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But these tests were frequently given in English lamictal 50mg on-line medications for factor 8, even when this was not the child‘s first language, and the children tested were often of lower socioeconomic status than the [22] monolingual children (Andrews, 1982). More current research that has controlled for these factors has found that, although bilingual children may in some cases learn language somewhat slower than do monolingual children [23] (Oller & Pearson, 2002), bilingual and monolingual children do not significantly differ in the final depth of language learning, nor do they generally confuse the two languages (Nicoladis & [24] Genesee, 1997). In fact, participants who speak two languages have been found to have better cognitive functioning, cognitive flexibility, and analytic skills in comparison to monolinguals [25] (Bialystok, 2009). Furthermore, the increased density is stronger in those individuals who are most proficient in their second language and who learned the second language earlier. Thus, rather than slowing language development, learning a second language seems to increase cognitive abilities. Structural plasticity in the bilingual brain: Proficiency in a second language and age at acquisition affect grey-matter density. Some species communicate using scents; others use visual displays, such as baring the teeth, puffing up the fur, or flapping the wings; and still others use vocal sounds. Male songbirds, such as canaries and finches, sing songs to attract mates and to protect territory, and chimpanzees use a combination of facial expressions, sounds, and actions, such as slapping the ground, to convey aggression (de [27] Waal, 1989). Honeybees use a “waggle dance‖ to direct other bees to the location of food [28] sources (von Frisch, 1956). The language of vervet monkeys is relatively advanced in the sense that they use specific sounds to communicate specific meanings. Vervets make different calls to signify that they have seen either a leopard, a snake, or a hawk (Seyfarth & Cheney, [29] 1997). Despite their wide abilities to communicate, efforts to teach animals to use language have had only limited success. One of the early efforts was made by Catherine and Keith Hayes, who raised a chimpanzee named Viki in their home along with their own children. Researchers speculated that Viki‘s difficulties might have been in part because the she could not create the words in her vocal cords, and so subsequent attempts were made to teach primates to speak using sign language or by using boards on which they can point to symbols. Washoe, who lived to be 42 years old, could label up to 250 different objects and make simple requests and comments, such as “please tickle‖ and “me sorry‖ (Fouts, [31] 1997). Washoe‘s adopted daughter Loulis, who was never exposed to human signers, learned more than 70 signs simply by watching her mother sign. He learned faster when he was younger than when he got older, he learns by observation, and he can use symbols to comment on social interactions, rather than simply for food treats. Kanzi can also create elementary syntax and understand relatively complex commands. Video Clip: Language Recognition in Bonobos The bonobo Kanzi is the most proficient known nonhuman language speaker. Kanzi usually requires many trials to learn a new sign, whereas human babies can speak words after only one exposure. Kanzi‘s language is focused primarily on food and pleasure and only rarely on social relationships. Although he can combine words, he generates few new phrases and cannot master syntactic rules beyond the level [33] of about a 2-year-old human child (Greenfield & Savage-Rumbaugh, 1991). With some exceptions, the information that can be communicated in nonhuman species is limited primarily to displays of liking or disliking, and related to basic motivations of aggression and mating. Humans also use this more primitive type of communication, in the form of nonverbal behaviorssuch as eye contact, touch, hand signs, and interpersonal distance, to communicate their like or dislike for others, but they (unlike animals) also supplant this more primitive communication with language. Although other animal brains share similarities to ours, only the human brain is complex enough to create language. What is perhaps most remarkable is that although language never appears in nonhumans, language is universal in humans. Language and Perception To this point in the chapter we have considered intelligence and language as if they are separate concepts. The idea that language and its structures influence and limit human thought is called linguistic relativity.
Psychological and social management: Some form of psychological and social management is important to help the patient to remain abstinent discount 200 mg lamictal overnight delivery treatment 5th metatarsal shaft fracture. Whatever approach is used, Medical uses of alcohol the focus has to be on abstinence from alcohol. Systemic alcohol is minority of patients may be able to take up controlled used in poisoning by methanol or ethylene glycol, since it drinking subsequently, but it is impossible to identify this competes with these for oxidation by alcohol dehydrogenase, group prospectively, and this should not be a goal of slowing the production of toxic metabolites (e. Management of alcohol withdrawal Alcohol-sensitizing drugs: These produce an unpleasant Awithdrawal syndrome develops when alcohol consumption reaction when taken with alcohol. The only drug of this type is stopped or severely reduced after prolonged heavy alcohol used to treat alcoholics is disulfiram, which inhibits aldehyde intake. Several features of acute withdrawal are due to auto- dehydrogenase, leading to acetaldehyde accumulation if nomic overactivity, including hypertension, sweating, tachy- alcohol is taken, causing flushing, sweating, nausea, cardia, tremor, anxiety, agitation, mydriasis, anorexia and headache, tachycardia and hypotension. These are most severe 12–48 hours after stopping may occur if large amounts of alcohol are consumed. Some small amounts of alcohol included in many medicines may be patients have seizures (‘rum fits’ generally 12–48 hours post sufficient to produce a reaction and it is advisable for the abstinence). A third set of symptoms consists of alcohol with- patient to carry a card warning of the danger of alcohol drawal delirium or ‘delirium tremens’ (acute disorientation, administration. Disulfiram also inhibits phenytoin severe autonomic hyperactivity, and hallucinations – which metabolism and can lead to phenytoin intoxication. Delirium tremens often follows after with- Unfortunately, there is only weak evidence that disulfiram drawal seizures and is a medical emergency. Its use should death may occur as a result of respiratory or cardiovascular be limited to highly selected individuals in specialist clinics. Management includes thiamine and other vitamin replacement, and a long-acting oral benzodiazepines (e. Acamprosate: The structure of acamprosate resembles that of chlordiazepoxide or diazepam), given by mouth if possible. It appears to reduce the effects of The initial dose requirement is determined empirically and is excitatory amino acids and, combined with counselling, it followed by a regimen of step-wise dose reduction over the may help to maintain abstinence after alcohol withdrawal. Increased metabolism of warfarin and usually of doubtful benefit but with side effects, include phenytoin have been reported in alcoholics. Alcohol enhances human chorionic gonadotrophin, growth hormone, caffeine, the gastric irritation caused by aspirin, indometacin and amphetamines, β-blockers and erythropoietin. They are Enhanced hypoglycaemia may occur following coadministra- claimed to enhance sexual pleasure and dilate the anus. Central effects are simi- euphoria, sedation, amnesia (implicated as ‘date rape’ drug), lar to alcohol. During withdrawal, convulsions are more often aggression, vomiting, coma, respiratory depression and seizure. Chloral hydrate and clomethiazole have similar potential for depend- Case history ence, and their use is difficult to justify. Laboratory tests reveal a raised mean corpuscular volume For more information on benzodiazepines, see Chapter 18. Solvents such as glues or paints are sniffed, Answer 1 often with the aid of a plastic bag to increase the concentration of Wernicke’s encephalopathy. Disinhibition can lead to excessively gregarious, aggressive or emotional behaviour. Cardiac Case history dysrhythmia can occur (as with hydrocarbon anaesthetics, A 20-year-old man is brought by the police to the Accident Chapter 24). Most deaths are associated with asphyxia as a result and Emergency Department unconscious. Excessive believe that he ingested condoms full of diamorphine prior to his arrest following a drugs raid. He had been in police chronic use is rare, but may lead to major organ failure, as custody for approximately one hour. There are no specific drug centrally cyanosed, breathing irregularly, with pinpoint therapies for solvent abusers and psychological and/or social pupils and no response to painful stimuli. Most synthetic anabolic steroids are derived Answer 2 Since naloxone is an effective antidote to diamorphine poi- from testosterone and are popular among body builders. The soning, close observation with repeated injections or infu- prevalence of anabolic steroid abuse among athletes is uncer- sion of naloxone, inhaled oxygen and bulk laxatives should tain. A handbook of drug and alcohol cal pharmacology of 3, 4-methylenedioxymethamphetamine.
Convergence: The second heart sound generic lamictal 200mg online symptoms acid reflux, (g) _______________, occurs at the end of (h) _______________ and represents the closure of the (i) _______________ and (j) _______________ 9. List the equipment you would do to prepare the patient, the room, and would assemble before performing the assess- the environment for an examination. In what position would your patient why would you modify these preparations for be placed? A small child Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. Write a definition of each instrument and how it is to be used dur- ing the assessment. Scenario: Billy Collins, a 9-year-old with a his- tory of allergies, including an allergy to insect stings, is spending a week at summer camp. What resources might be helpful for this suddenly reports to the camp counselor that he family? The counselor rushes Billy to the nearest emergency health center after helping him self-inject epinephrine. He presents with itching and hives, difficulty breathing, nausea, and palpitations. When his parents arrive, they ask you what more they can do, if anything, to prevent this situation from occurring in the future. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. The safety event report becomes a part of Circle the letter that corresponds to the best the medical record. When deciding whether to use restraints on a patient, the nurse should consider which of 4. According to a recent study, unrestrained older patients were three times more likely a. There is no evidence linking a relationship to sustain fall-related injuries than between childhood sexual abuse and certain restrained older patients. There are no physiologic hazards associated with the proper use of restraints on older b. Generally, a physician’s order is not neces- accidents involve the use of alcohol and/or sary to apply restraints. According to Pillitteri, ribavirin, used for respiratory infections in infants and a. Most people who die in house fires do not children, may be harmful to a developing die from burns, but from smoke inhalation. Fire is the major safety problem in hospitals expose residents to potentially unhealthy and the leading cause of accidental death substances. Stressful situations are more devastating to got out of bed and fell, restraints were applied. Which of the following statements reflect con- following would be the most appropriate nurs- siderations a nurse should keep in mind when ing intervention for Mrs. A medication regimen that includes diuret- to the use of restraints for ensuring patient ics or analgesics places an individual at risk safety and preventing falls? Allow the patient to use the bathroom expected of another nurse in a similar independently. Which of the following statements accurately will not attempt to get out unassisted. Inhalation anthrax produces fever, fatigue, Multiple Response Questions cough, dyspnea, and pain; the patient’s condition may progress to meningitis, sep- Circle the letters that correspond to the best ticemia, shock, and death. Which of the following statements accurately include a characteristic rash that progresses describe factors affecting safety in the general to crusted scabs in 5 days. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. Check agency policy for the application of that progresses symmetrically in a descend- restraints and secure a physician’s order.
They concluded from their studies that the positive consequences of illness are varied and more common than often realized trusted 50 mg lamictal medicine in ukraine. This model has primarily been used in research to ask the questions ‘How do different people make sense of different illnesses? Some research has addressed the links between illness cognitions and adherence to treatment. Predicting adherence to treatment Beliefs about illness in terms of the dimensions described by Leventhal and colleagues (1980, 1997) have been shown to relate to coping. They have also been associated with whether or not a person takes their medication and/or adheres to other suggested treat- ments. The results showed that a belief that the illness has serious consequences was related to medication adherence. In addition, actual cholesterol control was related to the belief that the illness was stable, asymptomatic with serious consequences. For example, Horne and Weinman (2002) explored the links between beliefs about both illness and treatment and adherence to taking medication for asthma in 100 community-based patients. The results showed that non-adherers reported more doubts about the necessity of their medication, greater concerns about the consequences of the medication and more negative beliefs about the consequences of their illness. Overall, the analysis indicated that illness and treatment beliefs were better predictors of adherence than both clinical and demographic factors. The results showed that poor adherence was related to beliefs about the necessity of the treatment, concerns about the consequences of treatment and beliefs about illness identity. Predicting recovery from stroke Research has also explored links between illness cognitions and recovery from stroke. For example, Partridge and Johnston (1989) used a prospective study and reported that individuals’ beliefs about their perceived control over their problem predicted recovery from residual disability in stroke patients at follow-up. The results showed that this relationship persisted even when baseline levels of disability were taken into account. Therefore, they asked the questions ‘Does recovery from stroke relate to illness cognitions? Using a self-regulatory approach, research has also indi- cated that illness cognitions relate to recovery. In particular, the Heart Attack Recovery Project, which was carried out in New Zealand and followed 143 first time heart attack patients aged 65 or under for 12 months following admission to hospital. The results showed that those patients who believed that their illness had less serious consequences and would last a shorter time at baseline, were more likely to have returned to work by six weeks (Petrie et al. Furthermore, those with beliefs that the illness could be controlled or cured at baseline predicted attendance at rehabilitation classes (Petrie et al. In addition, similar beliefs about time line were related to lower levels of disability and similar cure/control beliefs were associated with greater dietary changes. A self-regulatory approach may be useful for describing illness cognitions and for exploring the relationship between such cognitions and coping, and also for understanding and predicting other health outcomes. Beliefs about illness appear to follow a pattern and are made up of: (1) identity (e. This chapter examined these dimensions of illness cognitions and assessed how they relate to the way in which an individual responds to illness via their coping and their appraisal of the illness. Further, it has described the self-regulatory model and its implications for understanding and predicting health outcomes. Consider the ways in which you made sense of your illness and how they related to your coping strategies. The literature describing the structure of ill- ness cognitions assumes that individuals deal with their illness by processing the different forms of information. In addition, it assumes that the resulting cognitions are clearly defined and consistent across different people. However, perhaps the information is not always processed rationally and perhaps some cognitions are made up of only some of the components (e. The literature also assumes that the structure of cognitions exists prior to questions about these cognitions. Therefore, it is assumed that the data collected are separate from the methodology used (i. However, it is possible that the structure of these cognitions is in part an artefact of the types of questions asked.
