A Research On My Sophomore Honors English Class - 1693 Words

Over the past three years my sophomore honors English class completed a project-based unit where students publish a thoughtful collection of narrative nonfiction writing in which they tell specific family stories. Along the way students conduct interviews to produce a journalistic piece of writing and then utilize creative writing techniques to develop characters, settings and use selected literary devices. The project culminates with the publishing and launching of a hardbound copy book using professional methods and local collaboration. Why this project? Why a project-based unit? Four years ago our high school began the journey of opening a school within our school that would offer a project-based experience. The desire is to†¦show more content†¦StoryCorps.org is an organization whose mission is â€Å"to provide people of all backgrounds and beliefs with the opportunity to record, share, and preserve the stories of our lives.† StoryCorps furnishes a lesson that introduces students to their mission and helps students learn basic skills in interviewing and storytelling. During this students explore the meaning of story, watch and listen to video clips from StoryCorps, collaborate with classmates on interviewing techniques, and share strategies for improving an interview. StoryCorps also supplies a list of selected questions which is divided into specific categories like: â€Å"Questions for parents,† â€Å"Questions about growing up,† â€Å"Questions about serious illness,† or â€Å"Questions about military service.† It is not until we have worked through the StoryCorps lesson that I handout the document introducing the project. It outlines the publishing of a collection of biographical narratives where each student will contribute a specific story from one or more family members. Along the way, students will utilize methods of professional journalism, historians, biographers, authors and more. To get started I ask students to choose a family member/significant adult and using the StoryCorps question list schedule a time to interview the adult. I ask that they make at least an audio recording of the interview. I believe it is very important that students interview the adult in person. We talk about how the interview

Essay about Why the Crucible Remains Important Today

Why ‘The Crucible Remains Important Today For a story of any kind to have any relevance or meaning some 50 years after being written and indeed almost 400 years after it was set, it needs to contain themes and ideas that have been uniformly felt and experienced by people from all walks of life as well as continuing to speak to and have meaning to new and changed generations of people. Years after being written, Arthur Millers ‘The Crucible, still successfully speaks to numerous generations of people, that although live in different countries, under different governments and belong to different peer groups, experience the same issues that the characters of ‘The Crucible experienced as well as the same issues that were experienced by†¦show more content†¦Ã‚‘The Crucible not only addresses the issue of conformity, it attacks the poor balance of power that surrounds us everyday. Miller demonstrates how much power a sole in-dividual can have when the decisions made by that person effect a whole community. During the Witchcraft Trials in Salem, religion was, much more than now the answer to the unknown and the unexplained. As a result, the Church and the people in its service were people of prominence and power. They were the only people who could successfully interpret the Churchs doctrine, often to their own benefit, without being accused of a wrong doing and what could be more powerful than this in a theocratic society like Salem? This corrupt hierarchy meant that nobody could question a priest or minister because doing so would be considered questioning God. As a result, a per-son of such power could say almost anything they pleased, people would listen and appropriate action taken. This is evidenced with the supposed ‘cleansing of Salem. Although an event that occurred before the writing of ‘The Crucible, the Holocaust is a prime example of imbalanced power. Hitler, a man of great power, especially in Nazi Germany, basically accuse d a few million people of being witches. Action was taken and millions perished allShow MoreRelated Why The Crucible Remains Important Today Essay976 Words   |  4 Pages Why ‘The Crucible’ Remains Important Today For a story of any kind to have any relevance or meaning some 50 years after being written and indeed almost 400 years after it was set, it needs to contain themes and ideas that have been uniformly felt and experienced by people from all walks of life as well as continuing to speak to and have meaning to new and changed generations of people. Years after being written, Arthur Miller’s ‘The Crucible’, still successfully speaks to numerous generations ofRead MoreThe Crucible Critical Lens Essay866 Words   |  4 PagesDavis 1 Ashley Davis Mrs. Taylor CP English III, Period 7 22 November 2014 The Crucible Critical Lens Essay As Vladimir Lenin once stated, â€Å"A lie told often enough becomes truth.† This quote indicates that if you constantly repeat a lie, eventually people will come to believe it. I definitely agree with Lenin. A lie won’t stay a secret forever. Lenin’s quote remains true and evident in Arthur Miller’s, The Crucible. There are many characters Miller uses to prove this quote true through theRead MoreGerstle s Historiographical Of Mainstream Americanism1327 Words   |  6 PagesApril 2016 Gerstle’s Historiographical of Mainstream Americanism Gary Gerstle attempts to reinterpret twentieth-century American history in light of the power of race (and to a much lesser extent, or even not at all, class and gender). 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The small Puritan colony became so engrossed with fear of the Christian Devilâ„ ¢ that they began to suspect their own neighbors, and a select few individuals began using that fear for their own personal benefit, accusing their neighbors for the sakeRead MoreConvenience And Association When Talking With One Another1598 Words   |  7 Pagesand reveal an individual’s affiliation to a specific group. They are able to capture and reflect upon one’s unique culture, history, religion, and lineage. The sense of personal identity and uniqueness that a name gives us is why names interest us and are deemed so important to us as individuals. Unfortunately those of us who carry names that are â€Å"hard to pronounce† or are simply â€Å"strange† in the eyes of the western world, feel inclined to accommodate to much more Eurocentric names. In spite ofRead MoreThe Crucible By Arthur Miller1952 Words   |  8 PagesThe Crucible by Arthur Miller was probably one of the most breathtaking plays of his time. Taking place during 1692 it talked about the Salem Witch Trials mostly, what happened, who was accused, how did it start, and how did it end. He did an amazing job describing the scenes, using actual names of the people at the time, and the actual events in chronological order. Throughout the play he also hit on a major idea during the time which was known as McCarthyism, where Arthur miller himself was accusedRead MoreNature Versus Nurture1607 Words   |  7 Pageson genes (nature), but also on the environment (nurture). It is usually the joint product of genes and environment, one of the first principles in Leda Cosmides and John Tooby in Evolutionary Psychology: Nature and Nurture (attached). This remains our groups thesis. Introduction Take for example this Calvin and Hobbes strip. We assume that duplication is the same as cloning and therefore the two Calvins are genetically similar. Hobbes (that is the tiger) implies in the lastRead More Nature vs Nurture Essay1585 Words   |  7 Pagesonly on genes (nature), but also on the environment (nurture). It is usually the â€Å"joint product of genes and environment†, one of the first principles in Leda Cosmides and John Tooby in â€Å"Evolutionary Psychology: Nature and Nurture† (attached). This remains our group’s thesis. Introduction nbsp;nbsp;nbsp;nbsp;nbsp;Take for example this Calvin and Hobbes strip. nbsp;nbsp;nbsp;nbsp;nbsp;We assume that duplication is the same as cloning and therefore the two Calvins are genetically similarRead MoreEssay on The Dramatic Intensity of The Crucible’s Courtroom Scene4462 Words   |  18 Pagesplay. The Crucible is set against the backdrop of the mad hunts of the Salem witch trials in the late 17th century. It is about a town, after accusations from a few girls, which begins a mad hunt for witches that did not exist. Many towns’ people were hanged on charges for of witchcraft. Miller brings out the absurdity of the incident with the theme of truth and righteousness. The theme is conveyed through the struggles of Miller’s main character John Proctor. In The Crucible all the eventsRead MoreEssay on The Crucible - How John Proctor Changed2193 Words   |  9 PagesThe Crucible - How John Proctor changed throughout the storyline from mistreating his wife by cheating on her while she was ill with Abigail, to someone who took the blame so no one else got in trouble. The Crucible In this essay I will talk about how John Proctor changed throughout the storyline from mistreating his wife by cheating on her while she was ill with Abigail, to someone who took the blame so no one else got in trouble. The Crucible is based on the true story of the 1692

Business Communication for Managers

Question: Write report on "Business Communication for Managers". Answer: Introduction: In the year 1998, Hurricane cut an unmatched swath of devastation in the whole of Central America, leading to the deaths of thousands of Americans and damage of billions of dollars. In the location named as Nicaragua, experienced the death of more than 8,00,000 citizens. The rapid initiative and intervention of the government and also the generous assistance was given by the international organizations helped the people to recover the dreadful phase (Broadbent 2013). Our organization is an NGO generally provide assistance during a national crisis. The name of our organization is Mac Thomas Organization located in the heart of America. As an approach to seek help from the nation, foreign location and the government bodies, a project was designed and the name coined for the project was The MT Project. The main components of the project were to promote better health and hygiene, provide living condition and adequate food to the deserted ones and most importantly seek help from various sources via effective communication (Grunig 2013). As a part of the communication, three stakeholders were selected. The first stakeholder was the internal employees of the organization who have worked as an integral part of the project. According to Boyd (2015), they were the one who have executed the whole set of action and brought about the sign of victory for the whole organization. The second communication strategy was planned for getting the attraction and aid of the various government bodies involved in the welfare of the country. The government bodies were the vital stakeholders for serving this purpose since they were directly involved in providing fund and other necessities for the desolated citizens and the affected country. The third stakeholder to whom the message was conveyed was the general public. The general public might react emotionally and they have the capability to alter the situation. Their safety and kindness both the matters were a big concern during that phase (Habermas 2015). To reach the three different stakeholders, three various media were selected. According to Rossi et al. (2013), all the communication cannot be done verbally since the aim was to seek help from a mass and convey the message to every heart. In order to communicate with the internal employees, computer-based power point presentation was used. As discussed by Dequan (2016), the power point presentation involved a lot of information, strategy, and plans that were executed by the internal members of the organization. This communication aimed at successful execution of the work done. The second mode of communication selected was a written report prepared in order to get the help of the government via fund raising. The international funding was also involved in this matter. The last mode of communication was daily newspaper involving national or international paper released by the press. This communication strategy aimed at attracting the public emotion and their consciousness. Moreover, su ch an approach expected to get the attention of public globally (Loebach 2016.). Key message to the internal employees: Employee Communication through power point presentation and Engagement December 22nd, 1998. This presentation is used as a visual tool to locate the areas affected due to the hurricane. To visualize the presentation again go to www.slidespread.net. Key findings of the research: 8,00,000 people all over Nicaragua died, and 3,50,760 are admitted to government and private hospitals. Almost 5,00,000 people are desolated. The impact of the disaster on the political and administrative bodies: The spokesperson gave positive views and guaranteed about providing all types of support. The international ministry asked for help globally (Smith and Lasswell 2015). Duties of the employees: The role of the HR will be to communicate formally with the government bodies and the press. A, B and C will be under team 1, X, Y, and Z will be under team 2, and D, E, and F will be under team 3. Team 1 will be engaged in safety and sanitation in the Northern and Eastern part of Nicaragua, and Team 2 will be looking forward to aiding the Southern and Western part of Nicaragua. The Team 3 will be completely engaged in the raising of the fund from the government and the collection of public aid. 3 Basic things to remember: Listening along with speaking is important and also the oxygen to drastic change. Mobility and reach all the affected locations are important in order to provide help as much victims as possible. Lastly, working in coordination with proper communication is the key to reaching objective of the project (Segnestam 2015). Key message to the government: Hurricane M.T. report To the Honorable, the President and Members of the Common Council. Hurricane M.T. arrived in the heart of America especially in Nicaragua with a devastating effect and punched unmatched with the last ten years disasters. The disaster left an imprint in the whole country's economic and environmental status. Two aspects of this Hurricane is focused upon is the sanitation and the health condition of the public and also providing help to the homeless. As M.T. hit Nicaragua around, 8,00,000 died, and 3,50,760 people were admitted to the hospital. Almost 5,00,000 people became homeless. The government and other local and political bodies have attempted to regulate change and development in the social condition of the nation, but the success was too little. After hurricane had stricken the western regions of the country, it took around eight days for the "Disaster Management Center (DMC)" to establish their set up. Residents waited for several days for aid. Our survey shows the condition of the Southern part of the country is terrifying, and the condition of the resident is deteriorating day by day without proper treatment and other necessities. Moreover, the condition of the government hospitals is detrimental. The hospitals are overloaded with patients. Thus requires more set ups to be established in order to meet the health need of the patients. Around eighty percentage of the debris have been removed, and ninety percent of the general public has been rescued. Although all the levels of the administrative bodies have learned their lessons about the affects of the hurricane, no one has enacted migration principles (Moorhead et al. 2013). The coastal region has experienced maximum loss and had to suffer a lot. In order to bring about a change our organization Mac Thomas Organization has taken the initiative to bring about an alteration in the environmental and social condition of the victims of this disaster. The employees in our organization have been divided into groups for the assistance of the citizens of our nation. The rescue team has already achieved success in submitting the victims to various hospitals and provides protection to the deserted public. Moreover, the teams are now concerned about raising fund from various sources and developing sanitation (Keller 2015). The project M.T. developed in order to serve the nation and bring about changeable components in the social status of the country requires fund. The fund provided by the government can be utilized for establishing medical set ups to accommodate more victims and allocation of medical practitioners. Moreover, this fund will also be utilized in the rescue purposes. The accomplishment of the project requires the support of all segments of the marked community. It reflects there should be a number of initial actions of "community development mobilization,"social animation" or parallel society facilitation to guarantee all individuals of the affected society contributes to decisions relating to the proposed project (Norris and Reddick 2013). Key message to the public: The hurricane M.T. struck the nation Nicaragua on Monday 9th May 2016 resulting in the destruction of thousands of buildings and killed around 8,00,000 people. Around 3,50,760 were admitted to the government and private hospitals in and around the country. More than five lakhs people have become homeless. A prevailing storm surge pushed gigantic waves ahead of the terrifying hurricane, flooding most of the areas of Nicaragua, leading to destruction in the whole country. The James Street and other coastal areas were affected largely. The rescue team approached the affected areas, and many victims were rescued from those areas. Hundreds of men were suppressed under the debris, and thousands of dead bodies were recovered from the debris of the gigantic buildings. It is believed that many people were washed out into the ocean due to flood. No one else was as fortunate as the Ben family of The Maiden Street," stated the local councilor, Mr. X. The report states that the family sold their log house six months ago to another family and shifted from that place (Shahidinejad et al. 2014). The government has approached the other nations for providing aid. The government itself has taken initiative in funding. Other sub-ordinate bodies have put on less effort in order to bring about change in the social condition of the country. Various NGOs have been involved in the rescue program and developing better health in the community. The main objective at the present is to provide protection and safety to the citizens of the country. The government has of requested the citizens of the country to provide help that is possible from their side (Abraham et al. 2014). Discussion: In 1998, America experienced a terrifying hurricane named as M.T. The location named as Nicaragua was the country that was mostly affected. The NGO named as Mac Thomas Organization located in the heart of America was involved in the rescue program and also in evoking the inner emotions of the employees of the organization, the government bodies and also the general public. To reach the three different stakeholders, three various media were selected. As stated by Liu and Blake (2013), all the communication cannot be done verbally since the aim was to seek help from a mass and convey the message to every heart. The government was approached through a written report; the public was addressed using press media i.e. newspaper, and lastly the employees were explained about the plan of the approach using power point presentation. Although three different stakeholders were approached via three distinct media, the communication message was same for all the three stakeholders. The outcome of t he communication was positive with a success o0f around eighty-five percentage. The power point presentation was self-explanatory and thus helped the various teams of the organization to understand their duties and responsibilities. The government bodies and global bodies provided a fund in response to the hurricane, and there were more set ups established for better treatment of the victims. The public were emotionally touched and thus provided aid and approached in the emergency rescue procedure (Napier and Stratton 2013). References: Abraham, J., Kannampallil, T.G., Almoosa, K.F., Patel, B. and Patel, V.L., 2014. Comparative evaluation of the content and structure of communication using two handoff tools: implications for patient safety.Journal of critical care,29(2), pp.311-e1. Boyd, E.R., 2015. Where Should We Look? Accountability, Stakeholder Relationships, and the Role of an NGO as a Secondary Political Institution in Tanzania: A Case Study Analysis. Broadbent, D.E., 2013.Perception and communication. Elsevier. Dequan, Z., 2016. Humanitarian Landmine Action in China and the Role of the NGO.Journal of Conventional Weapons Destruction,10(2), p.34. Grunig, J.E., 2013.Excellence in public relations and communication management. Routledge. Habermas, J., 2015.Communication and the Evolution of Society. John Wiley Sons. Keller, B., 2015. Review of PowerPoint, Communication, and the Knowledge Society by Hubert Knoblauch Cambridge University Press 2013.Communication Design Quarterly Review,2(4), pp.84-86. Liu, B.F. and Blake, A., 2013. Opportunities, challenges and trends in US federal government communication.Government Communication: Cases and Challenges, p.59. Loebach, P., 2016. Household migration as a livelihood adaptation in response to a natural disaster: Nicaragua and Hurricane Mitch.Population and Environment, pp.1-22. Moorhead, S.A., Hazlett, D.E., Harrison, L., Carroll, J.K., Irwin, A. and Hoving, C., 2013. A new dimension of health care: systematic review of the uses, benefits, and limitations of social media for health communication.Journal of medical Internet research,15(4), p.e85. Napier, N.K. and Stratton, K., 2013. Communication during a merger: the experience of two banks.Human Resource Planning: Solutions to Key Business Issues Selected Articles,12(2), p.119. Norris, D.F. and Reddick, C.G., 2013. Local e government in the United States: Transformation or incremental change?.Public Administration Review,73(1), pp.165-175. Rossi, E., Rogan, J. and Schneider, L., 2013. Mapping forest damage in northern Nicaragua after Hurricane Felix (2007) using MODIS enhanced vegetation index data.GIScience Remote Sensing,50(4), pp.385-399. Segnestam, L., 2015. Interactions in hazard management policies: the case of drought in Nicaragua, 19762010.Disasters,39(4), pp.715-737. Shahidinejad, A., Amiri, I.S. and Anwar, T., 2014. Enhancement of indoor wavelength division multiplexing-based optical wireless communication using microring resonator.Reviews in Theoretical Science,2(3), pp.201-210. Smith, B.L. and Lasswell, H.D., 2015.Propaganda, communication and public opinion. Princeton university press.

Conference Mobile Communication Healthcare -Myassignmenthelp.Com

Question: Discuss About The Conference Mobile Communication Healthcare? Answer: Introduction: Diabetes is the most common cause of death among elderly patients and other populations alike. Diabetes is also a multi-factorial disease that occurs in people associated with other health issues like obesity, chronic heart diseases, kidney diseases and the leading cause of hospitalizations among geriatric patients. The case study describes a female patient who is 65 years old, having a medical history of diabetes for twenty years. The patient was admitted in the hospital from the emergency department with a case of severe glycemic shock, difficulty in breathing and severe back pain. On diagnosis, the reports showed that the patient has cardiac blockage, is currently obese with hypertension symptoms. The patient was also asses by Beck depression Inventory and showed positive results suggesting she was suffering from clinical depression but did not take any medication prior to this admission. The back pain of the patient was treated with pain medication to minimize the pain score. The report summarizes the care plan set up for the patient with reference to the current condition to treat her glycemic shock, administration of management for the condition and address the heart blockage and depression as well. Patient education is also an important factor for the completion of the care plan and the family of the patient was taught so that the home care can be arranged properly so as to reduce risk of hospital readmission. The family of the patient was also taught to monitor the patient to avoid the risk of falling which might cause severe repercussions, which is commonly observed in geriatric patients. Objective Data Pulse ox: 89% showing low levels Cough: No such detection Sputum: not detected Oxygen: room temperature Respiratory rate: 140/90 mm Hg very high, as seen in hypertensive patients Tachypneic/Hypoventilation (too slow/shallow: Respiratory effort: effort required due to blockage in heart Respiratory rhythm: difficult, erratic and very high due to heart blockage Breath sounds: no wheezing is observed, but breath rate very high Skin: WNL, normal Skin Turgor: Tenting Weight: 90kg/lb, overweight Capillary refill: WNL Apical pulse rhythm: irregularity seen Apical pulse rate: Tachycardia beats noted Heart Sounds: (Arrhythmic sounds noted) caused by hypertension Apical/radial deficit: yes Peripheral pulses: 80mmHg R radical= Doppler, R femoral= yes, R pedal=yes, R post tib=yes; L radical = yes, L femoral= Doppler, L pedal= yes, L post tib= yes. Edema: none such detected in the chest or throat, so no possible pathogenesis is the cause of breathing trouble R Hand/arm= no, R knee to thigh= no, R ankle to knee= non-pitting, R foot/ankle=no; L Hand/arm= no, L knee to thigh= no, L ankle to knee= no, foot/ankle=non pitting, Sacrum=non-pitting. Heart blockage noticed and needs immediate assistance. Deprivation of sleep due to difficulty in breathing Neurological Oriented to : patient Communication : slow but expressive Pupils:round, with a sluggish reaction to light. Glasgow Coma Scale(score range 0-15, Coma=7): Eye opening to: spontaneous=3, verbal command =2, pain=0, no response=1. Verbal responses to: slow and effort, converses=4, disoriented, converses=3, uses inappropriate words=4, incomprehensible sounds=1, no response=1. Motor responses to: verbal command = 5, localized pain=6, flexes and withdraws=3, flexes abnormally (decorticate)=4, extends abnormally (decerebrate)=3, no response = 1. Muscle tone strength Head/ neck: flaccid, Right hand: spastic, L Hand: flaccid, RUE: LUE: flaccid, RLE: flaccid, LLE: flaccid. The muscle on the leg seem to be stressed due to her weight and mild oedema is noticed on the joints due to pressure of weight. Legs: unable to walk properly due to weight gain Depression measurement: scored out of Beck Depression Inventory Erratic mood Low self esteem Sense of failure Lack of self confidence Body image issues Pity on self Old age depression Lack of satisfaction Slow movement Constant sighs Inability to express Demotivated boredom Musculoskeletal Gait: Appearance and no movement Arms: Appearance and movement Legs: Appearance and cannot walk Spine: Appearance and difficulty in moving Location of pain: back pain and soreness in legs Loss of activity: walking is being affected by the pain Description of pain: sharp and located Pain rating on a scale of 0-10: 6 Acceptable level for this client: 5 What makes the pain worse: walking and movement What makes the pain decrease: medication, and sleep. Psychosocial (and other relevant data) patients name: Surinder Kaur gender: Female birth date/age: 65 Marital status: Married Race/ethnicity: Indian languages spoken: English No such mental illness but chronic depression History: diabetes for 20 years and takes daily insulin Obese: 90kg/lb Hypertension Weight gain is the cause of depression Currently no medication is provided for depression Unable to walk due to obesity Suffers from hypertension and back pain Inability to walk Case Study of Client: (Holistic) Among different domains of Nanda approved nursing diagnoses, this assignment will utilize actual diagnosis. The patent in the case study is a 65 year old woman named Surinder Kaur. The patient in the case study had a more or less sedentary lifestyle and stayed in home. The patient had diabetes and had been getting insulin every single day. Still her blood glucose level as per her assessment had been discovered to be extremely high. Hence it can be stated from the assessment that has been carried out for the patient, it has to be mentioned that the patient had been unable to manage her blood glucose levels properly and hence a few other health care concerns have accumulated as well. First and foremost, as an indirect result of her high blood glucose level and her sedentary lifestyle the patient had been gaining weight from the past 5 years and had been obese. Along with that, there is direct link between the cardiac complications and hypertension, and the patient had also been sufferi ng from heart blockages and the hypertension ( Kusnanto, 2017). Surinder also had excessive back pain with a pain score of and had difficulty walking due to peripheral neuropathy, a common complication that is associated with diabetes. According to the assessment data discovered about the patient in the case study, it can be mentioned that all of the different health acre complexities that the patient is suffering from had been a direct or indirect consequence of her poor management of type 2 diabetes and resultant high blood glucose at more than 200 mg/Dl. Hence based in the thorough assessment, the nursing diagnosis for the patient is high blood glucose level with severe risk for uns Extremely high blood glucose levels and severe risk for instability. Assessing the patient for vulnerability to glyceamic shock to the patient so that there is no immediate danger to the patient. Medication administration and facilitating better management of the type 2 diabetes along with educating the patient regarding the diabetes management techniques as well. Encouraging the patient to adopt a healthier life style by starting to eat healthy and maintaining a strict dietary plan with a strict yet attainable physical exercise regimen. Assessment of signs of hyperglycemia so that there is no immediate insulin- glucose level imbalances that the patient is under. Diligently assessing the blood glucose levels of the patient preferably before meal times and at bed time as well ( Franks McCarthy, 2016). Assssing and monitoring the HbA1c-glycosylated hemoglobin levels of the patient as well. Administration of basal and prandial insulin so that tissue perfusion is promoted and helps in reverting the glucose concentration to the normal levels which in turn will slow down the progression of the microvascular disease ( Diab, 2012). Administration of Sulfonylureas like Glucotrol and Diabeta, meglitinides like Prandin, Biguanides like metformin, Phenylalanine derivatives lie starlix, alpha glucose inhibitors like the acarbose and miglitol, thiazolinidiones like actos and avandia and lastly Incretin modifiers like sitagliptin. The medication will decrease insulin resistance, increase insulin production and will delay the absorption of glucose into the blood ( Paschou Leslie, 2013). Monitoring the hypertension of the patient and administer hypertensive drugs as prescribed to the patient which will help in reducing the high blood pressure of the patent and will also work to reducing the risk for strokes. Educating the patient on how to monitor blood glucose on her own using the nursing glucose meters (Modic et al., 2012). Encouraging the patient to develop a healthier lifestyle that includes both dietary changes and active and determined fitness initiative. Engaging in a therapeutic casual conversation with the patient with a cultural liaison assistance to extract information regarding her sedentary lifestyle and diet pattern ( Wexler et al., 2012). Consultation with a dietician for her to help her develop a diet plan that will sit her nutritional requirements along with facilitating eight loss and cholesterol concentration drop. Encouraging the patient to eat less junk food and maintain a protein rich and antioxidant rich diet plan with lesser carbohydrate and fat content ( Juul et al., 2012). Educating the patient with interactive and cognitive therapeutic intervention towards changing her health behaviors towards a promotional health behavior for diabetes control. Enhancing the health literacy of the patient regarding diabetes and the associated co- occurring disorders so that she can work towards managing or preventing it. Lastly, encouraging and helping the patient to begin with mild and least tiresome exercise regimen to help her build her tolerance towards physical exercise. As the patient is accustomed to physical exercise help the patient build towards more tiresome and effective exercise patterns that are targeted at quick weight loss ( Spanakis Chiarugi, 2011). The current case study here focuses upon the Surinder Kaur who is a 65 years old woman and suffering from a number of co-morbid health conditions. She is suffering from hypertension along with back pain; hear blockage and diabetes; depression and weight gain. She had been talking insulin for the past 20 years. In this respect, a care plan could be made for the patient based upon the North American nursing diagnosis association (NANDA). The NANDA diagnosis could be divided into following four types such as actual diagnosis, risks diagnosis, health promotion diagnosis and syndrome diagnosis. In this respect, the actual diagnosis has been taken into consideration where the present health responses shown by the patient are taken into consideration. For the current study, a range of complications depicted by the patient have been taken into consideration. Out of this, blood glucose monitoring have been taken onto consideration for the current study. The patient her had been suffering from type 2 diabetes and had been taking insulin for the past five years. As mentioned by Rosenberg et al. (2014), excessive dose of insulin can often lead to the deposition of body fat. Some of these have been seen to contribute to the worsening of already existent clinical condition in the patient. As the patient has heart blockage the presence of obesity could further worsen the condition. As mentioned by Jindal et al. (2017), obesity has been linked with high blood cholesterol levels. Some of these conditions restricted the life processes of the patient. This further developed depressive thoughts or feelings within the patient. However, one of the most important clinical conditions which were expressed within the patient and needed immediate clinical intervention are monitoring of high levels of blood glucose level. Therefore, the high levels of blood glucose level could lead to fatal consequences where the patient could develop glycaemia shocks. The hyperglycaemia could be associat ed with a range of symptomatic expressions, which could dishevel the normal life of the patients. Some of these are excessive urination, excessive thirst, weight gain, diabetic neuropathy and diabetic retinopathy. As mentioned by Ng, Finnigan, Connellan, Kiernan Coward (2014), high levels of blood glucose can lead to a condition of nerve damage known as diabetic neuropathy. The diabetic neuropathy can have much serious consequences such as development of leg amputations in the patient. The leg amputations can disrupt the normal day to day movement making the patient dependent upon medication and aid. In this stage, additional level of support and care is required for the patient. Hence, the patient looses autonomy over their activities of daily living (ADL) which could further aggaravate the presence and expression of depression in the patient. The high blood glucose level has been associated with the development of retinopathy conditions which can affect the vision in the patient considerably. Therefore, the daily care activities of the patient need to be effectively monitored for the reduction in the clinical manifestations of the patient. Further complications The patient also had hypertension and was suggested regular medications for the control and management of depression. However, the patient hardly followed the medications pattern and doses. This increased the severity of clinical symptoms such as sleep deprivation in the patient. Moreover, the patient could not sleep owing to pain which was also aggravated due to psychological reasons ion the patient. Therefore, in order to control the pain and sleeo deprivation in the patient, the patient was suggested metformin and oxazepam, which could effectively control the rate of depression within the patient. In the lack of effective medication intake by the patient, she could be struck with lethal consequences such as myocardial infarction (MI). Therefore, in order to relieve the overall condition of the patient a holistic care regimen could be developed for the patient (Rossom et al., 2014). Discussion of interventions One of the most important nursing interventions and strategies which could be developed for the patient is implementation of physical exercises. Some of the physical exercises could include light walking, jogging along with light stretching. This could restore the movement and agility patterns in the patient. Additionally, provision of effective medication to the patient could also help in controlling and monitoring the blood glucose level. As mentioned by Zhou et al. (2017), provision of fresh food and supplements to the patient can also be effective in controlling the blood glucose level. The areas which had been highlighted as requiring care management in the above discussion are blood glucose monitoring and reduction in the symptomatic expression of several health co-morbidities. This area of care management was highlighted as the patient had expressed a number of physical abnormalities which impaired the daily life of the patient along with dependence upon insulin. Research and evidences have proved that too much of dependence upon insulin can impair the functioning of the heart and the patient was already suffering from heart blockage (Feigenbaum, 2012). Therefore, the patient had to be provided with a balanced care treatment plan which will help in reducing the daily life grievances of the patient. The focus has to be more upon a holistic care regimen. Additionally, diabetes could also stem unto a number of major health complications such as movement disability, retinopathy and cardiac shock. Therefore, in order to prevent such conditions from the disrupting the life of the patient an effective and balanced car plan is required. Additionally, the patient was also suffering from depressions which affected the rate of recovery of the patient. Hence, providing the patient with a holistic care regimen can help in infusing positive spirit in the life of the patient which could speed the recovery rate (Plat, 2017). Additionally, provision of effective counselling measures along with community based development program can also help in reducing the stress in the life of the patient. The community development program can also motivate Surinder Kaur to lose weight as she was suffering from obesity. Conclusion The above discussion makes it clear that the geriatric patients like Surinder Kaur, need to be closely monitored to avoid rick of glycemic shock. The care plan organized for the patient needs to holistic providing the medication with the respective rationale. Obesity is an indirect effect of diabetes, which needs to be controlled from early signs as weight gain had severe repercussions like cardiac blockage, which is very risky. The patient had also developed depression due to her prolonged illness, which needed to be addressed to help her recover. The glycemic shock was assessed and nutritive as well as pharmaceutical help was provided to her to minimize further risk leading to fatality. The main criteria of the care plan was to control the blood glucose level and control weigh gain to reduce her weight to help her improve her blocked heart condition and improve her ability to walk which she was then facing due to obesity. Obesity and diabetes are correlated with each other and crea te co-morbid conditions in geriatric patients. Cases like this require patient education planning after care plan management, which would help minimize the risk of hospital readmission and falling in these cases. The hypertensive condition clubbed with depression in the patient makes the situation serious and she needs to be well monitored in even home care facilities to minimize the risk of falling. References American Diabetes Association. (2015). Standards of medical care in diabetes2015 abridged for primary care providers. Clinical diabetes: a publication of the American Diabetes Association, 33(2), 97. Bray, G. A., Popkin, B. M. (2014). 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