy. Again I will encourage immediate feedback, checking if he understood the information, asking him to explain it back to me.
At the end of the half of hour with him, I will once again ask if he understood all the information I provided for him in the pamphlet, and if he has any questions. I would encourage that he read the pamphlet, which includes more information on care, so that he would be ready for second day of teaching. Second day of teaching, will include a visual poster on caring for the stoma and a demonstration of changing and cleaning the pouch. I will have him seated on the edge of the bed facing the poster taped on the wall, which will include pictures of unhealthy skin, reddened, swelling labelled as BAD, and a healthy pink and moist skin labled as GOOD. I will ask him what he learned from the pamphlet, than I will begin explaining how to care for the skin stressing the importance of keeping the skin healthy. I will explain that the entire unit should be changed 4-7 days.
First I will show him what materials he needs to change the pouch, which include; a pouch, gauze or wipes, warm water, scissors, pen, measuring guide and a disposal bag. By pointing to the poster I will explain the first step is to remove the old colostomy bag and barrier skin around the stoma and throw it in the garbage. Each time you remove your skin barrier and pouch by starting at the top, gently peel the adhesive off the skin. Use your finger to push skin away from the pouch adhesive look carefully at the skin for swelling, redness or rash and pain, and the stoma should be red and moist which is GOOD. Clean the area around the stoma with warm water and dry very carefully. Client was able to understand and repeat back key terms to me while pointing to the poster.
Third step, measure stoma using the stoma measuring guide, choose the opening which is closest to the size of the stoma and trace that opening on the back of the cutting guide. Next cut the skin barrier being careful not to puncture the pouch. The skin barrier should fit around the stoma without touching it so that all skin will be protected. Centre the opening in the pouch over the stoma. Gently press the barrier to be sure it has made good contact with the skin. Lastly make sure to close off the bag. Since this is such a complex process, the client might not be able to successfully complete it the first time.
Therefore my goal will be reassessed; I will ask the client what he understood, and plan on another teaching session. I will make sure to leave samples of barrier cutting and fake stomas for the client to practice on. For my last teaching I will demonstrate how to clean the pouch, I will explain the bag should be changed when it is 1/3 full. It’s best to empty the bag before you eat because the stoma is less active. The pouch is made odour proof, but it has to be cleaned from the bottom with a squeeze bottle filled with water. I will instruct the client to demonstrate it back to me, repeating the process of opening and closing the pouch. Client will be able to successfully empty and clean his ostomy pouch independently next time.
While take into consideration client L.J’s learning style and language barrier, I believe that the learning method I have developed has been successful. By dividing up the teaching lessons into two different days, I believe that the client will be able to absorb and understand the information better. The long- term behavior change will be for the client to do change his ostomy bag independently and empty and clean his pouch. The teaching plan has been modified to give the client more practice changing the entire unit. The goal has not been fully met, the plan is for to be met before the client is discharged. However, overall plan has been successful .
Spain Vs. USA: Differences In Government And Political Systems
There are a multitude of political systems around the world today. Regardless of similarities, each has its own unique qualities. This paper will discuss the differences and similarities of the political systems and government of both the United States of America and Spain. First, a short analysis of each countries history will be provided. This will give some background to the political, emotional and economical state of each country. This will lead to how the governments and political systems are now.
Finally, there will be an analysis on the similarities and differences between both countries. The United States of America: History July 4th 1776 has been noted as one of the most imperative, if not the most, dates in the history of the United States of America. Marking its independence from Great Britain, it also was the beginning of the creation of a federal government initially comprised of 13 states. This would eventually grow to the 50 states the country is now made up of. The original document binding the thirteen states together is known as the Articles of Confederation.
Though it linked the previously known colonies together, it gave most of the young nations power to the individual states, leaving the national government extremely weak. The Founding Fathers decided to replace this document with one that would put more emphasis on the national government. The Constitution that was put into operation in 1789 called for these states to give up their sovereignty in order to form a central authority. Each state is required to submit themselves to this government. While the system is relatively organized and states are compliant to this now, initially there were problems.
Before the Constitution was ratified the original 13 states initially had more power than the federal government. They each kept individual powers such as foreign policy and trade negotiations. For some time, many believed that the states were the supreme authority and had the right to nullify acts made by the federal government. This created immense tensions among the state and federal levels. After the adaptation of the Constitution, tensions began to subdue. Federalism was put into place, clearly defining the roles of national and state governments.
Foreign relationships, declaration of war and the coining of money are all overseen by the national government while public health and safety, interstate trade, education and the ratification of the amendments are all under the state government. Each level has its own powers, but they also share some duties. These include the making and enforcement of laws, taxation and the borrowing of money. The United States of America: Civil War January 1861 sparked the beginning of a tumultuous time for the United States of America.
After Abraham Lincoln was named the 16th president of the young nation, South Carolina, along with six more states, left the union to form the Confederate States of America. Since the beginning of colonization, tensions were evident between the South and North states. The main issue concerning this secession, however, was that of slavery. Lincoln’s opposition to the advancement of slavery throughout the nation was the Confederation’s greatest concern. President Lincoln was adamant on avoiding warfare, but the Confederation had other plans. In April 1861, the attack on Fort Sumter officially started the Civil War.
South Carolina overtook the Fort, which snowballed into a national crisis. The Emancipation Proclamation of 1862 was a shout to the world that choosing a side in the Civil War was taking a stand on slavery. It stated that all slaves that resided in rebelling states would be set free. After four long years of fighting and national suffering, the Civil War finally ended with General Pope Lee’s and his Confederate troops surrender in April 1865. With the unconditional surrender of the South, the Union was able to welcome back all seceded state. Slavery was permanently outlawed.
Also, the Constitution was amended, giving blacks the right to vote and hold office. This resulted in a nation much more similar to what it is now. The United State of America: Political System The political system that runs the United States of America is a result of the Constitution, Amendments and the Civil War. As mentioned before, there are 50 states that help govern the nation along with the national government, referred to as the Federal Government. The Federal Government is comprised of three branches: Legislative Branch, Executive Branch and Judicial Branch.
These three branches were developed to satisfy the principle known as ‘separation of powers’. This is the idea that no one institution has too much power. This also means that no individual member can be more than one institution. The principle of ‘checks and balance’ also falls under this idea. Each branch has limited authority to act on its own. With that being said, each branch regulates the other two and vies-a-versa to a certain extent. The House of Representatives and the Senate make up the Legislative Branch. Together they make the laws of the nation.
There are two senates per state, meaning 100 senators in the Senate House, and today in the 11th Congress there are 435 members. All congress members are elected by their respective states into either the Senate or House of Representatives. The President, his/her Cabinet and the Federal Departments and Agencies are all apart of the Executive Branch. The President is the head of the branch and together they enforce the law of the country. Because it is such a large task, the President appoints members of his/her Cabinet and different Federal Departments and Agencies to help them enforce the laws drawn up by the Legislative Branch.
As a nation, citizens of the United States of America can vote for the President. Elections are held every four years and both the President and his/her Vice President must have been residents of the US for at least 14 years and native-born citizens. It is also impossible for them to be elected into a third term as President. Voting for the President in the United States is a bit difficult to grasp. In actuality, voters are really voting for “electors” that make up the Electoral College. Once the Electoral College is voted on, then the “electors” vote for the President.
Each state has the same number of electors as it has senators and representatives. That being said, though each state has two senators, the number of representatives they have depends on the states population. Whichever candidate wins the majority vote of the Electoral College is dubbed the winner. In the extremely rare case that there is no Electoral College winner, the House of Representatives choose the President. Interpretation of the laws created by the Legislative Branch and enforced by the Executive is left to the Judicial Branch.
This branch is comprised of The US Supreme Court and other smaller courts. There is a fixed number of Associate Justices that accompany the Chief Justice of the United States in the Supreme Court. These Associate Justices are decided upon by Congress while the power of nomination is left to the President and actual appointments are advised and consented by the Senate. Though each state has its own court, the Supreme Court is the highest in the United States and has jurisdiction over all federal and state courts. The United States of America has adopted a two-party political system.
The Republican Party is known to position itself as right-of-center and supports a conservative platform while the Democratic Party supports a modern liberal platform and positions itself left-of-center in American politics. There are third parties in this political system, but they are weakly represented and play relatively minor roles. The two main parties, Democratic and Republican, have won every presidential election since 1852 and have gained control of the Congress since 1856. This makes it difficult for any new parties to gain a majority or large voice in US politics and government.
Spain: History The Constitution of 1812 marks a major advancement in Spain’s independence and government. It was a result of the Peninsula Wars, known to the Spanish as the Spanish War of Independence, and is considered to be the first enacted constitution of the country. Though Spain had been regarded as independent for a long time before that, the French had occupied and overthrew the Spanish administration. Before that, many other European nations came in and out of Spain. This first constitution was enacted by the Cadiz Cortes and is known to be the first national legislative assembly of Spain.
Under it, national sovereignty, freedom of press, land reform, free enterprise and universal male suffrage were all established. Ferdinand VII returned as Spain’s King and the constitutional monarchy was established. In 1814, Spain defeated Napoleon. The monarchy ruled over Spain until the First Spanish Republic was established from February of 1873 to December of 1874. This created a parliament that was mainly made up of radicals, democrats and republicans. The idea was to create a federal republic, but this plan fell short when the government collapsed and the Bourbon monarchy was restored, naming Alfonso
XII as king. Many years passed before another attempt at a Republic was made in 1931. The Second Spanish Republic started when King Alfonso XIII left the country and Republicans won the majority of votes in parliament. This was another short-lived period due to military rebellion led by General Francisco Franco at the end of the Spanish Civil War. Spain: Civil War and Franco Dictatorship Spain entered a troubling period of political power struggles after the exile of King Alfonso XIII. There were a series of failed military coups, but one was successful in 1936, effectively starting the Spanish Civil War.
The new government elected in 1936 brought about an economic crisis. The wealthy continued to gain, while the poor were becoming worse off. This led to a series of strikes in Spain. When Niceto Alcala Zamora was replaced by Manuel Azana as president, Spanish Army officers began planning to overthrow the Popular Front government that had been previously elected. In July of 1936, General Emilio Mola and Francisco Franco effectively executed the start of a military coup, leading a group of rebels known as the Nationalists. The two sides of the war were the Republicans against the Nationalists.
The Republicans were loyal to the Spanish republic that was already established. The war ended in 1939 with the victory of the Nationalists and establishment of a Fascist dictatorship led by General Francisco Franco. Franco’s dictatorship was similar to any other right-wing dictatorship. There was intense censorship; any opposition to Franco’s law was harshly dealt with by the secret police. The country was essentially isolated from the rest of the world. The monarchy was banned or fair elections. All political parties were banned, the only exception being the official party, Falange.
The Franco dictatorship lasted until his death in 1975. Upon Franco’s death, the Spanish monarchy was restored with Juan Carlos being named King. The transition to democracy was also commenced. Spain: Political System After the death of Franco, Spain was in a flurry to catch up with the rest of the world politically and economically. In 1978, the Spanish Constitution was enacted and aided in the transition to democracy. It was approved by the Cortes Generales in October and was voted into action on December 6th of that same year. December 6th is celebrated nationally in Spain as the Constitution Day.
The Spanish Constitution is what has led Spain to have the government that it does today. Spain is a Democratic and Social State. There is also a Monarchy, resulting in its political structure as being a Parliamentary Monarchy. So while there is a royal family and a King of Spain, there is also a President who governs the country. The roles of the two are very different. The Monarchy serves more as a symbol of Spain and represents the country in international affairs. The King also serves as a symbol of Spain’s unity, is Chief of State and nominates the President after elections.
Because of Spain’s political makeup, there is also a Parliamentary aspect. This is similar to that of the United States of America. There are two powers that make up the central government: Legislative Branch and Executive Branch. There is also a Judiciary Branch, but it is recognized as being separate from the central government. The Legislative Branch is comprised of the Cortes Generales. It is a bicameral parliament with two chambers. The lower chamber is known as the Congress of Deputies. This chamber has 350 members that are elected by popular ballot every four years.
This number depends on the population of each province. The upper chamber of this branch is the Senate. The number of people elected into the Senate depends on the province. Currently, there are four allocated to each Spanish province, three to the larger islands, two to the autonomous cities of Ceuta and Melilla and one to each of the smaller islands. In addition to these, the Autonomous Communities elect the rest: one each, plus another for every one million inhabitants. The Senate election process is also done every four years.
The Executive Branch is comprised of the President and his/her Council of Ministers (Cabinet). Every four years, the President is elected by the citizens of Spain and voted on in Congress, then appointed by the King after this vote. The President designates the Cabinet. This branch holds executive power and the President is effectively the Head of Government. They conduct civil and military administration, foreign and domestic policy and exercise statutory regulations and executive authority. The Judiciary Branch is separated from the central government.
The General Council of Judicial Power is comprised of 20 independent members and headed by the president of the Supreme Court. This is the highest legal body in Spain. There is also the Constitutional Court that is responsible making sure all the laws passed by parliament fall under the constitution. This also applies to all international agreements in which Spain takes part. National and regional governments make up a multi-party system that Spain has adopted. There are two types in this system: national and nationalistic, also known as regional.
Nationally there are two dominant political parties, the People’s Party (PP) and the Spanish Socialist Workers’ Party (PSOE). The PP is considered to have more conservative views and positioned on the right wing. The other major party, PSOE, takes a more socialist view and is positioned more center-left. These two parties have historically dominated nationally, however, regionally there are two more: the United Left (IU) and the Union, Progress and Democracy (UPyD). This makes it difficult in achieving an electoral majority in the Cortes Generales.
The IU promotes democratic socialism and communism and is positioned on the left wing. The other major party, UPyD, is positioned in the center and is considered to be a social liberal party. The United States vs. Spain The United States and Spain have found a fairly recent newfound understanding with each other. During Bush’s presidency, the two countries had many different opinions and bad relationship with each other. Once Obama was elected, the United States relationship with Spain went on the mend. Though things may not be perfect now, they are much better than before.
That being said, the two countries do share a lot in common when it comes to their history, government and political systems. They had both experienced outside dictatorship and gained their independence and eventually became Democratic States. The main difference there is that Spain went through a series of dictatorships before they entered the “Democracy game”. Both countries suffered from tragic civil wars, but where able to come out of them stronger than before. Spain may have fallen under a dictatorship as a result of theirs, but since Franco’s death, they have smoothly transitioned into what they are today.
Another difference is that there is an established Monarchy in Spain. After dealing with the British Monarchy, the United States was adamant on not having a Monarchy. This is why there are three branches of the Federal Government headed by the President. While he/she does hold some major authority, due to the principal of ‘checks and balances’ and ‘separation of powers’, no one individual or branch can overpower the other or the country. In Spain, these concepts are not intentionally enacted and there are only two branches of government: Legislative and Executive.
The King also does not serve any real power in government; he is more of a symbol for the country. Another difference concerning the government is that the Judiciary Branch is independent of the central government. When it comes to political parties, the two countries are relatively alike. This is due to the fact that both have two dominant parties, but there are also other parties in the country. However, a major difference concerning this is that though at the national level there are only two dominant parties, at the regional level in Spain, there are two more dominant parties.
Spain has a multi-part system while the United States of America explicitly claims to have a two-party system. This leads there to be a total of four dominant parties throughout Spain. The reason for this is that while Spain is a united country, there are 17 autonomous communities and two autonomous cities that make up the country. Each autonomous community has the right to self-government. Because of this, they each have their own government, administration, Supreme Court and President. The extent of autonomy given to each community is stated in the Constitution of 1978.
Further more, the autonomous communities are grouped into provinces that also have their own administration and are in charge of a range of services such as health and public works. Finally, the provinces are grouped into municipalities that are run by members of a council, each of whom are responsible for different local services. The idea of autonomous communities is not present in the United States today. During the Civil War, the Confederation attempted to secede from the Federal Government, but was unsuccessful. Because of this, the Federal Government has made sure that this would not happen again.
Though there are 50 different states in the United States and each has their own power, it is limited power and they are all brought together by the National Government. Overall, both countries have worked hard to be where they are at today. Things are not “perfect” in either government, but perfection is unattainable. Over the years, much suffering has been faced in Spain. They have been occupied by multiple countries, been through a dictatorship, and have switched governments numerous times. The United States of America has also been through some tough times too.
They endured colonization, a Revolution and a Civil War. The political systems have also been through a lot but the parties that have survived have become stronger than ever. Both countries have done the best they can with what they have been given and are continuing to grow and learn from past experiences, each other, and the rest of the world.
Works Cited
A&E Television Networks. (1996-2012). American civil war. Retrieved from http://www. history. com/topics/american-civil-war Darlington, R. (2012, November 09). A short guide to the american political system. Retrieved from http://www. rogerdarlington. me. uk/Americanpoliticalsystem. html Green, J. J. (n. d. ). Brief history of spain. Retrieved from http://www. csudh. edu/global_options/375students-Sp96/spain/HISTORY. HTML Just Landed. (2003-2012). Spanish government: the political system of spain. Retrieved from http://www. justlanded. com/english/Spain/Articles/Culture/Spanish-government McMillan, P. (n. d. ). Spain. Retrieved from http://www. spartacus. schoolnet. co. uk/WARspain. htm Structure of the united states government. (n. d. ). Retrieved from http://www. theusgov. com/
Technology Has Done More Good Than Harm Argumentative Essay
Technology has improved our lives in matters of convenience, but has not improved the human condition overall. Our behavior hasn’t changed for the better over the past few centuries. Technology causes our lives to be busier — involved in more mundane activities with more mundane objects. Television is a great technology that has compromised our attention span and our interactivity with other people. It also infiltrates our home with nonstop promotional advertising. I disagree. I have all the information of the internet available to me instantly from my home. I have google to sort it for me.
This is not a convenience, this is an unbelievable resource. Information is power. Throughout history the ruling class kept strict reigns on information in order to keep the masses in check. Without information, who really makes the decisions? With unlimited information, it is truly I who decide what to think. This by itself is proof of the benefits of technology. Speaking from the point of view of an individual, this is the greatest time to live to date. Advertising itself lends the illusion that we should be in constant pursuit of contests in an attempt to win something that we didn’t earn.
It, like lotteries, gives us false hope that we might get lucky, and causes many people to focus on such frivolities. Advertising is a reflection upon the common person, not the controlling force of them. If people were different then advertising would be different. The string is there, you just have it wrong about which end was pulling which. Telephones have made it easier to contact people, but also made it easier to be contacted, thus invading our privacy. While we can choose to go without services like a telephone, we generally cannot rightly do so and function properly within a basic community setting.
Again, this is information flow. It brings a community closer together. In days of old, those on the other side of town were strangers because you only saw them at church. Now you can call or email them. I am friends with you and you are a thousand plus miles away. Technology is good. Advanced modes of travel have made it easier to go long distances in a short time. But is there really an innate need for us to take so many trips to far-off places? Did people of the 1700s have such a need? Perhaps with the new technologies, we have created accompanying needs, which would mean that technology is also more demanding.
Families are moving farther apart, which creates a niche for greater travel. If we just stayed closer together, we could accomplish the same thing and eliminate the middle man. You presuppose that this travel is for travel’s sake alone and that there is no other reason. People move and travel for a great number of reasons. Most of them are reasonable and positive. I cannot see your logic here. Technology is a mechanism for achieving something that might not have been necessary or even beneficial, but since it was not previously possible is therefore assumed to be progression.
There are side effects to every adaptation. So what? Language, by itself, has had a number of unforseen consequences. Should we abandon language as well? Your facts are not in dispute. Your reasoning does not make sense. If you are saying that we as a community are not making the necessary adjustments to accomodate the new technilogocal lifestyle, then fine. But, that is not a problem with technology. That is a problem with us. Technology is represented by city life, while life before our current technology is represented by country life. Which people are happier?
Are the city folk better off because they have more gadgets? What do these gadgets do for them that country folk don’t already have? Do things faster, farther, with less effort? Are we turning into nothing more than very efficient machines? And are we always expecting more of them, never satisfied with the status quo? Sorry to dissappoint you there young fella, but the technology of farming is exactly what allows for city life to exist. That is the backbone of social technology. As far as people being happy, we are not simply products of our environments.
We are people. We can transcend environment with knowledge. Where and how we live is irrelevant. I am in the second least populated state and was raised in the least populated county in that state. I now live in the city. I can assure you that the country living and the city living are not as great a difference as you might imagine. Sure, on a physical level, technology is great. But on a socio-emotional level, it takes away about as much as it gives. It causes us to depend less and less on ourselves, and shifts the focus to form and away from substance.
All the “white noise” created by technology makes it harder to think clearly. Despite technological advances, we’re still desperately hanging on to our pastoral origins. A lawn and trees, bushes, flowers, etc. , are more than embellishments — they are often requirements to maintain sanity. We don’t cling to bits of the past for sentimental reasons so much as we do to keep some semblance of the simple in order to survive in the midst of the utterly complex. I like this. But let’s take this a step further.
It is our interdependence that will eventually bring us to the next level. Technology is the glue that binds us together as a community. ODN is a community. There is more opportunity for community than ever before. What would a smart guy (let’s say like you) in a rural community do with his mind even fifty years ago? Now, you can talk to PerVirtuous a thousand plus miles away and have access to another smart guy from a rural area. The ability to form communities using technology is only beginning. This will be the ultimate social change. This will redefine everything.
One positive social aspect of technology is that increased communications has deeprooted systems of government that are not for the people, and given the people more of a voice, so they have become less oppressed. No comment. When I retire, I’d like to “get away from the things of man,” as they say in Joe Versus the Volcano. And I don’t mean a trip to an exotic location, but a permanent vacation where there are no tourists. Somewhere in Colorado or Montana would suit just fine. Overall, that is a multi-layered question. We’ve got a few acres here for someone like you. It is exotic, though. So think about it first. Then C’mon up.