Hemorrhagic Stroke free essay sample

A Hemorrhagic stroke occurs when a blood vessel in your brain leaks or ruptures. Brain hemorrhages can result from many conditions that affect your blood vessels, including uncontrolled high blood pressure ,hypertension, and weak spots in your blood vessel walls ,aneurysms. A less common cause of hemorrhage is the rupture of an arteriovenous malformation (AVM) — an abnormal tangle of thin-walled blood vessels, present at birth. The types of hemorrhagic stroke include: Intracerebral, and subarachnoid hemorrhage. Each year in the United States, approximately 795,000 people experience new or recurrent stroke. Of these, approximately 610,000 represent initial attacks, and 185,000 represent recurrent strokes. Epidemiologic studies indicate that approximately 87% of strokes in the United States are ischemic, 10% are secondary to intracerebral hemorrhage, and another 3% may be secondary to subarachnoid hemorrhage. The incidence of stroke varies with age, sex, ethnicity, and socioeconomic status. For example, American Heart Association (AHA) researchers found that rates of intracerebral hemorrhage are higher in Mexican Americans, Latin Americans, blacks, Native Americans, Japanese people, and Chinese people than they are in whites. We will write a custom essay sample on Hemorrhagic Stroke or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page According to the World Health Organization (WHO), 15 million people suffer stroke worldwide each year. Of these, 5 million die and another 5 million are left permanently disabled. In intracerebral hemorrhage, bleeding occurs directly into the brain parenchyma. The usual mechanism is thought to be leakage from small intracerebral arteries damaged by chronic hypertension. Other mechanisms include bleeding diatheses, iatrogenic anticoagulation, cerebral amyloidosis, and cocaine abuse. Intracerebral hemorrhage has a predilection for certain sites in the brain, including the thalamus, putamen, cerebellum, and brainstem. In addition to the area of the brain injured by the hemorrhage, the surrounding brain can be damaged by pressure produced by the mass effect of the hematoma. A general increase in intracranial pressure may occur. The pathologic effects of subarachnoid hemorrhage (SAH) on the brain are multifocal. SAH results in elevated intracranial pressure and impairs cerebral autoregulation. These effects can occur in combination with acute vasoconstriction, microvascular platelet aggregation, and loss of microvascular perfusion, resulting in profound reduction in blood flow and cerebral ischemia. Intracerebral hemorrhage may be clinically indistinguishable from ischemic stroke, and a thorough history and physical examination are important. Problems to consider are as follows: hyponatremia or hypernatremia , migraine headache, hyperosmolar hyperglycemic nonketotic coma, differential diagnoses, encephalitis, headache, migraine, hypernatremia, hyperosmolar hyperglycemic nonketotic coma, hypertensive hmergencies, hypoglycemia, hyponatremia, labyrinthitis ossificans, meningitis, neoplasms, brain, stroke, ischemic, subarachnoid hemorrhage, subdural hematoma, transient ischemic attack. The treatment and management of patients with acute intracerebral hemorrhage depends on the cause and severity of the bleeding. Basic life support, as well as control of bleeding, seizures, blood pressure (BP), and intracranial pressure, are critical. Medications used in the treatment of acute stroke include the following: Anticonvulsants, Antihypertensive agents, and Osmotic diuretics.

Jane Eyre by Charlotte Bronte and David Copperfield by Charles Dickens. Essay Example

Jane Eyre by Charlotte Bronte and David Copperfield by Charles Dickens. Essay Example Jane Eyre by Charlotte Bronte and David Copperfield by Charles Dickens. Essay Jane Eyre by Charlotte Bronte and David Copperfield by Charles Dickens. Essay Essay Topic: Charlotte Temple Jane Eyre Literature In this essay I am going to discuss the theme of schooldays and education in general. I will do this in relation to my study of the pre 20th century texts Jane Eyre by Charlotte Bronte and David Copperfield by Charles Dickens. I will also show how much the system has changed. During the 18th and 19th century mainly upper and middle class parents sent their children to Pe-ping (private) schools. The poor who could not afford education, which cost one pence per week, sent their children to church schools. The classrooms were often bare except for an embroidered text; this text was religious and was meant to be uplifting. Many girls didnt attend school. They were taught at home about practical things such as sewing and cooking but others did, as in Jane Eyres case, she was sent to Lowood for punishment. Poorer children were only at school for 2-3 years before they had to work for a living. Only 20% of children actually went to school at all. The girl students at Lowood were aged from 9 to20 years of age. The older students often taught the younger ones. At Lowood the pupils could socialise with the other pupils, but could not talk unless spoken to in class. However David could not as he was taught at home, he had no children to play with As to any recreation with other children my age, I had very little of that this was because Mr Murdstone believed that all children were bad influences towards David The Murdstones made all children out to be a swarm of little vipers and held that they contaminated one another. There are many differences between pre 20th century and today. From my study it seems that pupils were taught and almost ruled by fear. During classes at Lowood pupils were given several tasks and had to learn by heart. David also had to learn by heart but had difficulty remembering what he had learnt before I began to feel the words I have been in infinite pains to get into my head all sliding away this was because of the Murdstones The very sight of these two has such an influence over me this may be because of pressure and fear of what will happen to him if he couldnt remember what he had learnt. The conditions at Lowood were unacceptable by todays standards. The pupils marched all day from meals to prayers to classes to the sound of clanging bells and teachers voices giving orders. Mr Brockelhurst, who owned the school, didnt believe in coddling the poor. In his opinion the more the girls learned to put up with hardship, the more self-reliant they would be in later life. The building was in bad condition with cracks and crevices in the walls, wind, whistling through crevices of our bedroom window had made us shiver in our beds, and turned the contents of the ewers to ice and kept food to a minimum of porridge at breakfast which was only just edible, if not burnt. Whereas David had a better time learning as he was taught at home in the second best parlour, I come into the second best parlour but the atmosphere was intimidating with the Murdstones watching over David and his mother. Teacher pupil relationships happen all the time in todays schools with every pupil having a favourite teacher or one they can talk openly to. David did not really have someone like that unless you include his mother who was his teacher. Jane however did, Miss Temple. Miss Temple ran the school and tried to do what she could to make things better for the girls. For example after the porridge was burnt, she tried to make it up to them by ordering a special treat of bread and cheese. Also when she finds out the truth about Jane, she invites Jane and Burns to share her tea and buttered toast. She also brought out a cake of her own and shared it with them. This shows that Miss Temple felt sorry for both Jane and Burns, and disagreed with the way they were treated. The cane was used as corporal punishment around the country. This punishment was used on David who reacted strongly and emotionally. Through anger he bit the executor, Mr Murdstone who later sends a sign saying, careful he bites to the school that David attended. The same punishment was used in Jane and Burns case as they had signs of Rebellious and Vain hung from their necks and were made to walk in circles in the rain. This was because Burns had naturally curly hair; that was frowned upon in school and was considered to be vanity. At the same time Jane was punished for being rebellious because she offered for her hair to be cut instead of Burns. Both were punished in other instances, Jane when Mr Brockelhurst came to the school and singled out Jane, announcing to the school Mrs Reeds charge of her being a liar. He tells the other girls that they should not talk to her all day. Jane had to stand alone for half an hour in the middle of the hall on a stool. She felt humiliated at being singled out as a liar. Burns gets punished for having dirty nails (although she didnt explain that the ewers were frozen) and is sent to a room to fetch a bundle of twigs. She does this as if she is doing a drill. She gets the twigs and undoes her collar but shows no emotion as she is being struck, she does though when she is alone as Jane sees her putting away her handkerchief. I looked narrowly as she emerged from the book-closet she was just putting back her handkerchief into her pocket, and the trace of a tear glistened on her thin cheek. This was because she didnt want to give Miss Scatchard the satisfaction of seeing her cry. In conclusion I believe that the system has changed dramatically and to great effect, every child has the chance to go to school, with no discrimination whether they are female or a different race. There is no physical punishment in schools; the only punishment given out is detentions, which parents are notified before their child stays behind. The buildings are in great condition and the teachers are strict without being unfair to pupils. Parents have a say about the way their children are treated teachers can not take dramatic action at the spur of the moment, though teachers can stop a child from learning by sending the culprit out of the classrooms. Facilities have changed with technology, with nearly every school having ICT facilities. With lessons becoming fun by using computers, the internet, videos and other tools of education and recreation.

Acid base balance Essay Example | Topics and Well Written Essays - 1000 words

Acid base balance - Essay Example This is so because the physical diagnosis of the patient showed that the man had a systematic blood pressure of 85 mm Hg/50 mm Hg. His heart rate was 175 beats per minute, his respiration was at the rate of 32 breaths per minute, and his temperature was 37.3 degrees Celcius. The arterial blood diagnosis revealed a pH of 7.23, pCO2 of 69mm Hg, O2 saturation of 88%, and the HCO3 2.2 meq per litre. The patient’s pH was 7.23. This was a clear indication that the patient was suffering from an acid-base disorder. The patient was extremely acidemic, and the acidemia appeared to be secondary towards the metabolic acidosis with a base mean observed to be excess more than 7mEq/I. This was linked to the problems with the compensation in the respiration that was insufficient to maintain the normal limits of the pH (Stewart, 2003). This is evidenced from the fact that his breathing was heavy; he had a weak and rapid pulse. The partial pressure of carbon dioxide was 31mm Hg in comparison to the normal range that is 40 mm Hg. The oxygen’s partial pressure was 69 mm Hg in comparison to the normal range, which is 90 to 100 mm Hg (Wilkes, 2008). Compensation is the regulation of acid-base imbalances in the body (Story, 2001). Different agents do exist to reversibly bind the ions of hydrogen and impede the pH change. The extracellular buffer involves agents such as ammonia and bicarbonate. The phosphate and proteins play the role of intracellular buffers. The patient’s body began compensating the disturbances in the acid base. This was done when the patient’s pressure started to be laboured and his blood testing showed increased elevation of creatine phosphokinase amounts of cardiac muscles. This showed a bicarbonate system of buffering which is normally the key since carbon dioxide was shifted by carbonic acid to the ions of hydrogen and biocarbonate. More often than not, acid base imbalances, which may overcome the system of buffer, could be compensa ted for a short time through altering the ventilation rate. This will change the carbon dioxide concentration within the blood, hence altering the body’s pH. If the body begins to compensate the disturbance in the acid base status, the blood pH will normalize. In this case, the blood pH will move towards the normal range. There are different types of acid base disturbances. The first disturbance is the mixed disorder. The existence of one derangement leads to a simple acid base disorder. It may involve alkosis and acidosis happening at the same time, hence counteracting partially with each other, or there can exist at least two conditions that may affect pH of the body. For instance, mixed acidosis involves a combination of the metabolic acidosis together with the respiratory acidosis. There is no specific arrangement as any of the arrangements is possible, except respiratory acidosis and alkalosis respiration as a person will not breathe too slowly or rather slow for the sam e time (Knaus, 2005). Other types of acid base imbalances that could lead to the increase in pH include carbon dioxide retention, non-volatile acid production from the protein metabolism and different molecules of organic, biocarbonate loss in the urine, acid and acid precursor’s intake (Figge, 2002). Those sources that may lead to the reduction of pH include hydrogen ion use in the metabolism of various organic anions and acid loss in the urine or through vomiting. Human errors are responsible for the false and incorrect results though implications of such errors are somewhat minor, non-existent, and sometimes merely lead to some inconveniences. In the context of health care, this might not necessarily be the case, given that there are increased chances of such