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An arch has ridges that enter from one side of the pattern buy strattera 10mg, make a wave in the middle discount strattera 10 mg with mastercard, and pass out the opposite side from which they entered discount 18mg strattera overnight delivery. It is important for an examiner to note the ridge fow of a print for orientation purposes and the recognition of focal areas that will ultimately assist in the identifcation process. While pattern confguration alone cannot be used for individualization, it can be used for exclusionary decisions made by an examiner. A latent fngerprint is the two-dimensional reproduction of the friction ridges of the fnger on an object by means of perspiration, oils, or other contami- nants that coat the surface of the ridges when a fnger touches an item. Tese types of prints generally must be made visible through the use of forensic technology such as alternate light sources, chemical techniques, or fnger- print powders. In some instances, latent prints can be visualized without the use of any fngerprint processing techniques and are called patent prints. Latent impressions are deposited by chance and are usually fragmentary in nature with varying degrees of quality. Alternatively, a known fngerprint is the intentional reproduction of the friction ridges of the fnger onto a fnger- print card or appropriate contrasting surface. A known exemplar can be recorded using a number of standard techniques, to include black printer’s ink, inkless/chemical methods, and LiveScan, which is a computer-based system that creates digital fngerprint images by scanning the fngers. Finally, a plastic print is an impression lef in a malleable substrate, such as wax or putty, which retains an image of the friction ridge arrangement. One aspect that has changed, however, is an increased awareness of the underlying scientifc basis for fngerprint identifcation. Tis change has resulted in the standardization of the identifcation process based on the extensive research of former Royal Canadian Mounted Police Staf Sergeant David R. Ashbaugh, which centers around a quantitative-qualitative philosophy to fngerprint examination called ridgeology. Ridgeology is a holistic approach that focuses on the bio- logical uniqueness of friction ridges and involves the sequential examination of the features and spatial relationship of ridges, noting the quality and quan- tity of the assessed information for identifcation purposes. Analysis focuses on the examination of the quantity and quality of infor- mation present in a print, which can be broken down into three levels of detail. Level 2 detail refers to ridge path, which corresponds to the spatial relationship of ridges and their characteristics in a print. Level 3 detail refers to individual ridge attributes, which involve ridge shapes and pore structure/location in a print. Te fngerprint examiner must consider various quality factors, such as distortion, that could alter the reliability of the observed information when determining the suitability of a print for comparison purposes. Te informa- tion present in the latent or poorest quality print is always examined frst, followed by examination of the known or best quality print. Comparison of friction ridge impressions is a side-by-side assessment of the information analyzed in both prints. Te latent or poorest quality print is compared to the known or best quality print to minimize cognitive bias. Te examiner frst assesses the level 1 information from the analysis of the latent print and compares this with the information gathered from the analysis of the known print. If the information matches, the examiner then assesses the level 2 information from the analysis of the latent print and compares it with the information gathered from the analysis of the known print. Comparison is not a simple “point counting” exercise; in fact, there is no scientifc basis for a minimum point threshold or specifc number of characteristics that Fingerprints and human identifcation 87 must match in two prints for an identifcation decision to be reached by an e x a m i n e r. Tese comparative measurements begin at a focal point selected by the examiner and progress through the ridges of the entire print in series. For this information to match, the ridge path, of sufcient quantity and clarity, must have the same unit relationship and relative position in both prints. When a fngerprint examiner determines that the information present in a latent and known print is in agreement, with no unexplainable dissimilarities, an identifcation decision can be reached (Figure 6. Due to the pliability of the friction skin, and other environmental factors, friction ridge impressions of the same fnger will never look exactly alike. Evaluation involves rendering a decision based on the results of the analysis and comparison phases of the identifcation process. Te second con- clusion is exclusion and is the determination that the information present in two impressions does not match, meaning that they are not from the same source. Te third conclusion is an inconclusive decision and is the determi- nation that a conclusive comparison cannot be reached because of a lack of quality or absence of a comparable area in the known exemplar. Although verif- cation is not technically part of the identifcation process, it serves as a form of peer review, ensuring reliable and accurate results. All individualizations made by a fngerprint expert are verifed, through an independent examina- tion of the identifed prints, by a second qualifed latent print examiner as a quality assurance mechanism.

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What effects might a permanent disability have on patients order strattera 18mg with mastercard, and how can you promote their coping? Chapter 33 in your textbook to answer the Scenario: Robert Witherspoon buy discount strattera 25mg line, a 42-year-old questions below cheap strattera 40mg with visa. His father died admitted to the pediatric unit as a result of a of complications of coronary artery disease. She is 235 pounds, has a decided “paunch,” and on complete bed rest and requires frequent reports that until now he has made no time positioning to maintain correct body for exercise because he preferred to use his free alignment and range of motion. He are nearby and express concerns about the red- enjoys French cuisine, including rich desserts, ness developing around her shoulder blades. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. Can assessment of this patient after the plan of you help me design an exercise program that care has been implemented. Identify pertinent patient data by placing a single underline beneath the objective data in the patient care study and a double underline beneath the subjective data. Complete the Nursing Process Worksheet on page 214 to develop a three-part diagnostic statement and related plan of care for this patient. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. For the purposes of this exercise, develop the one patient goal that demonstrates a direct resolution of the patient problem identified in the nursing diagnosis. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. Which of the following instruments receives Circle the letter that corresponds to the best and records electrical currents from the answer for each question. When an individual’s sleep–wake patterns have been unconscious follow the inner biologic clock, which of the c. On performing a sleep history on this patient, you find out that the patient is suf- Circle the letters that correspond to the best fering from fatigue, lethargy, depression, and answers for each question. The bulbar synchronizing region facilitates reflex and voluntary movements as well 10. Most authorities agree that an individual’s as cortical activities related to a state of sleep–wake cycle is fully developed by what alertness. Nap frequently during the day to make up person to remain awake for long periods for the lost sleep at night. Respirations are irregular and sometimes She is scheduled for an exploratory laparotomy interspersed with apnea. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. An average of 5 to 7 hours of sleep is gener- he/she could not sleep during the night. Which of the following statements accurately describe factors that affect sleep patterns? Which of the following describe the influences breathing between snoring intervals. Patients with restless arm syndrome cannot lie still and experience unpleasant crawling a. Place the following stages of a sleep cycle in interventions for patients experiencing insom- the order in which they would normally occur. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. Which two systems in the brainstem are quality of sleep believed to work together to control the cyclic nature of sleep? Marked muscle contraction that results in the jerking of one or both legs during sleep 2. Match the sleep disorder listed in Part A with its appropriate definition listed in Part B. Constitutes about 5% of sleep Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. List the average amount of sleep required for True False the following age groups. Older adults: time, he/she will return to sleep again by starting at the point in the cycle where 3. Exercise that occurs within a 2-hour interval before normal bedtime stimulates sleep. The administration of a larger mid-afternoon dose of asthma medication may prevent i. True False Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition.

Chaos deals with life at the edge order 18 mg strattera otc, or to the caring ideal that is unique to nursing cheap strattera 40mg mastercard. The holographic paradigm in science recognizes Certain nursing theorists have embraced the notion that the ontology or “what is” of the universe or of nursing as complexity in which consciousness generic 25mg strattera mastercard, creation is the interconnectedness of all things, that caring, and choice making are central to nursing the epistemology or knowledge that exists is in the (Davidson & Ray, 1991; Newman, 1986, 1992; relationship rather than in the objective world or Ray, 1994, 1998). Holography means that the implicit order from the decisions that were made about the struc- ture of organization (consciousness), the caring Holography means that the implicit order transactions that were engaged in (caring), and the (the whole) and explicit order (the part) effective negotiations or ability to make choices and are interconnected, that everything is a reconcile the system demands with the humanistic holon in the sense that everything is a client care needs (choice making). The theoretical whole in one context and a part in an- processes of awareness of viewing truth or seeing other—each part being in the whole the good of things (caring), and communication, and the whole being in the part. The dialectic of caring (the implicit order) in relation to the various struc- (the whole) and explicit order (the part) are inter- tures (the explicit order) illustrates that there is connected, that everything is a holon in the sense room to consider the theory as holographic. It is the relational aspect of informa- connected—humanistic and spiritual tion that makes it a holistic rather than a mecha- caring and the organizational system— nistic construct. Nursing is being shaped by the that everything is interconnected—humanistic and historical revolution going on in science, social spiritual caring and the organizational system—the sciences, and theology (Harmon, 1998; Newman, whole is in the part and the part is in the whole, a 1992; Ray, 1998; Reed, 1997; Watson, 1997; holon. In these new approaches, con- How can knowledge of caring interconnected- structs of consciousness and choice are central and ness motivate nursing to continue to embrace the demonstrate that phenomena of the universe, in- human dimension within the current economic cluding society, arise from the choices that are or are and technologic environment of health care? Can not made (Freeman cited in Appell & Triloki, 1988; higher ground be reclaimed for the twenty-first Harmon, 1998). Higher ground requires that we make task is to comprehend the relationship between excellent choices. It is therefore imperative that what is given in culture (the jural order) and what is spiritual and ethical caring thrive in complex sys- chosen (the moral and spiritual) between destiny tems. In nursing, the unitary-transforma- Bureaucratic Caring, illustrates that through spir- tive paradigm and the various theories of Newman, itual/ethical caring as the choice point for commu- Leininger, Parse, Rogers, and the holographic nication in relation to the complexity of the Theory of Bureaucratic Caring are challenging sociocultural system, nursing can reclaim higher nursing to comprehend a similar relationship. As noted, a re- Ray, 1991; Ray, 1994a, 1998; Reed, 1997; Vicenzi, vision toward this end is taking place in science White, & Begun, 1997). Nursing has the capacity to make creative and Through “authentic conscience” (Harmon, 1998) moral choices for a preferred future. Spiritual/ethical caring is both a part and a whole, and every part secures its Social- purpose and meaning from each of the parts that Physical Cultural can also be considered wholes. It brings with it a spirit of repentance, hended within as intimacy and spirit (Harmon, seeing in a new way, a change of heart. Because of the crisis of our rela- As the twenty-first century is evolving, nurs- tionship to work, we are challenged to reinvent it. As the Theory of Bureaucratic Caring in touch with others, not only in terms of personal has demonstrated, caring is the primordial gain, but also at the level of service to humanity or construct and consciousness of nursing. Reenvisioning the theory as holographic Work must be spiritual, with recognition of the shows that through creativity and imagina- creative spirit at work in us. Thus, nurses must be tion, nursing can build the profession it the “custodians of the human spirit” (Secretan, wants. The ethical imperatives of caring that join with The new scientific and spiritual approach the spiritual relate to questions or issues about our to nursing theory as holographic will have moral obligations to others. The union of science, ethics, edifying the good through communication and in- and spirit will engender a new sense of teraction involve never treating people simply as a hope for transformation in the work world. Ethical content—as principles of doing good, Nurses can reintroduce the spiritual and eth- doing no harm, allowing choice, being fair, and ical dimensions of caring. The deep values promise-keeping—functions as the compass in our that underlie choice to do good for the many decisions to sustain humanity in the context of po- will be felt both inside and outside organiza- litical, economic, and technological situations tions. Roach (2002) pointed out act on this awareness and no longer surren- that ethical caring is operative at the level of dis- der to injustices and oppressiveness of sys- cernment of principles, in the commitment needed tems that focus primarily on the good of a to carry them out, and in the decisions or choices to few. The holographic Theory of health is a community responsibility, an idea that is Bureaucratic Caring—idealistic, yet practical; rooted in ancient Hebrew ethics. The expression of visionary, yet real—can give direction and human caring as an ethical act is inspired by spir- impetus to lead the way. Spiritual/ ethical caring for nursing does not question whether or not to care in complex systems but inti- mates how sincere deliberations and ultimately the facilitation of choices for the good of others can or This transformation toward relational should be accomplished. Nurses can reintroduce the spiri- The recognition that we need to change the way we tual and ethical dimensions of caring. However, nurse researchers, nurse admin- istrators, and nurses in practice can use the politi- cal and/or economic dimensions of the Theory of Applications of Bureaucratic Caring as a framework to guide prac- tice and decision making. Use of these dimensions of the theory integrates the constructs of politics, Marilyn Ray’s economics, and caring within the health-care organization. The purpose of this chapter is to illuminate the Theory of notion of political/economic caring in the current health-care environment. Ray’s (1989) original Theory of Bureaucratic Caring included political Bureaucratic and economic entities as separate and distinct structural caring categories. The revised Theory of Bureaucratic Caring, however, is represented Caring as a complex holographic theory. Turkel dimensions of bureaucratic caring as portrayed in this chapter are illuminated as interrelated constructs. The political and economic dimensions of bu- Current Context of Health-Care reaucratic caring encompass not only health-care Organizations reform at the national level, but also refer to the po- litical and economic impact of these changes at the Review of the Literature: Political organizational level. Through sections on the cur- and Economic Constraints of rent context of health-care organizations, review of Nursing Practice the literature related to the political and economic constraints of nursing practice, economic caring Economic Implications of Bureau- research, political and economic implications of cratic Caring Theory: Research in bureaucratic caring, and visions for the future, we Current Atmosphere of Health-Care learn how the Theory of Bureaucratic Caring Reform applies.

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