Leadership and entrepreneurship Essay Example | Topics and Well Written Essays - 2250 words

Leadership and entrepreneurship - Essay Example Most of the basic organizational problems such as distorted structural design, poor morale of managers and employees, communication gaps, resistance to change, inefficient controls, iniquitous salary structure, scarcity of resources, incompatibility with external environment and so on are attributed to poor leadership. Entrepreneurship on the hand, which is derived from the French word â€Å"entrprende†, as defined by the famous economist Adam Smith as, â€Å"the economic agents who transform demand into supply for profits†. One of the definitions of the term, includes, the founding of an enterprise which apparently includes all those associated with it such as the decision makers, the stakeholders and the initiators of business or a business idea. In conclusion, entrepreneurs are leaders who develop and grow enterprises. (Stephen Robins, 2004) Bill Gates or McDonald could well be considered as entrepreneurs due to their sheer vision and dedication of converting a business idea into a profitable and economically viable business option. The size of the business rarely affects the leadership qualities. For example, a leader of a national or international enterprise / organization, commands wide – spread influence over a large number of people while the influence of the leader of a small work group in an organization is relatively limited in scope. However this does not affect the fact that they leaders in their own right and fulfill all the duties and responsibilities of an entrepreneur. In a formal organizational setting, a leader enjoys a position of command and exercise power over their subordinates in order to get the work done and achieve the entrepreneurial goals laid down by the organization. The larger the group the greater the difficulties in exercising control over their subordinates. In such a situation, the leadership roles are often distributed among the subordinates, chosen

Business Process Integration Coursework Example | Topics and Well Written Essays - 1750 words

Business Process Integration - Coursework Example In fact, the Internet offers the businesses a lot of opportunities to grow. It allows the businesses to reach the international markets and the worldwide customers without facing geographical restrictions and cost issues, improve business service and support, access to worldwide communications, reform associations, streamline internal procedures, share private data and information and run applications (Simpande & Jakovljevic, 2003; Norton, 2001; Shelly et al., 2005) Basically, the most excellent method to deal with determined business software issues is to remove the old stuff and bring in the innovation. In spite of the demand to put extra messes on the legacy or traditional enterprise resource planning (ERP) technology based system and keep the software applications and projects for another day, the idea is that software technology evolves very quickly as well as innovative EP tools emerges in critical regions like that accessibility, corporate process automation, business intellig ence and integration with new tools like that social CRM or mobile devices can help business organizations to improve their business processes. In this scenario, the latest delivery models like that software as a service (or simply SaaS), hosted Enterprise Resource Planning or innovative technologies like that open source ERP systems can dramatically change IT procedures as well as positively influence corporate performance. Though, latest business software applications and their deployments are for all time a major concern, however they come with a wide variety of risks, mainly when we are talking about our ERP systems. In addition, they are not small systems as they are corporate mission critical technologies that communicate nearly with each transaction in the corporation (gotERP, 2012; Weston, 1998; Simpande & Jakovljevic, 2003). In light of the above discussed facts, the selection of suitable Enterprise Resource Planning system is no longer simply a matter of choosing the corre ct vendor similar to SAP vs Microsoft vs. Sage etc. In the past, there was a standard process to get business licenses for software and then obtain the software services installation disks via email. On the other hand, at the present, we have a wide variety of delivery models of ERP technology. In addition, all the models do not support all the services however the majority can focus simply on one (gotERP, 2012; Weston, 1998; Simpande & Jakovljevic, 2003). In this scenario, one of the latest Internet supported ERP systems is cloud computing. Basically, the cloud computing is a most latest information technology fashion that many business organizations are adopting because of its environmental aspects, money savings, mobility, scalability and energy effectiveness. Basically, the cloud computing allows organizations or individuals to access all their tools, applications and files from anyplace on the earth, as a result releasing them from the limitations of the desktop and allowing wi despread group partnership (Modavi, 2010; Miller, 2009). In addition, a public cloud based ERP solution is possessed and remotely hosted by the vendor. In many cases, instead of taking the license for the entire software, organizations pay a fee for the services they want to use, it is a software licensing model known as SaaS. In this scenario,

Michelangelos Sistine Chapel Ceiling Essay Example | Topics and Well Written Essays - 500 words

Michelangelos Sistine Chapel Ceiling - Essay Example The project was based on fresco, which was a contemporary complex form of painting. Frescos sometimes required carving and minor sculptures as well. Although the medium was thus a very challenging one, Michelangelo was a versatile genius. He was well acquainted with designing and crafting frescos and he was an expert in this field. However, the main complexities in this project involved altitude and complexity of the subject itself. In order to complement the twelve apostles to be painted across the ceiling, Michelangelo had to create over 300 figures. â€Å"The rectangular panels in the centre depict episodes from the book of Genesis. They are surrounded by prophets and other biblical figures†.What is more, the ceiling was at a height of approximately 68 feet from the floor. The surface of the ceiling was considerably curved. So Michelangelo might have wondered that how exactly his painting was going to be viewed and understood from below. Now on a curved surface, any proport ional two dimensional representations would probably look awkward. For example, if a human figure is made across a curved surface, then some of its portions would emerge nearer to the viewer creating disproportions. Michelangelo apprehended this enormous challenge of visual illusions even before he actually began the work. Consequently, Michelangelo started to create disproportional human figures. For example, if the middle portion of a human figure was to be created across the distal concave part of the ceiling, Michelangelo magnified it.

Calculate the bounce Essay Example | Topics and Well Written Essays - 1250 words

Calculate the bounce - Essay Example There are 49 employees, with a total monthly payroll output of  £101,400. Each employee, on average, earns  £2069 monthly or  £24,828 yearly. However, bonus amount should be based on profit figures. Employees are used to receiving  £70,000 in commissions, therefore bonus should be more equal to this figure in which they have become accustomed in order to improve motivation and performance incentives. Analysis methodology should consider current objectives, such as whether the business is looking to invest or, perhaps, expand the company which will require additional expenditures. Questions should be asked such as whether owners’ equity, for the investor stakeholder, should be considered prior to paying a bonus. There is one important factor to consider: In 2008, the company agreed to  £16.5 million in goods in exchange for 50 percent of the company, giving the business these goods for a period of one year. This agreement raised inventory assets in the company, which only improves its position for growth or perhaps access to new credit. The current global accounting standards would identify these goods or perhaps depreciate their value over time, however its rising liquidity from the goods exchange makes the company stronger at the accounting level. Therefore, bonus should not be reduced as current profit levels remain unchanged even with the new 50/50 ownership. The goods received are still part of the company’s inventory. Profit in 2009 was  £7.72 million. There was no cash balance from 2008 to consider as profit was used to expand sales for 2009. With this in mind, if the company divided the entire profit among the 49 employees, it would be calculated as: However, this is far outside of industry norms and equates to more than the employees are used to receiving with their sales commission and would not add to the business’ cash balance, which is strategically

Political philosophy Essay Example for Free

Political philosophy Essay An English philosopher and physician regarded as one of the most influential of Enlightenment thinkers. Considered one of the first of the British empiricists, following the tradition of Francis Bacon, he is equally important to social contract theory. His work had a great impact upon the development of epistemology and political philosophy. His writings influenced Voltaire and Rousseau, many Scottish Enlightenment thinkers, as well as the American revolutionaries. His contributions to classical republicanism and liberal theory are reflected in the United States Declaration of Independence. Lockes theory of mind is often cited as the origin of modern conceptions of identity and the self, figuring prominently in the work of later philosophers such as Hume, Rousseau and Kant. Locke was the first to define the self through a continuity of consciousness. He postulated that the mind was a blank slate or tabula rasa. Contrary to pre-existing Cartesian philosophy, he maintained that we are born without innate ideas, and that knowledge is instead determined only by experience derived from sense perception. THOMAS HOBBES Hobbes was a champion of absolutism for the sovereign but he also developed some of the fundamentals of European liberal thought: the right of the individual; the natural equality of all men; the artificial character of the political order (which led to the later distinction between civil society and the state); the view that all legitimate political power must be representative and based on the consent of the people; and a liberal interpretation of law which leaves people free to do whatever the law does not explicitly forbid. He was one of the founders of modern political philosophy. His understanding of humans as being matter and motion, obeying the same physical laws as other matter and motion, remains influential; and his account of human nature as self-interested cooperation, and of political communities as being based upon a social contract remains one of the major topics of political philosophy. In addition to political philosophy, Hobbes also contributed to a diverse array of other fields, including history, geometry, the physics of gases, theology, ethics, and general philosophy.

King Lear and the Analysis of the Family Concept Essay Example for Free

King Lear and the Analysis of the Family Concept Essay The issue regarding which is more important, love and family ties or fame and political power are issues that are always present in every generation. Well, which is really more important that we should devote our lives in search for the more important thing? Is blood really thicker than water? It is a subjective topic in which persons have different experiences and stand about the subject matter. This paper aims to answer this question by referring to the epic play of William Shakespeare: King Lear. It is also important to look at the values and actions displayed by the characters of the stories and to analyze whether they are still applicable in our contemporary time. â€Å"King Lear† is regarded by many critics as one of the best works of the arguably greatest writer that has ever lived, the immortal William But despite being on of the author’s last works, â€Å"King Lear† had echoed throughout literary history as one of the best read and staged play. It has also become a staple material for those who endeavor in literature studies. The success of the text owes much to the themes that the text generates. One of those themes is an issue that the whole world can relate to about a family. The socio -cultural nature of the family had amplified significantly the readership of the text as it is being used as a study text by those in the social sciences. Family and Society Family is an essential part of the society. It is a major component in the aspect of social health in the world we live in. The family which includes the parents and children, all play a big role in shaping the society, in maintaining the social health of the place we call home. The family is a means of the propagation of life, wherein because of the family, societies continue to exist. It is because of the parent’s capability to bear children and raise them to become better people, thus accounting for a better society. Comparison and Contrast between Modern and Shakespearean King Lear Family The modern American family has more diverse components not just the typical family members. Often times, the structure of a modern family is greatly influenced with the modern influence brought about by the changing times and ideas. Modern societies are not only characterized with the great influence of technological advances and dependency, but rather in more complex terms, the modern family is subjected to changes in the ideals behind the essence of a modern family image. (Woloch 1997) But unlike in modern families, the aristocratic family of King Lear in Shakespeare’s work typifies the basic notion of family struggles at that time. The character of King Lear is portrayed as a struggling human being eager to win the favour of his children in the most drastic ways he knows best. The intention of the character of King Lear is to do what he thinks is best for his sons and daughters. However, he became so obsessed in power and blinded by his intention to protect his daughters at all costs in the expense of Cordelia. In discerning the true identity of a modern family, we realize the need to evaluate the changes in the basic unit of structure in the society from Shakespeare’s time until now. During the early centuries, the family is characterized by only one true virtue: it is composed of the father, the mother and their children. The history behind the family as a concept, involves the idea of each roles portrayed by each entity. The father is the sole provider of the family; the mother is the one who takes care of the children and the household; and the children are there to be nurtured, loved and provided for. But generally these concepts have become the main stereotypes brought into the modern societies. The play has those stereotypes. King Lear is portrayed as a noble aristocrat obsessed with his power. Cordelia is also a pivotal character in King Lear wherein she is seen as a typical good daughter who always follows her father. However, the fool can be put as an allegory of Shakespearean society wherein truth is at its essence of being true. Times change and almost everything in the society changes and has changed. Not just from infrastructure, but also the amount of knowledge shared and experienced by everyone. The concept of family has also changed dramatically. Brought by the women revolution and the emergence of the feminist concept, the country has experienced the women greatly influence the manner in which concepts in the society is changed.(Woloch 1997) The role of women in the society has greatly changed from the stereotyped domesticated females, to the working and productive women of the future.(Kemp Squires 1997) This is an important phenomenon in history that must be addressed in order to define the concept of changing family image. One notable contribution came from the â€Å"changed† status of women and the achievement of gender equality in the country. Another contributing factor to the changing views in family image made by the play King Lear is the role portrayed by men in the society. From a patriarchal type of society, King Lear for instance, experience a dramatic change brought about by the change in the status of women.(Woloch 1997) Men in modern times have to compete more and more with women in context of career and including family life. There is a great paradigm shift of roles from the earlier centuries wherein men have the sole right to work for their family. In modern societies, women share equal roles in bringing and managing resources within the household. These events are clearly depicted in both stories of King Lear and Cordelia. Placed in both different contexts, the two characters in the play depicted the changes within the modern family. In the King’s character, the life of a domesticated father is shown albeit part of the aristocracy. The concept of tough love towards Cordelia is present in all acts. Having experience what probably most modern fathers are experiencing, Shakespeare realized is that being a domesticated father entails the kind sympathy for mothers who spends most of the time taking care of the kids. While men busily work to earn their monthly income, mothers are entailed with a much greater responsibility in terms of taking care of the children. There is a conflict shown in the essay in which the author questions his capacity, as a male figure in the society, to handle such responsibility in the home. While his wife is away, he maintains to struggle between his job as a writer and as an on-hands father. Every domesticated father will realize that it is somehow degrading to realize that he can not do his job or fulfill his professional aspirations in life if he exchanges his role with the wife. There is the internal conflict that lies within the men to question their respective roles in the society and specifically in their own family. Osborne explains the struggles experienced by men in accepting that hard roles that women portray in the society. Once they too have experienced being domesticated, this eventually changes their own perception of their role in the family. Sexual identity and social identity is another main idea in the play’s depiction of courtship. In the story, social acceptance has a main role in considering this kind of modern family. This can be seen over the courting of the Duke of Cornwall towards Cordelia. Over the years, society has witness the growing number of social class relationships that includes a child or the wanting of a child. Many states still is irreconcilable with the issues behind aristocracy. But it is of practice to respect and tolerate the decision by the protagonist in handling his family. Obstetrics, Family, and Social Health on King Lear   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Obstetrics is a key in maintaining social health because it deals with a big part in the society – the family. A particular concept which can be adapted in thes paper, Obstetrics makes sure that life propagates, because it takes care of the women’s concerns during pregnancy, the formation of a new life, a life that would play a big role in the society. Obstetrics takes care of being able to have children of your own, which is another important factor in the family. A child, the product of the parent’s love and efforts, completes the society’s building block, the family (Nesbitt, 2002). As in the case of the main protagonist in the play, the same concept can be applied since King Lear had a difficult time in handling his children effectively. Comparison of the Concept of Family in other Shakespearean Plays In the story of Antigone, Haemon must choose between her love for Antigone and the fame and political power that await him if he obeys his father. In both Antigone and King Lear, the concept of patriarchal obedience is evident. Now Haemon is facing a dilemma because of the conflict between his love and his father. The same choice goes for Antigone for she wants to give her brother the honor of being buried in the right way. Both cases can be traced back to the struggles of Cordelia under his father. However, doing so would mean that she must disobey King Lear’s order. Disobeying the king does not only take the opportunity to be the princess by marrying the king’s son, Haemon, but her own life as well. But Antigone and Haemon decided to follow their hearts. In the end, Antigone killed herself. Knowing that his love is death, Haemon also decided to end his life. Thus, their value for their love ones cost them their own lives. However, they still gain the respect and sympathy of the people of Thebes. It can be said that the actions of Antigone and Haemon are not applicable in our present time. Although there are several movies that portray the same idea, this rarely happen in reality. It is a very rare case in which lovers decided to end their lives since it is impossible for them to be together. They can be considered as martyrs rather than heroes because of the act. Antigone also displays the kind of courage and determination that is greatly needed in our society today. Although she is a woman, she defies the odds and even the king for what she believes is right. Adding to the fact that she lives in the period when woman are considered inferior to man. This kind of courage is really needed by the present generation. Not only woman but men as well that have the courage to stand up and are willing to sacrifice their own lives in order to make a change. Today, although woman are accepted by our society and are ‘said’ to be equal to men, there are still some times that they are afraid to speak out and fight for their rights. Also both men and women are sometimes afraid to question some of the things that they find unjust in the society. They are afraid to face the consequences and are unwilling to make a change to improve social order. This characteristic is really needed in our society today, the courage to fight for what is right even if the whole society is against us. If only there are those like Antigone that are willing to give it all in order to make a change, I’m sure that our society will be a better place to live.   On the other hand, King Lear cannot consider himself victorious. His persistence and determination to exercise his power over the people of Thebes had a considerably great cost. Not only had he lost the sympathy of his people not to mention the approval of the gods but the life of his daughters and sons as well. His authority blinded him and the result is loosing the persons that he values the most. If our present leaders will demonstrate the same reason and behavior like that of King Lear, the people will surely revolt and take their powers and authority away and give it to someone more deserving and just. The people will surely not tolerate such actions. Whether to choose love and family over fame and political power is really a big decision. You cannot have the best of both worlds. To pursue love means to let go of powers and fame and vise versa. Also we cannot really determine which is important, whether to choose love and family ties over fame and power depends upon the situation. What is important is that we do not only consider our own benefit in making the right decision. Also the stories show that to pursue love and power is not wrong, however living your life to attain just one of them is sure to cost you a lot. In making a decision we should both consider the heart and as well as the mind in order to come up with the right decision. References: Ashbee, Edward. American Society Today. New York: Manchester University Press, 2002. Hertz, Rosanna, and Nancy L. Marshall. Working Families : The Transformation of the American Home. Berkeley: University of California Press, 2001. Hutter, Mark. The Changing Family. 3rd ed. Boston: Allyn and Bacon, 1998. Kemp, Sandra, and Judith Squires. Feminisms. Oxford Readers. Oxford ; New York: Oxford University Press, 1997. Woloch, Nancy. Early American Women : A Documentary History, 1600-1900. 2nd ed. New York: McGraw-Hill, 1997. Wakefield, Thaddeus, and NetLibrary Inc. The Family in Twentieth-Century American Drama. New York: P. Lang, 2004.

Pain Management and Post Operative Care Case Studies

Pain Management and Post Operative Care Case Studies This is a scenario based essay in which two scenarios will be looked at. One is on osteoarthritis and osteoporosis patient and the other one is based on oesophageal reflux disorder and peptic ulcer disease. The clinical manifestations of these two health problems and post-operative care of patients with these issues will be discussed in this paper. Complications of gastric diseases here in will also be discussed Osteoporosis also known as porous bone or fragile bone is a chronic form of metabolic bone disease characterized by a significant weakening in the structure of bone tissue and a low bone density (Brown and Edwards, 2012).This occurs when there is an imbalance between the bone formation and bone resorption. Under normal circumstances, osteoblasts constantly deposit bones which are resorbed by osteoclasts. This process is termed remodelling. In this case, the rate of deposition equals that of resorption such that for the total bone mass remains constant .However in osteoporosis, the bone resorption exceeds bone formation which leads to thin, fragile bones that are subject to spontaneous pathological fracture ( Craft et al,2011 ).Osteoporosis has some risk factors which are classified as modifiable and non-modifiable risk factors. Some of the modifiable risk factors include; low birth weight, cigarette smoking,malnutrition,low calcium intake, deficiency of vitamin D, deficit of oestroge n or androgen ,poor physical activity, some medications like steroids, anticonvulsants , vitamin A, and chronic conditions like thyroid, liver diseases as well as diabetes while the non-modifiable ones are race,sex,advanced aged,genetics,dementia, previous fractures as an adult(Kenny and Karen,2013).Osteoporosis is often regarded as a silent disease. This is because during the early stage, the bone loss is usually asymptomatic. At this point, Claire may not realise that she has osteoporosis but as the disease progresses, her bones become weaker such that even a slight or sudden bump or fall results to a fracture of either the hip, vertebral or wrist.However,Acute back pain is one of the earliest clinical manifestations Claire will be experiencing. This occurs due to vertebral compression fracture. Groin or thigh pain may also occur due to hip fracture (Brown and Edwards, 2012). Osteoarthritis on the other hand develops when the articular cartilage that protects the ends of bones in a joint begins to disintegrate. This disorder is more prevalent among the elderly and regarded as part of their aging process. Any localized wear and tear may hasten the situation and its symptom may be confined only in one joint. Early in the disease, the cartilage starts to break becoming roughened and thinner thereby interfering with easy movement.Cytokines which stimulate the release and production of an enzymes called protease are released( LeMone et al,2011)). This enzyme causes increase in the disintegration of the cartilage. To this end, the subchondral bone becomes damaged and exposed while cysts and osteophytes spurs developed around the margin of the bone. Osteophytes piece and cartilage starts to break off into the synovial cavity which further causes irritation and makes the joint space narrower. This exposes the bony surfaces hence they, rub against each other causi ng pain thus making the affected joint to become inflamed frequently (LeMone et al, 2011). Osteoarthritis has many clinical manifestations occurring due to body’s response to this degenerative change which ranges from mild discomfort to major disability. ( Brown and Edwards, 2012).some clinical manifestations Claire may experience may include joint pain.and swelling. It occurs due to weight bearing and movement. The pain may be unilateral and eventually becomes more severe as the degenerative changes progresses (Brown and Edwards, 2012 ).During the initial stage, this pain can be relieved by rest but as the disease advances, the pain may occur even at rest and Claire’s sleeping pattern may be interrupted as a result of joint discomfort. This joint discomfort may become more severe following a change in weather condition (Brown and Edwards, 2012).There will be limited joint movement due to loss of cartilage which is irregular and worn and osteophytes developed. Also crepitus may be heard as the joints become irregular, rubbing against each other.Towards the en d or middle joint of fingers, Claire may develop bony lumps known as herberden and bouchard nodes leading to structural deformity. (Brown and Edwards, 2012). Following Claire’s fracture repair, her post-operative nursing care and management are directed towards promoting safety, monitoring vital signs and applying the general principles of post–operative nursing care. The nurse will ensure that all the necessary safety equipment’s are near the patient’s bed side and in good working condition in case of emergency. Assess patient’s airway, circulation and breathing sounds for patency and check vital signs and pulse oximetry for baseline (Perry et al, 2012). Determine patient’s pain level using the pain rating. This will reveal the nature of pain and as well direct the nurse towards suitable interventions. Assessment of Claire’s neurological status is also of paramount important to ascertain the level of consciousness and movement of extremities (Perry et al, 2012). Observe IV access for patency and signs of infection, noting the rate to avoid insufficiency and overload. Check catheter drainag e for patency, colour, amount, ensuring frequent emptying and proper documentation in the intake and output chart (Perry et al, 2012). Also neurovascular assessments of the affected extremity are very important in order to detect changes while movement restraints or activities related to the turning, positioning and extremity support should be monitored closely and proper alignment and positioning to minimize discomfort and pain should be encouraged. Also, cast or dressings should be observed closely for signs of bleeding or drainage. It is pertinent to note that, any significant increase in the size of the drainage should be reported and documented (Perry et al, 2012). It is expected that Claire’s mobility will be impaired following surgery. Therefore, frequent assessment of common complications of immobility like pressure sore formation, renal calculi, deep vein thrombosis, pneumonia, paralytic ileus and pulmonary embolism are necessary and appropriate measures taken to alleviate it must be taken. Some of these measures include two hourly change of patient’s position according to hospital policy .This can be done by assisting in repositioning while stabilizing the fracture site (Lewis et at,2006).Other measures can be deep breathing and coughing exercise, active range of motion exercise, providing TED socks as well as early ambulation. Immobilization of the elbow to prevent wrist supination and pronation is necessary while the nursing management should include steps to prevent or reduce oedema and regular neurovascular assessment. Extremity should be supported and protected along with active movement of the fingers and thumb. This ex ercise helps reduce oedema, avert stiffness and increase venous return (Lewis et al, 2006). Active movement of the shoulder to prevent stiffness or contraction should be frequently performed by patient and must be encouraged. Deep venous thrombosis and subsequent pulmonary embolism which may occur due to venous pooling can be alleviated by using techniques to promote lower limb blood flow. Electrical stimulation induced contractions have been shown to improve skeletal muscle movements preventing venous stasis and oedema (Broderick, 2010). Regularly assessing the pin insertion sites and providing pin site care as per hospital policy is highly important and any signs of infection like redness, purulent drainage and increases tenderness must be reported and documented ( LeMone et al,2011). Prescribed medications such as antibiotics and analgesics per physicians order must also be administered and charted. The patients may also require assistance with ADLs especially where the stronger hand is the one affected (Farrell Dempsey, 2011). Following Claire’s complain of pain, it is important to assess patient’s level of comfort and the character of her pain. This can be done by asking her about the precipitating factor, quality, radiation ,severity and timing and also asking patient to rate the pain level using a scale of 1 to 10.All this measures will assist to determine the type and level of pain the patient is experiencing and to decide the type and dose of prescribed analgesic that will best suit patients pain where there is a choice .It can also help to decide whether her pain can be managed with non- pharmacological measures like arm elevation, ice application or even finger exercises (Perry et al, 2012 ). After these measures have been taken, neurovascular status fine and patient still in severe pain, the nurse will check the last time patient was given analgesic, route ,dose, frequency and as such its effectiveness .This is to determine the need for another dose and if the dose need to be increase d. However, before administration, the order must be checked by two nurses, the six rights of medication administration observed and patient’s identity confirmed using two identifiers such as name and date of birth for safety. After administration, the nurse will re-assess patient for effectiveness (Perry et al, 2012). Following Claire’s fracture and surgical procedure, some of the post-operative complications she may experience include compartment syndrome, fat embolism, deep vein thrombosis, pneumonia, pulmonary embolism, pressure sore, paralytic ileus, renal calculi, loss of appetite. This potential problems can be prevented by early ambulation which will help promote muscle tone, improve urinary and GIT, promote circulation to eliminate venous stasis and hasten wound healing (Mak et al, 2010). Additionally, problems associated with bony union and possible infection may occur. If adequate muscle and tissue coverage is not achieved following muscle and flap grafts, amputation may be needed (Mak et al, 2010). SCENARIO TWO Gastroesophageal reflux disease is a condition caused by the reflux of gastric contents into the oesophagus which aggravates symptoms and alters ones quality of life. This structural change produces heartburn and regurgitation. Reflux occurs when the lower oesophageal sphincter pressure is deficient or pressure in the stomach exceeds the lower oesophageal sphincter pressure. This leads to reflux of acid, bile, pepsin and pancreatic enzymes thus resulting to an injury in the mucosal lining (Giorgi et al 2006). Peptic ulcer disease generally known as painful sore or ulcers is most commonly found in the proximal duodenum and also in the antrum of the stomach or lower oesophagus (Brown Edwards, 2012). Normally, water, electrolytes and water soluble substances like glucose pass freely through the mucosal barrier while acids and pepsin are denied entry. This defence mechanism can be altered in certain conditions allowing backflow of acid and pepsin. As hydrochloric acid or pepsin penetrates the mucosal barrier, the tissues are exposed to continue damage due to acid diffuses into the gastric wall. Ulcers may erode more deeply into the muscularis and then perforate the wall. As erosion invades the blood vessel wall, bleeding takes place (Brown Edwards, 2012). This peptic ulcer disease has various clinical manifestations. Pain is one of the symptoms patient is experiencing. Its nature is typically described as burning, gnawing, aching or hunger-like and is often felt in the epigastric region, sometimes radiating to the back mainly when the stomach is empty (WebMD,2014). The pain is usually relieved by eating or by ingestion of antacids. Other symptoms the patient may be presenting with are loose of appetite and weight loss, heartburn or regurgitation, vomiting. Chest pain or dysphagia, anaemia. As patient’s condition become more severe, there may be malaena .This occurs due to bleeding from perforated mucosal wall.Haematemesis may also result (Brown Edwards, 2012). Helicobacter pylori infection are amongst the most common cause of peptic ulcer disease which directly and indirectly weakens the protective mucosal lining of both the stomach and duodenum allowing easy access of acids to the sensitive areas. As this happens, the lining becomes irritated and wears off resulting to sore formation (Duggan Duggan, 2006). Other factors includes excessive intake of NSAIDS such as aspirin or ibuprofen,genetic,smoking,high consumption of alcohol and coffee, liver or lung diseases, starvation, stress and certain diets(Duggan Duggan,2006). Histamine 2 receptor blockers like ranitidine are indicated for a patient with peptic ulcer disease. These drugs act by inhibiting histamine binding to the receptors on the gastric parietal cells to reduce or stop secretion. Proton pump inhibitors such as omeprazole which stops the acid secreting enzymes functioning as proton pump, disabling them for a period of 24hours also provides effective pain relief and promotes rapid ulcer healing (Brown Edwards, 2012). Antacids also stimulate gastric mucosal defences thereby aiding in ulcer healing. Other mucosa agents that can be helpful include sucralfate, Bismuth compounds and prostaglandin analogs (Brown Edwards, 2012). Many disease conditions can present with symptoms found in peptic ulcer thus making its diagnosis difficult. However to avert this, certain diagnostic procedures such as gastroscopy and colonoscopy need to done and the nursing care of a patient undergoing these procedure shall be explained in this part of the paper. Firstly, the nurse will ensure that consent is obtained, explain procedure to the patient, informing the patient his role.Prepre patient’s bowel by checking when last patient eat or drink, ensuring patient is on nil by mouth for 8hours prior to surgery (Perry et al, 2012).Depending on physicians order, patient may be on clear fluid for 1 to two days pre- procedure and enema given the previous night to permit easy insertion and clear visualisation. Checks vital signs and assess oxygen saturation level to obtain baseline and to compare post-operatively. Provide patient with gown, carefully remove patient’s dentures and artificial prosthesis patient may have an d storing them in a safe place (Perry et al, 2012). After the procedure, vital signs should be monitored closely especially temperature as sudden rise in temperature may indicate perforation, patient’s level of consciousness must be assessed to determine his ability to comprehend and follow instructions. Flatus, abdominal discomfort, fever, rectal bleeding, chills, swallowing difficulty, malaena, haematemesis are common therefore should encourage patient to report if notice any (Brown Edwards, 2012).Assess patient bowel sound and swallowing reflexes and encourage to eat and drink when present. Normally patient’s are not allowed to drive or operate machinery 24hours following procedure, therefore nurse should ensure that patient is accompanied home by an identified driver (Perry et al, 2012,). In a case of rectal bleeding, the nurse will support patient to bed to ensure comfort. Check vital signs because any significant drop in blood pressure and sudden rise in heart rate may serve as a good indicator for severe blood loss. If noticed any deviation, patient appears weak and unstable, urgent fluid replacement with 0.9% normal saline must be given to replace fluid loss. Closely monitor his abdomen for tenderness and distension. If after all these measures his condition still remains the same, medical team must be alerted for further treatments (Craft et al, 2011) Putting in place the above nursing interventions will help alleviate pain and manage post op complications in patients. Nursing care considerations always need to be specifically befitting the patient’s condition and their current presenting problem. As in the above the care consideration for a patient with musculoskeletal problems is definitely different from the other patient with gastrointestinal system diseases.