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Movie Review

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Movie Review

God Father 1 is one of the best movies that I have ever watched. To begin with, the movie has a simple story line that makes it easy to follow the story. After watching the movie, I gained a lot of understanding about the mafia and how they operate. Through the movie, I was able to learn how the retirement of the mafia leader can ground the whole movement into a halt. This was evident after Vito Corleone retired as the leader of the mafia group and the whole team nearly became extinct. However, through the intervention of Michael, the mafia family is once saved and they are able to exert revenge on those who had killed their brother. Through the movie, I was able to learn how loyalty is crucial among the mafia groups. I understood the importance of respect not only in families but in any endeavor to attain anything meaningful.

Another thing that I got from this movie was the beautiful scenery of Sicily where the movie is based. Apart from learning about the customs of both Sicily and Cabala, the thing that captivated me was the American story. I was specifically intrigued by how people can rise and become successful in the so called land of opportunity. The spectacular examination of the opposition behind the success of America was something that was a bit of an eye opener to me. Through the movie, I was able to comprehend how people make their money in the capitalist world and how through careless mistakes they squander the money in worthless ventures. This is both an entertaining and an educative movie (Block, & Wilson, 2010).

Reference

Block, A., & Wilson, L. (2010). George Lucas’s Blockbusting: A Decade-By-Decade Survey of Timeless Movies Including Untold Secrets of Their Financial and Cultural Success. Harper Collins.

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Moral Isolationism

In morality and its critics, Mary Migday presents us with the abstract concept of us trying to understand different cultures and how it is difficult for a person to understand a particular culture fully. She presents the Japanese Samurai as an example through which culture can be misunderstood by people. She states that it is only in some situations whereby we can fully understand what a specific culture means along its practices. She also says that the only best understanding is understanding other people’s cultures through our own. The situation of being unable to understand other cultures fully and being faced with conditions that present to us the different cultures, as she states that our parents would have been shocked with, and the difficulty of understanding them is what she refers to ‘moral isolationism’.

She states that some people criticize other cultures for how they behave in a funny or unappealing manner, yet they have not fully understood that culture and this she frames as wrong practice. She also questions different features and concepts in dealing with cultures. For example, on page 611, she puts across the question of whether the understanding barrier towards cultures blocks a person’s ability to praise or blame a particular culture for its doings. She presents both sides of the coin by stating that we could only praise what we can thoroughly criticize. Therefore this calls for an understanding of a culture and not just trying to blame them for what does not appeal to us but also understanding why what they do is done in a specific manner. She also goes ahead to question what judgment involves, and therefore in this she states it is the formation of opinions.

However, it is wrong to form only crude notions of thoughts about other cultures. The last question Mary poses is if we cannot judge different cultures due to our ability to understand them fully, is it possible to consider our own that we are aware of? Here she discusses how moral isolationism would ban moral reasoning. However, these conditions and situations are present within the societies for our good because it is through the judgment that we get a direction to follow or avoid a culture. Finally, she admits that there is only one world, and with all the differences between different cultures and different people, we have to live within this world.

From the above discussion, it is clear that cultures and different people interact differently and at different rates. Every person has an opinion which they always want to prove, be it positive or negative. Therefore cultures have to interact appropriately because the inability to interact peacefully and adequately, as Mary suggests, leads to misunderstandings and other clashes of the culture and individual persons. This can come as a way of a person misunderstanding a specific culture like it is with the Samurai being misunderstood in its dealings and activities. Therefore, moral isolationism is a good factor towards social betterment. It discourages judgment and victimization of other cultures.

According to Mary’s analysis of moral isolationism, we come to realize that the unfair practice is not judgment as moral isolationism might try to make us see from a distant understanding. However, the basic tenet about our cultures and the world is the ability to understand each other, make sound judgments and provide relevant criticism of the different cultures. At the same time, be able to praise them and not just judge them for what they are not doing right. Therefore this is an essential aspect of any person’s knowledge of the world and the cultures. The concentration of samurai also has significance on Marys’s work as this culture is mainly misunderstood. People end up making judgments than being able to criticize effectively and analyze the culture for its strengths and weaknesses. She also talks of how anthropologists have only concentrated on small communities for their studies, thus providing and coming up with perfect studies. On the other hand, there has been a development of larger communities that bring in complexity about how society and culture operates.

Work Cited

Midgley, Mary. Trying out one’s new sword. Courses Publishing, 2000.

Moral Philosophy at the Theater (MPAT) employs cinema to apply the ideas and arguments learned from the required readings and class presentations. Students may research the plot to become familiar with the film. It is permissible to view any additional clips on YouTube. The goal of the essay is to apply ethical ideas from the course to create an informal argument, using the persuasive essay format as a tool to analyze the morality of the movie.  

Essay #1 focuses on a conception of morality depicted through the scenes in the movie, Noah.  Write a persuasive essay addressing this prompt: 

Discuss the Euthyphro dilemma in the context of the movie.  Take care to attend to the validity of the argument and reliability the reliability of premises as presented in the textbook.  Pay critical attention to the theme of the autonomy of ethics in class presentation.

The criteria for a successful essay requires the student to identify the conception of morality depicted in the movie clips and thoughtfully explain its connection to two or three ideas from the required readings and class presentations. (Do not merely summarize the scene.)  

This persuasive essay requires a well-formed thesis statement (about 25 words). The thesis statement should be the last sentence of the first paragraph. This sentence should have an independent clause asserting the conception of morality in the movie clips with an independent clause (marked by “because”) to provide two or three reasons justifying this interpretation.  The essay should also include succinct body paragraphs with topic sentences built from the words in the thesis. Within each body paragraph, include two supportive pieces of evidence containing verbiage from the movie and course materials.  (Review the illustrated, persuasive essay template.) 

The length of this persuasive essay should be between 500  and 700 words (maximum).  This length is about 3 to 5 well-formed paragraphs. The font type should be Arial 12 point.  Only Word format will be accepted as an attachment.  Creating/editing a document and pasting it into the “text entry box” of the assignment space is the preferable way to submit this essay. The guidance provided for the persuasive essay includes a paragraph template, a video tutorial, tips for formulating a thesis statement, and a rubric.

Moral Leadership

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Moral Leadership

Leadership is all about responsibilities, while morality entails instilling values for individuals to live and abide by. Moral leadership inspires and motivates people to act and hold themselves accountable. When you see people fail to step up and provide purpose or even do something that can give goodness to a more significant number of people, step up. Moral leadership is subject to respect for ethical beliefs and values to preserve human dignity and their respective rights (Ciulla, 2014). When discussing moral leadership, one must remember concepts such as honesty, integrity, trust, fairness, charisma, and consideration. Ethical governance is primal to building trust, inspiring colleagues, creating meaning, or helping individuals imagine a better future. It enables people always to do the next right things. This paper aims to enhance our awareness of moral leadership, what it entails, and various ethical leadership concepts.

World leaders are often celebrated based on their achievements and bravery. However, when it comes to moral leadership, the ideas seem far-fetched. As such, it comes down to whether morality counts when it comes to matters about administration? Numerous studies have concluded that moral leaders are better equipped to execute their obligations than their amoral counterparts (Lemoine, Hartnell, & Leroy, 2019). People seldomly celebrate ethical leaders in the current world. Perhaps, most people are accustomed to celebrating the wrong category of individuals. Great leaders, may it be in organizations or countries, will always work hard to ensure that morality permeates all aspects of their governance. A strategic initiative is imperative or rather subject to the ethical and effective management of projects. It is always hard to make a proper decision as every moral dilemma is subject to a solution. The success of institutions is entirely dependent on a decision-making process that involves moral dimension, ethics, and good governance. Three forms of moral leaders often overlap, namely, ethical, servant, and honest.

Ethical leaders tend always to refer and adhere to norms and regulations. They reciprocate the prevailing institution norms, standards, and culture to enact adherence to those standards among the individuals under their leadership. An ethical leader represents a moral role model and suppresses activities aiming to promote corruption in an institution, such as bribery and compromising classified information (Hannah, Avolio & Walumbwa, 2011). This form of leadership demands spearheading individuals into attending their respective obligations to avoid scandals, lawsuits, bad public image, and embarrassing the institution. It is expected that this form of leadership to a formidable bond that leads to mitigating harassment as people are always acting in the right way. The wrong side is that ethical leaders may enact self-gains regulations that other people might regard as offensive and immoral. For example, the United States may take an opportunity to financially aid third-world countries’ economies that work for better living standards. However, it would frown upon the Americans. Such actions are justifiable by ethical leaders based on their moral appropriateness by that country’s means but would hold less meaning when it comes down to the United States citizens.

Servants leaders tend to be so much inclined to outcomes. Servant leaders concentrate on how others get helped or harmed by their acts and often tend to spearhead institutions to perform better in the best interests of the public wellness (Lemoine, Hartnell, & Leroy, 2019). Servant leaders serve to take care of people. When it comes to business organizations, servant leaders put their employees into consideration first while at the same time looking out for other stakeholders, such as clients, shareholders, surrounding communities, vendors, among others. When it comes to the nation’s servant leaders, they will always put the interest of their people first and, at the same time, consider others. Servant leadership often faces the dilemma of balancing all the stakeholders involved in their governance. When it comes to economists, the vast majority of them would argue that any wealth spent on corporate social responsibility, ensuring the world’s wellness, is inversely suppressing the shareholders’ and employees’ returns.

Authentic leadership is often intertwined with fairness, honesty, and wisdom. Authentic leaders are highly aware of their strengths and weaknesses and always work hard to improve the people they lead by helping them understand themselves (Lemoine, Hartnell, & Leroy, 2019). Their decision-making process is subject to their moral compass, instead of other people’s opinions of morality. Authentic leaders listen to other people’s views, but ultimately, they would not primarily adhere to rules, or people’s expectations, or even what the majority would applause (Caza & Jackson, 2011). An authentic leader is a leader who can display moral courage to execute what they feel is right. They set an example for others to follow and encourage them to always be the best version of themselves. In most practical terms, think of organization leaders who, as soon as they assume power, overhaul everything and do what they feel is right. Such leaders can do unexpected things on some occasions, at times, go contrary to the rules, and sometimes it may have appeared as if they were doing something against the stakeholders involved in the short term. However, that felt right to them.

Authentic leadership is often associated with uncertainty, following internal drives that are only predetermined and only known (Lemoine, Hartnell, & Leroy, 2019). Individuals who follow a contrary moral compass to authentic leaders can write off such leadership as a loose cannon.

It is practical for leaders to have more than one element of ethical leadership. It may not be mutually exclusive to employ the above three moral leadership forms. Correspondingly, leaders may consider utilizing different moral leadership forms as significant based on present situations, as per the need dictation. The vast majority of the people make the mistake of categorizing themselves as virtuous and often try to generalize that other individuals hold a similar opinion than they do. It is a prerequisite for leaders of institutions to acknowledge that what they perceive as morally righteous may have a different interpretation of other people under their leadership. For instance, a chief executive officer of a given organization may practice an ethical leadership style; however, employees may be morally inclined toward a servant or authentic leadership. As such, one has to match the people’s morality under his/her supervision to achieve your goals effectively. People may support your idea of being an ethical leader, but you are the only one to give or rather determine what that entails.

Reference

Caza, A., & Jackson, B. (2011). Authentic leadership. The SAGE handbook of leadership, 352-364.

Ciulla, J. B. (Ed.). (2014). Ethics, the heart of leadership. ABC-CLIO.

Hannah, S. T., Avolio, B. J., & Walumbwa, F. O. (2011). Relationships between authentic leadership, moral courage, and ethical and pro-social behaviors. Business Ethics Quarterly, 21(4), 555-578.

Lemoine, G. J., Hartnell, C. A., & Leroy, H. (2019). Taking stock of moral approaches to leadership: An integrative review of ethical, authentic, and servant leadership. Academy of Management Annals, 13(1), 148-187.

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Moral Psychology

When it comes to the ethics of a situation, it’s a frequent misconception that people understand the choices they’re making. Toby Groves made choices based on his desire to save his company. Toby was focused on the business side of things, according to Tenbrunsel, with the goals of being competent and successful. His ethics and values vanished from view as he was exclusively focused on mending his business.

These reasons do not prove that Toby did nothing wrong, but they do provide insight into how people like him might improve. We can learn from folks like Toby and use what we’ve learned to help prevent unethical behavior. These are solid and acceptable explanations for Toby’s behavior and how he came to act unethically, in my opinion. He pledged to his father that he would never act unethically, but he ended up making unethical actions due to his lack of awareness of ethics in his situation. This can be utilized as a learning tool to assist you avoids making unethical mistakes in the future.

Toby was born and raised on a farm in Ohio. He placed a high value on the thought that he was a person of good moral character when he was a child. Then, when Toby was around 20 years old, he went home for a visit with his family on a Sunday in 1986, and he had an event that made the urge to be good even more pressing. After making that commitment to his father, Toby found himself in front of the same judge who had convicted his brother, facing the same charge of fraud. Not just any fraud, but a multimillion-dollar bank scam that resulted in the closure of several businesses and the loss of over a hundred employees. Toby was sentenced to prison in 2008, where he claims he spent two years staring at the ceiling, attempting to figure out what had happened.

Toby adds, “Those were things that tormented me every second of every day.” “I couldn’t understand it.” Toby has recently gotten a lot of attention from scientists, especially those who are interested in how human brains absorb information when making judgments. And the researchers concluded that the majority of us are capable of acting in deeply unethical ways. Not only are we capable of it without recognizing it, but we also do it regularly.

Consider a current argument regarding justice and demonstrate how at least two distinct approaches result in different outcomes. Do you believe that any of the techniques is superior to or inferior to the others? Why? (Of course, you don’t have to put up a fight — I just want to hear what you think). “We are all capable of behaving fundamentally unethically without realizing it,” says Toby Groves. Our minds simply can’t digest the options we’re presented with. Business perspective: succeed no matter what Ethical perspective. People can be completely oblivious that they are acting in an immoral manner. It’s not that they’re bad people; it’s that they’re blinded. And, if we wish to combat fraud, we must recognize that much of it is inadvertent.

Maximizing welfare:

Utilitarian/Consequentialist

Aim for the greatest happiness for the greatest number of people possible.

Promoting wealth, raising living standards, and boosting economic growth

Result/goal/incentive focused

Respecting Freedom:

Libertarians/Deontological.

Individual rights must be respected.

Who makes the decision, not what makes the decision.

Oriented toward procedures and rules.

Promoting Virtue:

Virtue Ethics

Religious rights and cultural conservatives

The pleasures of life

Cultivating the attitudes and dispositions, or character attributes, that a decent society requires

Maximizing welfare, honoring freedom, and developing virtue are the three ways mentioned by Sandel. Insulin costs a lot of money and has been increasing in recent years. People with diabetes have no choice but to spend a lot of money on insulin as a result of this. People are also forced to ration their insulin as a result of this. The maximization of welfare is used to justify the high cost of insulin. The insulin business controls the price of insulin, which makes them extremely wealthy. Individual freedom is at the heart of the argument against the high cost of insulin. People with diabetes are unable to choose whether or not to purchase insulin. Their lives rely on it, forcing them to pay the astronomical price for the drug. I believe that maximizing welfare is the worst option since it ignores individual rights in favor of the entire market, wealth, and numbers. Sandel disputes the idea that government and policy should be morally apolitical when it comes to difficult moral issues. He contends that engaging, rather than avoiding, our fellow citizens’ moral convictions may be the most effective approach of achieving a just society.

References

Katz (2018). “Secular Morality”. In Brandt, Allan; Rozin, Paul (eds.). Morality and Health. New York: Routledge. pp. 295–330.

Narvaez, D (2017). “Moral complexity: The fatal attraction of truthiness and the importance of mature moral functioning” (PDF). Perspectives on Psychological Science. 5 (2): 163–181. CiteSeerX 10.1.1.187.2813. Doi: 10.1.

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“Death of a Salesman”

Introduction

“Death of a Salesman” is a play that was written by Arthur Miller 1949. It was awarded The Tony Award for Best Play and Pulitzer Prize for Drama. It uses Willy, a disillusioned salesman, his conscious and caring wife, Linda and their two sons Happy and Biff as the protagonists. They help us to understand the turbulent life in this family which is involved in a constant disagreement. Willy does not get happiness from his job as a salesman, a job he gets sacked from even after serving for a very long time.

He is not pleased with his sons whom he blames for not making him proud. Biff, his older son, fails the math class and drops out of college. His father’s efforts to lure him to venture into business later fail when he instead opts for farming. On the other hand, his younger brother, Happy, a womanizer, is loathed by Linda for his cheap lifestyle is a family arbiter. As events unfold, such a scenario, places Willy into a constant rivalry within and out of his household. Eventually, he opts to commit suicide at least to make his older son happier. However, this does not happen since Biff turns down the insurance compensation.

Conflict

The above synopsis indicates that conflict is one of the major themes of this play. In deed, there is a constant rivalry. Willy, the “weak, low” man, disagrees with all the people within his reach: his wife, Linda; sons, Biff and Happy; neighbor, Charlie and his boss, Howard.

To begin with, Willy and Linda disagree in many occasions. First, Willy is unfaithful in his marriage. He is involved in an extra marital love affair with Ms. Francis, whom he had been with, in a hotel, during the time, when his son was still a promising student in the Summer School. In fact, this is the reason why Biff loses hopes in studies and finally drops out of school as was narrated by Bernard. He says, “I am a failure!” Meaning there was a misunderstanding. Moreover, Willy turns down Linda’s offer of pleading to his boss to transfer him to their home town. Willy refused to buy this idea, however, good it was. Whereas Linda believed that it would prevent him from travelling that might cause him a tragic road accident.

Besides, there is a disagreement between Willy and his two sons. First, he is not happy with Biff’s decision to drop out of school. Later, he refuses to pursue a business career proposed by his father. Instead, he opts to try his hand in farming because that is what he likes most. The failing to fulfill Willy’s expectations of him, constantly puts them in a rivalry. In his opinion, Biff would have to be as successful just like his friend Bernard who has become a lawyer and a responsible husband. On the other hand, Biff blames his father’s promiscuity to be the sole cause for his failure. While in the restaurant Willy gets annoyed with his sons when they decide to abandon him. Instead, they enjoy the company of prostitutes. This incident infuriates Linda to the extent that she rebukes her two sons. She felt that it was so stupid of the boys to show such an irresponsible conduct.

Finally, Willy is in a disagreement with his neighbor and employer. Even though Charlie is a good friend who often helps him in case of difficulty, Willy frequently turns down his offers. In fact, he even refused to be employed by Charlie when he lost his job. This is because, he is jealous of his son, Bernard’s success. He is threatened at his success because he was expecting him to be equal to his sons. When he goes to Howard to discuss better working terms, Willy gets sacked when he is told, “You will no longer represent this company!” This is so unfair because his long time dedicated service finally gets unrewarded. This enmity continued even after his death. Otherwise, he would be accorded a colorful burial.

Case Study Example

Scenario:

Joe is in his 80s and has been receiving outpatient chemotherapy for cancer. He fell in his apartment and broke his hip, so he ended up in the hospital for 2 weeks. Towards the end of his stay, he began experiencing a fever and rapid heart rate. He had stomach pain and terrible watery diarrhea many times throughout the day. He became severely dehydrated. It was hard for him to manage the nausea. His doctor took a stool sample and noticed an anaerobic Gram positive bacteria.

This case is an 80-year-old cancer patient, named Joe, who acquired an in-hospital infection while being treated for a hip fracture secondary to cancer. Joe is currently undergoing cancer treatment with chemotherapeutic drugs. Hospital acquired infections are a serious matter within our healthcare system; so much so that in 2014 the CDC did a study and determined that about 4% of hospitalized patient’s suffered from a hospital acquired infection (Monegro et al., 2020). To put that number into perspective we look at local, nationally ranked Johns Hopkins Hospital. Johns Hopkins has roughly 107,000 inpatient admissions annually, using the 4% number mentioned previously, that equates to 4,280 patients in one hospital system in one year that suffered from a hospital acquired infection (Fast Facts: Johns Hopkins Medicine, 2020).

Based on the information provided in this case study I have determined that Joe is suffering from a common hospital acquired infection, Clostridium difficile. Joe’s compromised immune system, his abdominal pain, fever and watery stool are all classical indicators of a Clostridium difficile infection. Clostridium difficile (C. difficile) is a spore-forming, gram positive anaerobic bacillus (Clinical C. Diff Q & A, 2020). C. difficile is a common cause of antibiotic associated diarrhea and currently accounts for 15-25% of all episodes of antibiotic associated diarrhea (Clinical C. Diff Q & A, 2020). C. difficile is often caused by specific antibiotics that wipe out the “good bacteria” within a patient’s GI tract, other patients at risk are those with compromised immune systems (Clinical C. Diff Q & A, 2020).

C. difficile has some key characteristics that make it easy to spread within a hospital environment; for one, it has a protective outer coating that potentially allows it to live for months if not years on surfaces and in the soil (Prevent the Spread of C. Diff (Deadly Diarrhea)., 2019). Second, C. difficile requires the use of soap and water to prevent the spread of germs, with the increase in usage of alchol based hand sanitizers like Purell in the hospital environment, which is not effective at killing C. difficile, it is easier for hospital staff to unintentionally spread the disease (Prevent the Spread of C. Diff (Deadly Diarrhea)., 2019). Third, C. difficile requires cleaning beyond the traditional norm within the hospital environment, a bleach solution is required in order to kill C. difficile spores, this is a higher level of cleaning than is what is typically used for most room turnovers within a hospital environment (Prevent the Spread of C. Diff (Deadly Diarrhea)., 2019). Finally, it is important to note that various studies have shown that C. difficile has been present in anywhere from 2%-15% of the healthcare workers sampled, while this is a relatively low number, it could provide a substantial source of potential infection to the immunocompromised patient’s that C. difficile infects so readily (Prevalence of Clostridium Difficile Colonization among Healthcare Workers, 2013). C. difficile is shed through GI tract and out of the body through feces and can be transferred with any surface contact of infected materials (Clinical C. Diff Q & A, 2020). In the hospital setting modes of transmission could include any number of items: hospital beds, rectal thermometers, sheets, toilets or hospital employees’ hands just to name a few. While surface contact is the most common mode of transmission, a 2010 study suggests that C. difficile is also transmittible through the air and notes that individual rooms are the safest option for preventing the spread of C. difficile (Adalja, 2019).

Despite its virulence, C. difficile generally responds well to treatments. About 20% of patients who acquire C. difficile will see it resolve with just the discontinuation of the antibiotics they were previously prescribed (Clinical C. Diff Q & A, 2020). The remaining patients will often see improvement with a change to a more appropriate antibiotic, usually Vancomycin for Fidaxomicin (Clinical C. Diff Q & A, 2020). Other treatments will include replacement of fluids to prevent the dehydration that is commonly associated with diarrhea. It is important to treat C. difficile early as it can lead to serious conditions such as dehydration, sepsis, toxic megacolon and in rare cases death (Clostridium Difficile: Epidemiology, Diagnostic and Therapeutic Possibilities—a Systematic Review, 2013).

If left untreated, C. difficile can cause a number of different symptoms, the most common of which are watery diarrhea, fever, loss of appetite, abdominal pain or tenderness and nausea (Clinical C. Diff Q & A, 2020). While those symptoms might sound minor, in totality they can ultimately lead to dehydration, a perforated colon (which is a life threatening condition that will require surgery) or a very serious condition called sepsis which is characterized by high fever, high heart rate and severe low blood pressure which can ultimately be fatal.

According to the Cleveland Clinic, with treatment, the prognosis for C. difficile is usually positive, they state that with proper antibiotics the fever will subside within two days and the diarrhea within two to four days (C. Diff (Clostridioides Difficile) Infection Outlook / Prognosis, n.d.). They do report that 10-20% of patients may see a re-emergence of symptoms within one to two weeks (C. Diff (Clostridioides Difficile) Infection Outlook / Prognosis, n.d.). More serious complications like a perforated colon, dehydration or sepsis could require longer hospital stays to treat appropriately.

In conclusion, our patient Joe, is suffering from a Clostridium difficile infection acquired during his hospital stay for his broken hip. His immunocompromised system, caused by his cancer treatments, places him at an increased risk for hospital acquired infections. With quick identification and rapid treatment with appropriate antibiotics, Joe has a good chance of overcoming his C. difficile infection and getting discharged to rehab to continue healing from his hip fracture.

Works Cited

Adalja, A. A. (2019, January 29). Airborne Spread of Clostridium difficile | 05-14-2010 | CBN article. Clinicians’ Biosecurity News | Johns Hopkins Center for Health Security. https://www.centerforhealthsecurity.org/cbn/2010/cbnreport_05142010.htmlThis source is a world-renowned hospital that is consistently ranked as a “top hospital” within the United States.

C. diff (Clostridioides difficile) Infection Outlook / Prognosis. (n.d.). Cleveland Clinic. Retrieved November 8, 2020, from https://my.clevelandclinic.org/health/diseases/15548-c-diff-clostridioides-difficile-infection/outlook–prognosisThis source is a world-renowned hospital that is consistently ranked as a “top hospital” within the United States.

Clinical C. diff Q & A. (2020, March 27). Centers for Disease Control and Prevention. https://www.cdc.gov/cdiff/clinicians/faq.html#anchor_1529601781962This source is a federal government agency.

Clostridium difficile: epidemiology, diagnostic and therapeutic possibilities—a systematic review. (2013, November 1). PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3950610/This source is a peer reviewed medical journal.

Fast Facts: Johns Hopkins Medicine. (2020, January 1). [Graph]. Hopkins Medicine. https://www.hopkinsmedicine.org/about/_downloads/JHM-Fast-Facts.pdfThis source is a world-renowned hospital that is consistently ranked as a “top hospital” within the United States.

Monegro, A. F., Muppidi, V., & Regunath, H. (2020, September 3). Hospital Acquired Infections. PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/books/NBK441857/This source is a peer reviewed medical journal.

Prevalence of Clostridium difficile colonization among healthcare workers. (2013, October 4). PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3850636/This source is a peer reviewed medical journal.

Prevent the spread of C. diff (deadly diarrhea). (2019, November 4). Centers for Disease Control and Prevention. https://www.cdc.gov/cdiff/prevent.htmlThis source is a federal government agency.

Acute Impaired Tissue Perfusion

Introduction

The ability of blood to circulate unimpeded throughout the body is what is known as perfusion, it involves the process of hemoglobin in the blood binding with oxygen through respiration in the lungs, in cases where the process is unable to be complete a perfusion state is said to exist. This deficiency can be identified through the diagnosis of the inadequate tissue perfusion symptoms and signs of organ failure, mainly due to lack or inadequate circulation of oxygenated blood through body organs or system. It is with this above understanding of its importance that this article seeks to address its effects on patients with acute impaired tissue perfusion, characteristic, other related factors, outcomes in both patient and caregiver diagnosis, relevant interventions and rationales and the family and patient teachings.

The perfusion within the ineffective tissues can occur in various body systems like the peripheral, cerebral, renal, gastrointestinal, and cardiopulmonary. It can be described as a condition that exhibits a reduction in the blood flow which results in the capillary tissues failure to nourish, since it causes less nutrition and oxygenation at the cellular level. There are divergent effects on a patient if the condition persists mainly if it is an acute condition can turn tragic and cause tissue or organ damage or even death, if it is a mild condition it will have no or few effects on the patient (Maylor ME, 2005).

The main defining characteristics for diagnosing the condition include peripheral issues such as clammy skin, absent or absent peripheral pulses, edema, numbness or pain, cerebral issues like seizures, lethargy, restlessness, confusion decrease to light reaction, and cardiopulmonary effects such as angina or hypertension. The renal system can also have impacts like hematuria and blood pressure change or problems in the gastrointestinal like abdominal pain, nausea or absent or decreased bowel sounds.

Indicators of tissue perfusion on patient would include symptoms of possible impaired blood clotting capabilities and blood flow, and decreased tissue perfusion. Also by monitoring and comparing the patients pulse to ensure that it is steady. Other indicators could be identified through performing therapeutic interventions that have diagnostic testing characteristics like vasodilator therapy and angiograms indicators like heparinization or embolectomy. It can also be done by performing a possible cardiac output test like by using an anti-embolism device or raising an affected limb as necessary. Other specific interventions would include administration of oxygen, range of motion exercises or often change of body positions (Gardiner SM et, al, 1990).

Other related factors that also lead to perfusion of tissues would include mismatch of blood flow with ventilation, Hypovolemia, venous flow interruption, hypoventilation, altered affinity of hemoglobin for oxygen, interruption of arterial flow, impaired transport of oxygen across capillary membrane or alveolar, enzyme poisoning; hypervolemia, decreased hemoglobin concentration in blood, exchange problems, mechanical reduction of arterial blood or venous flow (Kupper N, et.al, 2011).

The care givers expected outcomes would include improvement in the Urinary Elimination, Circulation Status, Fluid Balance, Cardiac Pump Effectiveness: cardiac and Tissue Perfusion, Tissue Perfusion: Peripheral and Tissue Perfusion: Cerebral. On the other hand the expected client outcome would include them demonstrating an adequate and efficient perfusion in their tissues as demonstrated by them having dry and warm skins, an absence in respiratory distress, palpable peripheral pulses, verbalized treatment regimen knowledge, adequate urinary output, recognize change in lifestyle that would encourage tissue perfusion, include appropriate medication and exercise and their possible actions and side effects.

Patients who exhibit acute cerebral perfusion symptoms would include them showing signs of orthostatic hypertension which causes them to experience dizziness while getting up; the interventions would include teaching them on remedies of addressing the dizziness like rising slowly, while seated they flex their feet upwards, they set for a while before standing, trying to have someone present while trying to stand and sitting immediately they start feeling dizzy. The rational for emphasizing on addressing this condition would be that it leads to a decrease in the cerebral perfusion fusions or stroke which if addressed early can be treated.

It can also be diagnosed by monitoring the neurological status, mainly by performing an examination of the neurological functions, or in cases where symptoms of a (CVA) cerebrovascular accident are present like in hemiplegia, hemiparesis or dysphasia. Feeling the temperature and skin color for signs of mottling, skin pallor, absent of pulse, cold skins or cool temperature could signify obstruction within the arteries, which would signify urgency for immediate intervention (Makhsous, M et.al, 2007).

The main lessons for the family and the client would be them being taught on importance and ways of avoiding getting exposed to cold conditions in any kind of weather condition by stressing on their dressing. They will have a better understanding of proper foot care and the need to inspect and wash their feet daily since they will be aware of its relevance to a diabetic patient and as such implement the recommended special insoles, padded socks and jogging shoes. The diabetic client will be more knowledgeable on the relevance of undertaking a comprehensive foot examination annually that comprises of a Semmes-Weinstein monofilaments sensation assessment where they will be referred to a footwear professional for therapeutic inserts and shoes fitting, in which the incurred costs are covered by the Medicare (Wipke-Tevis D,et.al,2004).

In patients with arterial disease they are taught on the importance of following proper weight loss programs, not smoking, controlling hypertension and hyperlipidemia, careful control of their diabetic conditions and stress reduction. For the patients with venous disease, they are taught on the relevance of maintaining the recommended procedures of elevating their legs at intervals, wearing support hose and watching for skin breakdown on their legs as stipulated by the physician. The client/family are also taught on ways of recognizing symptoms/signs that the physician should be notified about example presence of a new foot lesion, change in skin temperature or abnormal sensation.

Reference

Maylor ME.(2005) Signs and symptoms of hypothetical wound assessment by nurses. Br J Nurs (6):S14-20.

Makhsous, M, Priebe, M, Rowles D, Zeigler M, Chen D, Lin F. (2007)“Measuring Tissue Perfusion During Pressure Relief Maneuvers: Insights into Preventing Pressure Ulcers.” Journal of Spinal Cord Medicine, (5): 63-73.

Kupper N , Mitchell D , et al:(2011) Nursing management: inflam-matory and structural heart disorders . In Lewis S , editor: Medical-surgical nursing: assessment and management of clinical problems, ed 8 , St Louis , Mosby/Elsevier , p

Wipke-Tevis D , Rich K , et al: (2004)Nursing management: vascular disorders . In Lewis S , editor: Medical-surgical nursing: assess-ment and management of clinical problems, ed 8 , St Louis ,Elsevier , pp 866 –

Gardiner SM, Sompton AM, Bennett T, Palmer RMJ, Moncada S (1990) Control of regional blood flow by endothelium-derived nitric oxide. Hypertension 15:486–492

Case Study Form (CMCN307 Leadership Communication)

Your Name: Bobby Lada

Title of this paper: Pandemic Problems

Theory or concept you used for analysis:

Source of information (APA style):

Storyful Rights Management. (2020, October 8). Woman calls 911 After Being Refused Service for Not Wearing a Mask [Video]. Youtube.

https://www.youtube.com/watch?v=tDOzkkjeIVwDeveloping The Leadership Message. Leadership Communication. Retrieved from

https://westsidetoastmasters.com/resources/communication_secrets/ch01.htmlCase description (more than 300 words) – You have to add the number of word count (such as 456 words) at the end of this section to indicate how much words you wrote for this section.

In this case, a woman is trying to go get into a shopping center to get grab a couple of items. She gets to the door and tries to enter the store without a mask on and one of the employees of the store quickly denies her from entering the premises. The employee continues to explain to her that she needs to wear a mask in the store because of the pandemic that the world is in but she feels like it is her right to not want to wear a mask in the store. The lady tries to convince the employee that if she wears a mask it causes her serious anxiety and discomfort. She then continues to complain and decides to call the police. She gets on the phone with the police expecting them to support her ridiculous protest, but they explain to her that the company has the right to refuse service to whomever they want especially if there is a sign in front of the store that says wearing a mask is required. The woman stands in the doorway as she continues the conversation on the phone with 911 calling out specific laws that she says allows her the right to be able to not wear a mask and now adds on the has a religious exemption. When the store employee notices her reasons changed from panic attack to religious, he pointed this out and her response is that it is a mixture of everything. Further more she explains that she should be allowed entry into the store because no one is in the store, and the employee stated that he is someone and is in the store and does not want to be at risk of COVID nor of losing his job for not following protocol.

(Word Count: 301 Words)

Theoretical analysis (more than 300 words) – Why is this case a case of leadership communication? How can the theory or concept you have chosen be applicable for or relevant to the case you selected? Add a word count at the end of this section.

According to westside toast masters, “Leadership communications consists of those messages from a leader that are rooted in the values and culture of an organization and are of significant importance to key stakeholders, e.g. employees, customers, strategic partners, shareholders, and the media”. The employee at the store directly showed his leadership communication by delivering his companies expectations to guest upon entering their place of business. He not only informed the woman of the store policy, he refused her entry, and he also named out stake holders that would be impacted by now following this protocol. He named out himself as an employee, other people that might be entering the store being at risk due to this woman not wanting to wear a mask and also the company policy being fair across the board for all people entering the store. Furthermore, his leadership really showed up as he remained consistent in his message even when the woman tried to use fear to get him to change his answer and calling 911. The gentleman remained calm, talked in respectful manner, and delivered proper reasoning. The reasons aligned with the store’s values and values of the community with the 911 operator reiterated on the phone with faced with the situation This builds trust and shows the company has values, consistency, and morals. Lastly, according to Westside Toastmasters traits of leadership communication are significance, values, consistency, and cadence and the employee displayed each of these characteristics in this video. Hence, he showed a great role of leadership communication and all of the situation is documented on video. The company will know they have a true leader on their hands that not only showed up for this situation but will show up in any situation and is there to follow the rules and will lead their organization with integrity.

(Word Count: 304 Words)

Acute Tubular Necrosis

Institution

Name

Course

Tutor

Date

Acute Tubular Necrosis

A lady in her mid-40s was admitted to the emergency room. She had been involved in road carnage. She had suffered abdominal injuries, and her femur was fractured. Surgery was the first thing she done because her liver had been lacerated and her ileum perforated. Two blood units were transfused during surgery, and other two while in the recovery room. While in the surgical intensive care, she developed a transfusion reaction that led to the discontinuation of the transfusion. Her laboratory result during the day of surgery showed decline in urine output to 10-20ml/hr, an elevation in urinary sodium, levels of serum creatinine of 4mg/dl and BUN levels of 70mg/dl. Her output of urine never improved upon administration of plasma expanders.

On the third day her urine output stabilized at levels of 20-25ml/hr. this was a clear sign of acute tubular necrosis (Fogo, 2006).

Serious hypertension (BP 190/120) combined with hyperkalemia called for hemodialysis by the use of an external cannula. The patient was then counseled and all the questions she had answered. Fluid replacement therapy was started on the patient. Sterility of dressing was maintained during change of dressings, bleeding was monitored and any signs of infection were monitored. Antibiotics were also administered appropriately (Schumacher & Chernecky, 2010). The patient slowly recovered and after one month she was allowed to go home having fully recovered from the acute tubular necrosis but still nursing the other injuries. She was given an appointment to come for further check-up after a month.

References

Fogo, A. B. (2006). Fundamentals of renal pathology. (Springer e-books.) New York: Springer.

Urden, L. D., Stacy, K. M., & Lough, M. E. (2006). Thelan’s critical care nursing: Diagnosis and management. St. Louis, Mo: Mosby/Elsevier.

Schumacher, L., & Chernecky, C. C. (2010). Critical care & emergency nursing. St. Louis, Mo: Saunders Elsevier.

acute tubular necrosis. (2010). Oxford University Press.