Abstract
The paper discusses the insertion of a chest tube that is used for spontaneous pneumothorax, a common clinical problem involving air in the pleural space, between the lung and chest wall. The paper explores the goals of nursing regarding this procedure, which include pain management, prevention of complications and health teaching for the patient and family.

From the Paper
"Insertion of a chest tube is used for spontaneous pneumothorax, which is a somewhat common clinical problem involving air in the pleural space, or air between the lung and chest wall. Traumatic pneumothorax is rare and results from injury to the chest. In either case, if excess fluid or air accumulates in the pleural space, the patient will experience shortness of breath and increased respiratory rate and effort. A chest tube inserted into the pleural space will drain the air or excess fluid and relieve respiratory distress Coughlin & Parchinsky, 2006). "Nursing care includes preventing complications, resolving the pneumothorax, managing pain, and educating the patient and family" (Roman & Weinstein, 2003, p. 161)."

Tags:spontaneous, pneumothorax, lungs, chest, wall, valve, diaphragm, breathing, coughing

Abstract
This paper provides a literature overview of chest tube removal with regard to pain management. It further discusses the appropriate nursing interventions that are most applicable to chest tube removal in the light of the research data and studies that are available. It concludes, based on the literature, that there is a need to explore new avenues in addition to the present standard protocols. It also examines how these new techniques, and means of reducing pain in chest tube removal, revolve around a more inclusive and interactive approach to pain management, where aspects such as anxiety and information flow are catered to.

Outline:
Introduction
Literary Overview of the Problematics of Pain Management
Conclusion
Appendix

From the Paper
"Standard pain management techniques for chest tube removal relate to medications such as Morphine. " Morphine is one of the most often, if not routinely, used opioids for treating pain due to chest tube removal." (Puntillo and Ley, 2004) However, this is not always the most effective procedure in this situation. "...when morphine was used in small doses (ie, a mean [less than or equal to] 3 mg), pain associated with chest tube removal was rated as moderate to severe. Higher morphine doses have not been tested for their effect on such pain. " (Puntillo and Ley, 2004) Other medications include the use of Ketorolac, which is a nonsteroidal anti-inflammatory drug and is considered to be an effective analgesic for pain due to chest tube removal. "

Tags:lung, expansion, drain, fluids, intervention, postoperative, phase

Abstract
The paper discusses how insertion of a chest tube is used for spontaneous pneumothorax, which is a somewhat common clinical problem involving air in the pleural space, or air between the lung and chest wall. The paper also addresses traumatic pneumothorax which is rare and results from injury to the chest, and relates that in either case, if excess fluid or air accumulates in the pleural space, the patient will experience shortness of breath and increased respiratory rate and effort.

From the Paper
"Insertion of a chest tube is used for spontaneous pneumothorax, which is a somewhat common clinical problem involving air in the pleural space, or air between the lung and chest wall. Traumatic pneumothorax is rare and results from injury to the chest. In either case, if excess fluid or air accumulates in the pleural space, the patient will experience shortness of breath and increased respiratory rate and effort. A chest tube inserted into the pleural space will drain the air or excess fluid and relieve respiratory distress Coughlin & Parchinsky, 2006). "Nursing care includes preventing complications, resolving the pneumothorax, managing pain, and...""

Tags:chest, tube, care

Abstract
This paper describes "Pirates of the Caribbean: Dead Man's Chest," its cast and characters, director, awards, genre, and intended audience. Additionally it includes a proposed promotional budget with rationale. The paper includes a plot summary of the film.

From the Paper
"The film "Pirates of the Caribbean: Dead Man's Chest" is the sequel to the original award-winning "Pirates of the Caribbean" movie subtitled "The Curse of the Black Pearl" which starred Johnny Depp as Captain Jack Sparrow.
"Sparrow together with Will Turner-played by Orlando Bloom, who must battle a band of treacherous pirates to save Will's true love, Elizabeth, and to recapture The Black Pearl ship, save the British navy and relinquish a fortune in forbidden treasure." "

Tags:Pirates of the Caribbean, Disney, Dead Man's Chest

Abstract
This paper studies how medical professionals diagnose and treat thrombolysis during critical care for patients experiencing chest pain. The paper provides a detailed analysis of scientific and clinical evidence indicating that patients experiencing acute myocardial infarction benefit from the early administration of thrombolytic therapy. The paper then discusses the challenge for multidisciplinary providers in ensuring that patients give true informed consent for all procedures, from administration of medication to invasive procedures. The paper explains that the setting can be chaotic, however, it maintains that effective communication between patients and providers is imperative.

From the Paper
"The definitive diagnosis of AMI is best obtained by following a standard chest pain protocol. Most accident and emergency wards have these in place. It is standard to initially obtain a 12 lead electrocardiogram (ECG) and begin cardiac monitoring. Patient's routine laboratory studies include electrolytes, blood urea nitrogen (BUN), complete blood count (CBC) and markers for myocardial injury (Creatinine Kinase isoenzyme-myocardial (CK-MB) or troponin). Normal serial CK values rule out an acute infarction but are negative in the setting of acute unstable angina. A slight rise in CK-MB or troponin indicates myocardial injury but is not specific for ischemic syndromes. Troponin assay is highly sensitive for identifying acute coronary syndromes. Troponin has longer half life in the system than CK-MB but is less specific for the identification of infarction as opposed to repeated episodes of myocardial ischemia. As the total CK greater than two times the upper ranges of normal is indicative of infarction it can be used as an adjunct in diagnosis ischemia versus infarction and also in determining the relative efficacy of reperfusion. Serum troponin may take up to six hours to become diagnostically sensitive enough (Dougan, 2001)."

Tags:heart, attack, chest, pain, hospital, doctor, nurse, informed, consent, myocardial, cardiac, arrest, emergency, room

Abstract
"Jake (name changed) is 23 years old and is of Aboriginal descent. He attends a community college. He was admitted to hospital with chest pain. His experience was very negative with doctors but was more understanding with nurses. He needed some help with telling his story because he uses few words to express himself. He needs to make some changes in his lifestyle for the sake of his health and wellbeing. He needs to learn how to cope with white people's negative attitudes and stereotypes about First Nations people. He needs a new perspective so that he can achieve control over his health and life and will be able to lead a meaningful life (Egan & Schroeder, 2009). "

From the Paper
Analysis of a Helping Experience Introduction Jake (name changed) is 23 years old and is of Aboriginal descent. He attends a community college. He was admitted to hospital with chest pain. His experience was very negative with doctors but was more understanding with nurses. He needed some help with telling his story because he uses few words to express himself. He needs to make some changes in his lifestyle for the sake of his health and wellbeing. He needs to learn how to cope with white people's negative attitudes and stereotypes about First Nations people. He needs a new perspective so that he can achieve control

Tags:listening, communication, helping

Abstract
This paper relates that evaluation of chest pain is possibly one of the most important elements of nursing assessment skills. The paper then provides an assessment of myocardial infarction versus angina and shows how discerning angina from a myocardial infarction is a difficult task, requiring the rapid use of evaluation skills as well as the prompt administration of treatment.

Outline:
Introduction
Clinical Paper
Conclusions

From the Paper
"Chest pain is notoriously difficult to assess. Depending on the signs and symptoms, findings on the ECG and lab results the management of the patient differs significantly. The classic presenting symptoms of a myocardial infarction (MI) is chest pain or discomfort. Angina pectoris may present the same way but will generally be of shorter duration. Both may be described as pain, pressure, tightness, heaviness, burning or squeezing. Both may radiate into arms, shoulders, jaw or back. Not all patients will have these classic symptoms."

Tags:chest, pain, ECG, symptoms

Abstract
This paper examines the standards set by the National Service Framework for coronary heart disease regarding emergency cardiac care for patients presenting to the accident and emergency system at a hospital. The paper explains that these standards place a priority on aggressive management and providing early thrombolysis and that this type of treatment is controversial because it is questionable whether, given the suggested timeline and the need to differentiate from non-cardiac causes of chest pain, an adequate history and physical can be performed to prevent the administration of thrombolytics in patients where they are contraindicated. To further examine this topic, the paper gives a clear definition of acute myocardial infarction, looks at how to diagnose a patient with acute chest pain, explores the history, indications, and contraindications of thrombolysis, and reviews a multidisciplinary approach to thrombolytic administration.

From the Paper
"The definitive diagnosis of AMI is best obtained by following a standard chest pain protocol. Most accident and emergency wards have these in place. It is standard to initially obtain a 12 lead electrocardiogram (ECG) and begin cardiac monitoring. Patient's routine laboratory studies include electrolytes, blood urea nitrogen (BUN), complete blood count (CBC) and markers for myocardial injury (Creatinine Kinase isoenzyme-myocardial (CK-MB) or troponin). Normal serial CK values rule out an acute infarction but are negative in the setting of acute unstable angina. A slight rise in CK-MB or troponin indicates myocardial injury but is not specific for ischemic syndromes. Troponin assay is highly sensitive for identifying acute coronary syndromes. Troponin has longer half life in the system than CK-MB but is less specific for the identification of infarction as opposed to repeated episodes of myocardial ischemia. As the total CK greater than two times the upper ranges of normal is indicative of infarction it can be used as an adjunct in diagnosis ischemia versus infarction and also in determining the relative efficacy of reperfusion. Serum troponin may take up to six hours to become diagnostically sensitive enough (Dougan, 2001)."

Tags:electrocardiogram, (ecg), monitoring, electrolytes, acute, infarction, unstable, angina

Abstract
Asthma is an intermittent disorder, which affects the patient from time to time. Resistance to airflow may be triggered by external factors, such as inhalation of substances, or resistance can occur without any external stimuli. The paper explains that the clinical symptoms of asthma include wheezing, chest tightness, and breathlessness. It also shows that, in America alone, there are more than seventeen million people suffering from asthma, and asthma attacks alone are responsible for some 500,000 hospitalizations every year. The paper presents details of the disease and explores treatment options.

Table of Contents:
Introduction
What is Asthma?
Asthma and the Immune System
Diagnosis of Asthma
Radioallergoabsorbent Test [RAST]
Prick Tests
Treatment
Steroids
Bronchodialators
Conclusion
Bibliography

From the Paper
"Our lungs are equipped with elaborate defense methods to guard against the potential invasion of foreign bodies. The tiny hair like protrusions called the cilia, constitutes the first line of defense. The cilia pushes the trapped particles (along with the mucus) into the mouth which we swallow and the pathogens are destroyed by the action of the digestive enzymes. The bronchioles constitute the second line of defense."

Tags:bronchial, tubes, histamine

Abstract
This paper explains that Dean is a social liberal, whose stance on such issues as abortion and same-sex unions remains consistent. The author points out that Dean is strongly in favor of repealing the 2001 Bush tax cuts and is emphatic about balancing the federal budget.The paper relates that Dean has relied heavily on the Internet for support and for fund raising, and his Internet BLOG sets his campaign apart from other candidates.

Table of Contents
Candidate Profile
Voting Records and Public Stands on the Issues
Campaign War Chest/Money Raised
Position in Political Opinion Polls
Major Endorsements
Campaign Themes
Major Assets
Major Obstacles
Summary

From the Paper
"Dean's political career began in the early 1980s, when he was elected to the Vermont State House of Representatives. He served there from 1982 until 1986, when he was elected as Lieutenant Governor of Vermont. He was re-elected to that post twice, in 1988 and again in 1990. Dean first became Governor of Vermont in 1991 not by being elected but because the sitting Governor, Richard Snelling, died suddenly of heart failure. However, Dean was re-elected five times, in 1992, 1994, 1996, 1998, and 2000. He did not seek re-election in 2002. After his fourteen-year tenure as Governor of Vermont, Dean decided to step down from his office to chase after the big seat in the White House. He became the first democrat to formally enter the 2004 Presidential Race in May 2002."

Tags:vermont, md, abortion, blog, repeal