When my husband Joe had cancer surgery five years ago, each of his family members responded just as I knew they would. John, his father, decided to organize the family’s calls. Because, of course, everything would run so much more smoothly. Thus Jane, Matt, and Jim received detailed sheets of instructions in the mail. Telling them which days to telephone r.j. smith hospital to talk to Joe and what presents to send. Jane, enraged, promptly threw a tantrum. Calling Matt and me to complain about her father’s overbearing behavior. “I,” she yelled, “am a Psychiatrist who knows how to handle these situations, i am not still a child.” Matt also responded predictably. By avoiding the situation. He threw himself into his work. Normally a late sleeper, Matt took to leaving at 5:00 a.m., driving on the deserted expressway and arriving at work before six a.m. In addition, he didn’t return until 11:00 p.m. When he would fall into bed so exhausted that he couldn’t worry about Joe. Jim, too, responded predictably. He fumed inside for weeks, ignored John’s instructions, and sent cartons of books to Joe. So that he would never be bored. The books were funny. Because Jim had read Norman Cousins’ book about the healing power of laughter. Within a few months, Joe recovered from the surgery-in spite of his family
Treatment of atrial septal defect depends upon the size and symptoms and therefore is individualized an atrial septal defect of less than 3mm usually closes spontaneously (The Merck Manual, 2006). When the defect is between 3mm and 8mm it closes spontaneously in eighty percent of cases by the age of eighteen months, however, atrial septal defects located in the anteroinferior aspect of the septum (ostium primum) or in the posterior aspect of the septum near the superior vena cava or inferior vena cava (sinus venosus) don’t close spontaneously. If the defect is very small does not close spontaneously and the patient is asymptomatic. The treatment may be simply too monitor via an annual echocardiogram. Of course their is a risk of patients’ becoming symptomatic.
Moderate-sized atrial septal defects or larger or patients’ who are symptomatic require closure of the shunt this is usually done between the ages of 2 and 6 years. A catheter-delivered closure device, such as Amplatzer Septal Occluder or Cardio-Seal device. May be used for closure of atrial septal defects less than 13mm in size, except than primum or sinus venosus defects. If the defect is greater than thirteen milimeters or located near important structures. Surgical repair becomes necessary. If the atrial septal defect is repaired during childhood there mortality rates approach 0 and the patient’s life expectancy approaches that of the general population prior to surgical repair, patients may need to be treated with diuretics; digoxin; ACE inhibitor; or beta blockers to prevent congestive heart failure (Moser & Riegel, 2007). Following surgical repair patience will receive aspirin to prevent clots, and be monitored closely for dysrhythmias and pulmonary hypertension. Oxygen and nitric oxide therapy have proven to be beneficial in treating postoperative pulmonary hypertension. Also patients who have primum atrial septal defect will need endocarditis prophylaxis.
2.Describe when the following words would be used in a scholarly essay (define each word). Then, use those that are appropriate to a scholarly essay in a sentence.
- Their, there, they’re
- Affect, effect
- Its, it’s
- your, you’re
- then, than
- accept, except
- 3.Describe the use of apostrophes in writing in general. When should apostrophes be used in formal writing? When should apostrophes be avoided in formal writing?
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Also posted onMay 11, 2020 @ 8:56 pm