The Hurricane Katrina Hit New Orleans - 878 Words

Hurricane Katrina hit New Orleans in August of 2005. A once vibrant and cultural community was decimated by harsh winds and extreme flooding. The rescue efforts sent to Louisiana were substantial, consisting of now only FEMA but also donated services from other countries as well. Even so thousands of people were displaced from their homes. There are people who refused to leave even after their homes were flooded and their mementos lost to the dirty polluted water. Ten years after the fact the city is still under construction. There are varying degrees of repair from street to street, the tourist area was one of the first few areas to be repaired, and the neighboring residential areas seem to have become of secondary importance. People were forced into homelessness because they could not afford to repair the house they had worked to attain before the hurricane toppled their economy. Still to this day the homeless line the streets, which should seem scary and dangerous, but it does not feel that way. It has become obvious that people need to learn to look beyond their own beliefs to better understand the world as a whole because not everything is how it seems. I went to New Orleans in May of 2015 to see my brother graduate from Loyola University, I had never gone to see him once in his four years there because my parents feared for my safety. I was told to be afraid of the people on the streets, to always be with someone who was bigger and stronger than myself. I was walkingShow MoreRelatedThe Impacts of Hurricane Katrina on New Orleans798 Words   |  3 Pages I am doing a project on the impacts on New Orleans after Hurricane Katrina. Hurricane Katrina hit on August 28, 2005. The hurricane caused many deaths and many injured people after this disaster. They lost so much money for repairs and all the oil that they lost from this catastrophic event. 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PeopleRead MoreHurricane Katrin Human Made Disaster Essay1315 Words   |  6 PagesHurricane Katrina: Human-made Disaster â€Å"Situated on a bend of the Mississippi River 100 miles from its mouth, New Orleans has been the chief city of Louisiana and the Gulf of Mexico’s busiest northern port since the early 1700s. Founded by the French, ruled for 40 years by the Spanish and bought by the United States in the 1803 Louisiana Purchase, New Orleans is known for its distinct Creole culture and vibrant history. Significant battles of the War of 1812 and the Civil War were fought overRead MoreHurricane Katrina Essay866 Words   |  4 PagesHURRICANE KATRINA Hurricane Katrina was one of the deadliest hurricanes ever to hit the United States. Hurricane Katrina started out as any other hurricane, as the result of warm moisture and air from the oceans surface that built into storm clouds and pushed around by strong forceful winds until it became a powerful storm. 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Finger pointing started before the event was over. Most of the focus on Hurricane Katrina was on its impact on New Orleans; however, the storm ravaged a much wider area than that. This paper will briefly summarize the event, the impact on the city of New Orleans and the lessons learned to ensure preparedness today. Hurricane Katrina FormedRead MoreRace, Hurricane Katrina, and the Aftermath Essay1125 Words   |  5 Pages â€Å"George Bush doesn’t care about black people.† these are the words that Kanye West spoke during a Hurricane Katrina fundraising concert. Not only did the sentiment expressed with those words resonate with many Americans watching the concert that day, but observing the post Hurricane Katrina aftermath some would go a step further and argue that the United States government doesn’t care about black people. Although there were several events in the history of this country that would lead oneRead MoreThe Wrath of Mother Nature: Disaster Management of Hurricane Katrina1341 Words   |  6 PagesEarth. Hurricane Katrina was one of the worst natural disasters ever recorded. With fierce winds and high water levels Katrina hit the city of New Orleans with great force on Monday Aug 29th 2005 (Oshinsky). The water rose so high that it left about 80 percent of New Orleans underwater (Oshinsky). The truly sad part of this whole situation is how ill prepared New Orleans was for this disaster. Many people thought that Hurricane Katrina would skim by the coast of New Orleans like many hurricanes in the

Compare the historical performance of William Hill against Ladbrokes

Essays on Compare the historical performance of William Hill against Ladbrokes for their growth analysis over the last few years Essay RATIO ANALYSIS OF WILLIAM  HILL  PLC Growth of a firm is the fact that encapsulates the interests of shareholders, investors, analysts and all other stakeholders (Mouri, Sarkar Frye, 2012). Importantly, this growth is geared and contributed by various factors, and understanding of the growth is only possible with an insight into the trend of these factors. Concurrently, the strength of this growth is also gauged in comparison with the performance of competitors. In a similar pattern, this report assesses the growth of different financial components of William  Hill  PLC, which is one the leading bookmaking service provider in the United Kingdom (Google Finance, 2014a). The comparison is developed against competitor  Ladbrokes  PLC, which is another leading betting and gaming company in the UK (Google Finance, 2014b). Revenue and Profits Growth The growth trend of the revenue and profits of the two competitors shows the following: Revenue Growth 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004                                  WMH  PLC Rev 1,486,500 1,276,900 1,136,700 1,071,800 997,900 963,700 940,400 894,200 10,746,000 8,287,700 16.4% 12.3% 6.1% 7.4% 3.5% 2.5% 5.2% -91.7% 29.7%    LAD Rev 1,117,700 1,084,400 976,100 980,100 1,032,200 1,172,100 1,235,000 970,000 11,505,000 11,893,000 3% 11% 0% -5% -12% -5% 27% -92% -3%    Profits 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 William  Hill  PLC 257,000 277,700 187,400 193,300 120,900 293,300 209,200 235,400 176,000 205,300 -7% 48% -3% 60% -59% 40% -11% 34% -14%    Ladbrokes  PLC 67,600 200,700 134,600 147,100 174,100 250,200 344,200 243,000 240,000 311,000 -66% 49% -8% -16% -30% -27% 42% 1% -23%    The revenue trend of both companies shows that they have consistent growth, though the growth of the competitor remained in the negative domain for most of the season. However, there has been wide variation in the performance of the profits growth. LAD, in terms of revenue, remained in the negative domain while the company under discussion showed consistent fluctuations. The fluctuation in the profit did not show any notable reflection on total assets. Further, notable growth of the fixed assets was reported in 2004 and then in the most recent reported year, while in the remaining years the current assests absorbed the fluctuation. This is unlike LAD’s trend of total asset growth, which showed a decline in the initial years, with a drop in sales, and only managed to recover to some extent. The trend is as follows: William  Hill  PLC 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004    Fixed Assets 2,141,200 1,685,200 1,643,700 1,670,600 1,674,400 1,727,300 1,595,200 1,563,500 1,369,000 858,100 Growth 27% 3% -2% 0% -3% 8% 2% 14% 60%    Current  Assets 272,700 190,000 164,600 156,700 176,000 108,600 107,500 144,000 97,000 82,700 Growth 44% 15% 5% -11% 62% 1% -25% 48% 17%    Total Assets 2,413,900 1,875,200 1,808,300 1,827,300 1,850,400 1,835,900 1,702,700 1,707,500 1,466,000 940,800 Growth 29% 4% -1% -1% 1% 8% 0% 16% 56%      Ladbrokes  PLC   2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 Fixed Assets 1,041,700 933,200 893,600 909,900 893,200 1,013,400 840,100 715,900 656,000 4,234,000 Growth 12% 4% -2% 2% -12% 21% 17% 9% -85%    Current  Assets 77,000 93,100 106,900 102,500 174,600 260,700 205,300 114,400 4,794,000 870,000 Growth -17% -13% 4% -41% -33% 27% 79% -98% 451%    Total Assets 1,118,700 1,026,300 1,000,500 1,012,400 1,067,800 1,274,100 1,045,400 830,300 5,450,000 5,104,000 Growth 9% 3% -1% -5% -16% 22% 26% -85% 7%    Liabilities and Equities Total assets are financed either by debt or equity. In the initial years, WMH financed its total assets from the long term liabilities (in 2005 and 2006), and since then it has been retiring its debt and shifting its focus towards equity and short term financing. It raised its long term liabilities again in the current year for financing total assets. On the contrary, Ladbrokes  Plc has recentlty increased its reliance on equity after consistent retirement of sizebale equity in the years around the finacial crisis.    2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 William  Hill  PLC Short Term Liabilities 328,600 273,300 257,800 224,900 552,700 212,600 148,500 181,400 186,000 203,600 Growth 20% 6% 15% -59% 160% 43% -18% -2% -9%    Long term 1,062,000 579,500 662,700 759,200 553,600 1,275,200 1,321,100 1,335,600 1,061,000 486,200 Growth 83% -13% -13% 37% -57% -3% -1% 26% 118%    Total Liabilities 1,390,600 852,800 920,500 984,099 1,106,302 1,487,800 1,469,600 1,517,000 1,247,000 689,800 Growth 63% -7% -6% -11% -26% 1% -3% 22% 81%    Equities 1,023,300 1,022,400 887,800 843,200 744,100 348,100 233,100 190,500 220,000 251,000 Growth 0.09% 15.16% 5.29% 13.32% 113.76% 49.34% 22.36% -13.41% -12.35%    Ladbrokes  PLC Short Term Liabilities 184,800 144,700 280,200 271,300 304,600 818,300 561,500 381,600 589,000 988,000 Growth 27.71% -48.36% 3.28% -10.93% -62.78% 45.73% 47.14% -35.21% -40.38%    Long term 506,900 460,600 414,300 484,500 823,600 783,800 934,700 1,075,600 2,268,000 1,565,000 Growth 10.05% 11.18% -14.49% -41.17% 5.08% -16.14% -13.10% -52.57% 44.92%    Total Liabilities 691,700 605,300 694,500 755,800 1,128,200 1,602,100 1,496,200 1,457,200 2,857,000 2,553,000 Growth 14.27% -12.84% -8.11% -33.01% -29.58% 7.08% 2.68% -49.00% 11.91%    Equities LD 427,000 421,000 306,000 256,600 -60,400 -328,000 -450,800 -626,900 2,593,000 2,551,000    1.43% 37.58% 19.25% -524.83% -81.59% -27.24% -28.09% -124.18% 1.65%    Return on Equity Overall growth of a firm is measured by the return on equity of the firm. Accoridng to Palepu and Healy (2007), the measure for sustainable growth of the firm as follows: ROE x (1 – dividend payout ratio) However, since both firms do not offer dividends to their shareholders, the measure of ROE on the whole is taken as a measure of sustainable growth. WMH showed huge growth in the intial years of assessment; however, it fell steeply after the financial crisis. Moreover, the ROE has attempted to regain the strength. On the other hand, competitor LAD showed a similar wide fluctuation of the ROE as well, where it indicated no trend from 2006 to 2009 and gained a position almost doubled in comparison to that of WMH, as shown from figures below: Growth 2013 2012 2011 2010 2009 2008 2007 2006 2005 ROE (WMH)% 25.11 27.16 21.11 22.92 16.25 84.26 89.75 123.57 80 ROE (LF))% 15.83 47.67 43.99 57.33 n.s. n.s. n.s. n.s. 9.26 Hence, the overall growth performance of WMH was found to be considerably consistent as compared to LAD. References Google Finance. (2014a). William Hill Plc. Available from http://www.google.co.uk/finance?q=LON%3AWMHei=zedIVLCKIamgwwOu1YDACg [Accessed 23rd October, 2014] Google Finance. (2014b). Ladbrokes Plc. Available From http://www.google.co.uk/finance?q=LON%3ALADei=evVIVMHJJoKmwAPJjoCIDQ [Accessed 23rd October, 2014] Mouri, N., Sarkar, M. B. Frye, M. (2012). Alliance portfolios and shareholder value in post-IPO firms: The moderating roles of portfolio structure and firm-level uncertainty.  Journal of Business Venturing,  27(3), pp. 355–371. Palepu, K. Healy, P. (2007).  Business analysis and valuation: Using financial statements. Cengage Learning.

Athletes and Ethics The Choice to be Role Models Free Essays

The merits and ethics of athletic scholarships, and the accountability athletes had to accept to conform to projected social norms is a contentious issue. On one hand, the pressures athletes face depend on the nature of the various normative and actual notions of role models projected onto athletes by the relevant institutions, the branches of these institutions, and society at large. However, the pressures athletes face depend on the attitude of the athlete towards the concept of the ‘role model’, and how seriously the athlete takes subjective notions of public image   and civic virtue. We will write a custom essay sample on Athletes and Ethics: The Choice to be Role Models or any similar topic only for you Order Now The social and institutional versus athlete pressure/role model dynamic essentially hinge on whether athletes should be viewed as role models, the difficulty in being a role model, whether they should indeed be expected to be role models, or if athletes even have a choice in the matter. Athletes and Ethics: Big Pressure for High School and College Athletes A young boy enters the house in his favorite purple Lakers jersey. As he sat in front of the television, he sees his favorite basketball star, Kobe Bryant, arrested for allegedly sexually assaulting of a woman.   From the perspective of civic functionality, there are some strong views against the use of athletes as role models. Citing the high profile example of Kobe Bryant, Brown (2005) contends that there can be a discrepancy between the public persona and private deeds of high profile professional athletes. Bryant’s case is instructive of cases where an athlete’s public good standing can be shattered in the light of public scrutiny. Whether or not there was truth to the allegations, did Bryant hold any responsibility to the public regarding the damage this has to his image? Either way, he did not have a choice. Athletes as Role Models: A Perception of the Past   At issue here was the view that to be a role model was defined by the contributive function made by a member of society. Doctors, police, firefighters and soldiers were apparently more intrinsically deserving of the social abstraction of â€Å"role model.† However, the philanthropic activity of athletes did not negate their supposed lack of social function outside of a sport (Brown, 2005). The emergence of the celebrity status of athletes as role models of the youth may seem to be a product of mass media and marketing. To prove that this was not so, all puns aside, Mosher (1998) gave further credence to the image of sports people as role models. A presentation of the athletes as role models in a historical and sociological context must be done to show the perception these sports people had for the longest time. The British amateurism in the sports of the 19th century, where amateurism and elitism worked hand in glove to exclude the working classes from any participation in certain sports that were the reserved for the â€Å"civilized gentlemen† of the ruling elite (Mosher, 1998). Chivalry was the image of role models, as translated to the modern century America’s language, was both universally accepted and desirable. America, where improving one’s lot was the central pillar for its foundation, did not let amateurism find fertile ground in this self-proclaimed egalitarian nation. Hence, with professionalism and the social mobility associated with it, came the desire of upstanding role models in sport inherited by concepts of chivalry in the Old World. Going back further in time, the Greeks were seen to greatly influence how heroism was related to sports. During their time, sportsmen were regarded as heroes. Competition was something that was highly regarded and those who participated were regarded to be men who were above ordinary men (Boon, 2005). The hero figure was someone who had physical strength, courage and an innate ability to confront dangerous circumstances without fear; most of these qualities were attributed to their Greek athletes as well as to their great warriors. A hero was the Greek’s version of the public’s role model, even if it the modern term was an understatement and less romanticized. Athletes still held the same power, influence and impact that were given by history to sportsmen. They were ideally seen to transcend mediocrity and to prove themselves by exceptional acts and to serve as perfect examples because of their superior qualities (Boon, 2005). They were seen to dominate human action and to symbolize success and perfection, as well as the conquest of evil. Thus, they were seen to be men of good character because if they were not it would mean they were imperfect and mediocre. Aside from the Greek correlation of sports and heroism, aside from physical development, how did sports become a tool to build character in the American perception? There was a time wherein sports was not even considered to be something good in American life as it was seen to be the root of gambling and everything that was un-Christian? How come it has now been regarded as an avenue of chivalry and gentlemanly behavior? It was during when the Church attempted to regulate sports that it was seen to serve the purpose of character development for boy and girls (Mosher, 1998). Even basketball was created to promote teamwork, self-sacrifice, obedience, self-control as well as loyalty. The biggest factor that was seen to have implanted the idea that athletes must be role models was the Olympic movement (Mosher, 1998). In the present, the analogy of comparing people of chivalry in the past to athlete role models of the present time was seen to be outdated. However, the fact that it was still existing seemed to provide the sense of intrigue as to where this concept came from and why it had survived for so long (Skidelsky, 2003). In the 19th century, sportsmen accepted the idea that they had a special duty to behave well. Athletes were seen to be required to behave under the â€Å"proponents of ‘muscular Christianity’† as it was instilled in moral instruction of the sports (Skidelsky, 2003). This created the belief that physical robustness was expectedly connected to moral purity, something that would be indubitable in the present world of sports. The public, at present, would be constantly bombarded with how athletes were not able to cope with the pressures and temptations of fame. Unlike the requirement of the past, professional sports had ceased to require any form of moral or responsible behavior for these athletes to be successful (Glenarden, 1997). Possessing success seemed to be held by society to be more important than possessing good character, morals or ethical behavior. How to cite Athletes and Ethics: The Choice to be Role Models, Papers

Nursing Practice in Context Evidence-Based Nursing

Question: Discuss about the Nursing Practice in Context for Evidence-Based Nursing. Answer: Pathophysiology of post-operative hypovolemia The post-operative hypovolemia indicates a decrease or reduction in the blood volume due to the absence of sufficient blood plasma also known as volume contraction occurring due to blood loss or sodium or intravascular water loss from the body (Yoder-Wise, 2014, p.90). According to Geerts et al. (2012,p. 670) studies, any condition like vomiting, diarrhoea, injury, large burns, and insufficient fluid intake can contribute to the hypovolemia condition. Basically, there are four stages of hypovolemia out of which the fourth stage is considered to be most severe state of hypovolemia shock. In the present case study, Mr. Jensen is in 3rd stage of hypovolemia where his systolic BP Loya et al. (2012, p.616) indicated that the state of hypovolemic shock is a stressful stage where the body does not persist enough blood to fulfil its requirements leading to decreased blood pressure or hypotension development in the body. As the heart is not able to get sufficient pumping blood it leads to lowering blood pressure. Kobayashi, Costantini Coimbra (2012, p. 1410) studied that initial stages of hypovolemic there is a loss of skin elasticity, dryness and lower urine output. To overcome this blood loss, human body tries to compensate by accelerating heart rate, heart contractions and shrinking periphery blood vessels. But, in the state of continuous blood loss, the compensation ability of body gets reduced that results in hypotension development. Mr. Jensen is observed of having this severe state of hypovolemic shock where his pre-operative condition of hypertension has now become hypotension due to huge fall in his blood pressure from BP- 155/100 to BP-104/55. Geerts et al. (2012, p. 672) studied that hypotension is a state of decreased blood pressure rather than low blood pressure that is identified by a comparing the current BP and baseline BP of the patient. Therefore, Mr. Jensen is in hypotension state where his current BP is very low when compared to his baseline blood pressure. This hypotension is the outcome of hypovolemic shock condition that is produced by the different bodily system to control haemorrhage. According to Weingarten et al. (2012, p.45) there is activation of the coagulation cascade and shrinking of blood vessels by the hematologic system to compensate blood losses in the body. The thromboxane A2 gets activated creating immature clot in the bleeding source that takes 24 hours for maturation. Therefore, the body remains in a state of hypovolemic shock for the minimum period of 24 hours. Further, Kobayashi, Costantini Coimbra (2012, p. 1416) studied indicated that cardiovascular system of the body shows acceleration in myocardial contraction, heart rate and peripheral blood vessels contraction in response to hypovolemia. This leads to lowering of blood pressure in the body. The renal system of the body reacts by acceleration in renin secretion, which leads to the development of Angiotensin II. This Angiotensin II helps by reversing the stressful haemorrhagic situation by activating aldosterone secretion that improves sodium reabsorption in the body. According toHolte (2010, p. 4156),pathophysiology of postoperative hypovolemia is highly contributed by the neuroendocrine system that leads to lower urine output in the body. The activation of antidiuretic hormone (ADH) is initiated by the neuroendocrine system as a response of hypotension. This ADH favours an increase in reabsorption of salt and water in the loop of Henle, collecting ducts and distal tubule in the kidney. Therefore, a decreased urine output is observed as a symptom of hypovolemia. In the case of Mr. Jensen decreased urinary output identified as post-operative condition contributes to hypovolemic shock. His urinary output of1ml/kg/hr and dilute indicates a much low level of urine output from his body. Further, there are many indications in assessment data of Mr. Jensen that must have contributed to the pathophysiology of hypervolemia stressful condition where he had a cold body indication as the initial symptom of stress. The heart rate of Mr. Jensen was recorded as 107BPM that is little higher than normal heart rate indicating cardiovascular activities of hypervolemia state working to manage decrease in the blood pressure. He was under Hartmanns Solution intake at 125mIs/hr that is a replacement for lost mineral salts and body fluid indicates a loss of body fluid in his body. He was also under the state of hypoxemia having FiO2 à ¢Ã¢â€š ¬Ã‚ ¨6 ltires supply to the body. Geerts et al. (2012, p. 669) indicated that hypoxemia is also a part of hypervolemia pathophysiology where a low level of blood plasma leads to low oxygen absorption it the blood creating respiratory disorder. The organs like brain, heart kidneys and liver of body win to overcome the traumatic condition of hypovolemic but organs like skin, GI tract and skeletal muscle fails to do so. The physiology of body response involves increased respiration, cardiac output and retention of sodium. But, the body is not able to compensate hypotension and tachycardia situation occurring in this condition. There is an increase in vasopressin, epinephrine and angiotensin by the body to overcome this state with baroreceptor-mediated vasoconstriction (Polit Beck, 2013, p.101). This results in lower urine output, minimized pulse rate, tachypnea and tachycardia (Schlag Redl, 2012, p. 90). Identifying priority problems of Mr. Jensen as per ABCDE approach and their justification The ABCDE (Airway, Breathing, Circulation, Disability, Exposure) exposure approach is the most reliable and acceptable clinical approach of immediate patient assessment to allow immediate essential interventions and treatment. ABCDE approach is used in case of all clinical emergencies and injuries where specific techniques are applied to gather data about the critical problems confronted by the patient (Morandi, Brummel Ely, 2011, p. 46). In this study, ABCDE approach is used to access the priority problem of Mr. Jensen that requires proper treatment and intervention. Airway evaluation This is the very first step of ABCDE assessment approach where the airway obstruction of the patient is identified using see-saw respiration technique. This is done to access any kind of obstacle in the airway that can harm the normal breathing and speech of the patient (DiCenso, Guyatt Ciliska, 2014, p. 145). In the case of Mr. Jensen, he is observed to be having a clear airway obstruction because he is already on FiO2 with normal respiration rate 24BPM indicated in his assessment data. Breathing evaluation: This assessment involves identifying the respiratory rate, movements of chest walls, pulse oximetry, chest beating and auscultation of lungs. The main aim of this assessment is to determine the breathing depth, respiratory patterns and chest deformities occurring due to illness or injury. This process involves recording the respiratory rate and SpO2 rate (Wilson Giddens, 2014, p.120). In the case of Mr. Jensen, there is no priority issue identified for his breathing as he is having a normal respiratory rate and SpO2 rate as per his assessment data. Circulation evaluation: This assessment step involves identifying the issues in the circulatory system of the body that are identified by abnormal symptoms in skin, pulse rate, blood pressure, ECG monitoring, and capillary refill time (CRT). In the case of injury, the external condition is examined to determine the severity of haemorrhage (DiCenso, Guyatt Ciliska, 2014, p. 145). In the case of Mr. Jensen, the circulation evaluation indicates a major problem of hypotension indicated by low diastolic blood pressure count that is 55. He is also having a fluid loss problem, which is compensated with Harmans Solution running at 125mls/hr. Another priority issue is to manage the low urine output of Mr. Jensen that is only 1ml/kg/hr, as well as urine, is very dilute indicating a major issue. He is also having a slightly higher heart rate, which is 107 BPM that is higher from normal heart rate that should be within 60 to 100 beats per minute. Further, his wound condition is critical having notable swelling and appearance of sereous ooze with the injured leg being cool when touched. These assessment conditions confirm the presence of hypovolemia as another priority concern in the patient. Disability evaluation: The disability evaluation involves determining the pain responsiveness, alert, and voice responsiveness along with accessing the blood glucose level, limb mobility and pupillary reflexes as per the conscious state of the patient (Wilson Giddens, 2014, p.122). In the case of Mr. Jensen, he is having a priority issue of high pain score that is 7 out of 10 indicating a requirement of pain management. He is also identified with a very high blood glucose level of 17mmols/ltr. 2mIs/hr unit of insulin and dextrose infusion manages his high blood glucose. Exposure: This assessment is used to identify the exposed skin condition and temperature of the patient body (Wilson Giddens, 2014, p.125). In the case of Mr. Jensen, he is having a normal body temperature. Describing nursing goal for each identified priority problem in case study The below-provided table involves the nursing goal for the care of each identified health problem in the case of Mr. Jensen along with its explanation. Health problem Nursing goal Explanation Hypovolemia To maintain and monitor the normal body fluid balance This goal will help to overcome the state of hypovolemic shock in the patient. Further, monitoring will help to manage the fluid balance to avoid Hypovolemia in future (McGregor et al. 2012, p. 510). Hypotension Physical activities and movements support an increase to blood circulation The minor physical movement will help in increasing body heat and blood circulation (Chan Perry, 2012, p. 2255). Low urine output Maintain 24-hour balance of input and output body fluid This goal will help to overcome the deficient fluid volume in the body of patient (Chianca et al. 2012, p. 860). High pain score Pain controlled and complication prevented This goal will focus to apply intervention for minimizing the pain score of 7 (Merriman, Stayt Ricketts, 2014, p. 120). High blood sugar level Provided education about self-care management technique (DSME) The goal is let patient understand the seven elements of self-care for managing diabetes mellitus type -2 (Fairman et al. 2011, p. 194) High heart rate Deficient knowledge addressed and implemented for patient This goal will address the knowledge defects regarding self-care and treatment regarding heart problems (Stevenson et al. 2014, p. 256) Fracture swelling Control over critical condition This nursing goal will involve care techniques to minimize the swelling issue (Cwik, 2012, p. 441) Serous exudate in fracture site Successful monitor and documentation of exudate condition This goal will work to detect the complications such as infection in the wound (Chan Perry, 2012, p. 2254). Pain controlled and complication prevented Nursing intervention Rationale Provide immobilization of injured body part or organ with the help of support, bed rest, splint, cast and traction This intervention was practice in the study of Stevenson et al. (2014, p. 283) where immobilization was maintained for pain relief that also helped in preventing complications like bone displacement and other injuries. Borchers Gershwin (2014, p. 245) indicated that it is better to immobilize the painful part or organ in the state of fracture to avoid extension of injury. This intervention works to minimise the high pain score of the patient. Avoid or replace the Lenin bed sheets, plastic covers and pillows under limbs in the chuck. This intervention will minimize the discomfort that can occur due to the fiction of such materials used in beddings. Kobayashi, Costantini Coimbra (2012, p. 1410) indicated that clothes like Lenins and chiffon can lead to heat production in the body as well as pressurization on injuries. Periodic and regular ROM exercises for other regions of the body except injured parts. This intervention provides strength and functionality to other body parts or muscles that facilitate the treatment of injured parts or muscles. Borchers Gershwin (2014, p. 253) indicated that Range of Motion (ROM) exercises are specifically meant for specific body parts. Therefore, they can best address to provide mobility under fracture conditions for other parts of the body. Kobayashi, Costantini Coimbra (2012, p. 1419) studied a survey in hospital where patient practising ROM exercises dwell early recovery in comparison to non-participating patients. Apply stress managing and comfort providing techniques (massage, relaxation, deep breathing, talking, backrub) Lave et al. (2014, p. 9) indicated that nursing stress management in painful condition gets a control over pressure, anxiety promotes sensory stimulation, and minimises the traumatic condition. These nursing stress managing and comfort providing techniques persist invisible pain control processes. Periodic evaluation and documentation if discomfort and pain using similar pain scale tool (0-10 scale). Observe and document the non-verbal vital signs, movements, behaviour and emotions of pain. A continuous pain evaluation and monitoring helps to determine the effectiveness created by nursing interventions in the present condition of pain. Further, documenting pain-monitoring outcomes is a nursing duty that can further help the physician in developing the treatment protocol. Lave et al. (2014, p. 7) indicated that regular pain evaluation in between score of 0-10 provides a numerical report of patient pain that can be considered as a prove of successful intervention. However, Stevenson et al. (2014, p. 282) indicated that there are feeling like anxiety, stress etc. can lead to expressionless pain. Therefore, dependency on the pain scale is not completely reliable assessment. Therefore, nurses should keenly observe the non-verbal vital signs indicating the painful condition and provide documentation report of such observations. Provided education about self-care management technique (DSME) Nursing Intervention Rationale Implementing DSME guidance and knowledge The Diabetes Self-Management Education is an intervention provided by American Diabetes Association that helps in addressing patient knowledge deficits regarding diabetes self-management. This intervention of guidance and knowledge will involve information about daily sugar monitor, self-management exercises, nutrition requirement of the body and required physical activity (Powers et al. 2015, p. 420). Guiding about nutrition therapy Redmon et al. (2014, p. 3) indicated that obesity along with diabetic gives rise to a very critical state of disease. It is essential to reduce the obese condition of the patient by applying or guiding patient about nutrition therapy. The daily nutrition chart provides at the time of DSME intervention will help in self-management of obesity. Educating about seven diabetic self-management techniques The seven elementary diabetes self management techniques studied by Powers et al. (2015, p. 423) involves risk assessment, avoiding substance abuse, risk-reducing practice, daily sugar monitoring, stress managing exercise, slow walking, and avoiding harmful diet. These seven elements as education program easily explain the patient about the concept of diabetes self-management. Teaching patient about requirements of critical conditions It is advisable to reach the physician in certain critical condition when the blood sugar crosses its specific limit, unconsciousness and weakness. Redmon et al. 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