Impact of Foreign Aid on Economic Development in Pakistan

Impact of Foreign Aid on Economic Development in Pakistan Impact of Foreign Aid on Economic Development in Pakistan explains that Pakistan is getting into a steady wave of debt burden. It is the International Monetary Funds in general and United States, Great Britain, Japan etc in particular which Pakistan uses as a main source of taking Debt. IMF alone has given more than 11 Billion US Dollars to Pakistan as debt. The researcher has narrowed down the wide topic into two main variables. First one being the Debt burden and other one explained as Economic growth in terms of Gross Domestic Products growth. The researcher argues that there are many reasons that make a country rely on foreign aid and debts. First reason is more of a political reason and the terms and conditions attached to the foreign aid, which in general are beneficial for the country taking it in a shorter term perspective. The other main reason is associated with the composition and the break up of external aid to loans in hard form. With the passage of time, there is a shi ft from providing grants to any Underdeveloped or friendly country to aid, which is further associated with interest payments and principal payback. The world today is facing a paradigm shift in terms of equipping someone with capital, from friendliness to enmity in the form of heavy interest re-payments. It was also concluded that there are many sides of the external debt and the way it interacts to solves the basic economic problems of a country. External aid brings positive as well as negative results in the long term aspects. Foreign aid no matter brings a positive up thrust in the Gross Domestic Product of a country in short term, as it boosts up agriculture, Informational Technology, Education, Health services etc. But in many cases the long run results are much difficult to handle. The major draw back seen of heavy external debt is the Balance of Payment Deficits. This deficit in Balance of Payments is covered by the allocated funds of the Social Sector development. The rese archer also explains about the policy matters which are the most important part in handling the external debt and its servicing. Proper and effective policies are to be made in order to retire the aid taken for better implementation of the policies, which in return will ensure the effectiveness of aid taken by the country and all the problems linked to mis utilization and mis management of the resources taken from external resources. Amakom Uzochukwu S. in his Research paper Nigeria Public Debt and Economic Growth: An Empirical Assessment of Effects on Poverty argues that there should be external debt to be raised by Under developed countries like Nigeria in Africa but there should be a limit attached to every country which should define to what extent the debt is to be raised. This limit is definitely be calculated and research watching all the financial indicators of past and futuristic look on the same indicators should also be given some weight. He also suggest that if proper weight is not given to the financial indicators of the country, it will in the end cause supplementary in-debtness of the International Monetary Funds and other sources of debt to be taken. He explains that the Public debt of Nigeria is slightly more than 75% of the total Gross Domestic Product of Nigeria. This is a very big number in absolute terms and according to the International Monetary Funds and The World Bank, Nigerian Effective debt to export ratio is also more than 200 percent with a total debt accounted for approximately 28.5 Billion US Dollars by 2002. This figure is not alone as it is also associated with the debt retirement of 3.3 Billion US Dollars in 2002 and 5.3 Billion US Dollars in 2003. The situations in Nigerian on financial aspects are much worse. There is immense poverty in the country where Gross Domestic Product growth rate is stagnant over the years, where the intake of debts from IMF and other domestic source has been shooting up randomly. Income per Capita is far-off from the total figures of debt that has been taken by the country. The researcher in his research paper has applied the crash of public debt and growth on poverty using the per capita income approach where he majorly focused on public debt the country is raising and the way it is creating more problems or solutions for alleviating poverty from the country. The end results of the research also showed the impact of loans taken from internal as well as International Monetary Funds on the economic and poverty structure of Nigeria. It was concluded that poverty in Nigeria is growth and debt elastic, as there is enormous poverty spread through out the country and the total accounted figure for debt is around 28 Billion US Dollars. There were multiple factors which were accounted fro in the case of Nigeria including population, domestic and external debt figures, employment rate, school enrolment rates, Balance of Account and terms of trade which are directly linked with the Economic growth of the country. James Njeru in his Research, The impact of foreign aid on public expenditure explains that for many of the Sub Sharan countries, taking economic aid from International Monetary Funds and The World Bank constitutes as an important participation for the sake of running economical as well as political structures of the country. In most of the African countries like Kenya, almost all the financial indicators are not in a good health. They all share relatively same narrow tax base, low on export side and large deficits in Balance of Payment Accounts. Saving of the people is also negligible since poverty head count is much on a higher side. The paper majorly focus on the response of the Kenyas Government in terms of its expenditure when experiencing massive aid cut from IMF and internal malfunctioning of public debts. The research showed that the spending outline of the government gets changed when this is an inflow of economic aid from International Monetary funds of debt is raised from internal resources. On the other hands, it was really difficult for Kenya in short term to deal with the effects of the aid freeze which were much influential in ordinary days supporting fiscal structure of the country. Fiscal measures were not capable sufficient to offset the change and started facing a downfall in no time. It was also concluded that the rise seen in the Kenyan domestic debt was always attributed to the persistent fiscal gap present in the country which caused suspension of the load payment by International Monetary Funds in 1991. This caused real problem for Kenyas economy as to overcome the fiscal deficit, the recipient country in result of getting suspended by loans has to look for many other new options, like raising the normal and corporate tax rate, increase domestic borrowing from the central bank as well as other commercial banks, having a massive cut in development and social development expenditure and printing more money which causes inflation and employ ment in the country. The mentioned problems were a major threat to the Kenyas economy, which it had face in terms of the crowding out effect in investment and added to the domestic debt. The situation got further difficult when Kenyan economy faced major expenditure cuts in governments cutting in social development sector and unemployment after having sky high inflation. Over reliance on external debt, particularly from International Monetary Funds made financial matter more critical for Kenyas economy and the effects of 90s is still faced by it. Michael Atingi-Ego in his report Budget Support, aid dependency and Dutch Disease argues that Ugandas economy is another difficult economy which has been facing sever challenges and threats in successfully running and implementing financial system of the country. It was due to the mere support of many countries on bi lateral and multi lateral country which supported Ugandas economy from crashing many times in history. Presence of International Monetary Funds in Ugandas economny is another problem since the country is not capable of abiding by the rules and regulations put by International Monetary Funds on it. It was until Financial year 1999, Support inflows to Uganda were comparatively small than the newer ones, constituting 200 Million US Dollar on annual basis. It was the help of numerous donors which in terms of grants or debt gave cushion to Ugandas economy many times and helped to decrease its fiscal and monetary deficits. Uganda is another African country where unemployment , low tax base, inflation, less saving by the public and high balance of payment accounts are seen over the time with no proper source of revenue excluding contacting International Monetary Funds for raising external assistance. For the sake of supporting budget deficits till FY 1996, loans from other countries in Uganda does the major source constitute 56%. Grants taken by donor countries also constituted to 73% moderately support the uptrend of Ugandas external debt and financial sustainability of the country. Ugandas government has also put ceiling on taking aid which can be taken in the form of loans and grants. In adding up to the upper limit and the suggested ceiling, it is always to evaluate that both domestic revenues and grants are insufficient to finance the national budget that government has skinny and less loans that are highly concessional. As a multi lateral donor, World Bank has also taking part in Ugandas fiscal deficit financing giving 225 Million US Dollars by 20 01, International Monetary Funds being 53 Million US Dollars. The research shows that Uganda is heavily laid on the mercy of budget support which is on an average more than 50 percent of its total expenditure. These measures have created inflationary and unemployment in the country which the country is trying to control on, but the over all situation is so much aid dependent, exchange rate and interest rates are out of the reach of Government to control them and bring positive financial changes in the country. Bazoumana Ouattara in his Research paper Foreign Aid, Public Savings Displacement, and Aid Dependency in Cote dIvoire explains that the economic effectiveness in any developing country is an important issue which is dependent upon the policies which are formulated in terms of raising aid from any of the external sources present in the world in the time of financial deficit. Right now, the donor countries and agencies are also inclined to issue loans to such countries which have effective and efficient economical structure, which has the muscle to return back the loan well in time with healthy interest payments. Governments workings and efforts in increasing the tax base and consuming on a lower side explains the good financial environment in any country. Public savings are another factor which has not been addressed directly which is another important concern when looking on the over all financial deficits and issuing external debt. In countries having huge public saving gaps, it i s much important to look as on the issues such are over dependency on external aid from International Monetary Funds and The World Bank, which are the most important factors if the relationship is to be gauged between taking aid and the economic growth of the country. If the public saving gap is reduced, the dependence for external debt even on the internal sources of debt will be minimum in order to finance the fiscal deficits in ant country. This brings macro economic stability and a self sustainable growth with long term dependence on external sources of Financing as International Monetary Funds. In the case of CÃ ´te dIvoire during the period of 1975 to 1999, it was observed that the wide gap of domestic saving caused another wide gap in monetary gaps in the country which are to be addressed immediately by contacting International Monetary Funds and other sources of International and Domestic sources of funding the gap. It was also concluded that aid dependence of CÃ ´te dIvo ire increased with an increase in Financial Program aids into the financial system, where as Technical Assistance grants and Food Aid Programs helped to reduce the aid dependence. Nevertheless, CÃ ´te dIvoire faced massive challenges and is still facing many financial threats which it has to face in terms of heavy interest payments as well as other imposing clauses made by the donors. Bazoumana Ouattara in his Research paper Disaggregating the Aid and Growth Relationship explains that foreign aid and debt there is a mystery which has not been solved by any Under developed country regarding its usage and encouraging economic growth in the country. Many of the researches by Papaneck any many other concluded the relationship between aid dependence on external source and growth to be open to doubts and questionable. But the recent researches by Burnside and Dollar claims that external aid is a way which can bring fiscal and monetary muscle in the economy and also helps to promote the trade policies of the country. Again the researcher argues that there are numerous bodies which are present through out the world giving loans and debts to less developed countries where they get into their trap when they have to take further money to pay back the previous one. So, there should be some policy which should elaborate some financial indicators which explains the solid financ ial policy atmosphere. In the research, it was concluded that the aid incomings into the countries which are already facing financial problems in their structure so get a positive response by the financial structure and it sponsors growth and financial augmentation but there are many other factors which are to be accounted for in order to create a healthy balance in taking loans and dealing with financial or fiscal deficits with in the country. Role of International Monetary Funds, according to the researcher, is the most important yet crucial one to discuss. They sanction aid to the less developed countries which have to stand for the monetary rules and regulations framed by IMP consultants. As a matter of fact, a country asks for monetary help since the internal situation on financial side is facing a serious ailment. Due to the new policies being compelled to that country, it always bring about further confusion and disorders in terms of inflation, unemployment, heavy debt piles , low tax generation, and most of the time its comes with massive political instability in the country, which further worsen the over all financial conditions of deficit edge. The research was mainly focused on the policy making which should be drafted with a lot of care and having a revolutionary thinking in order to eliminate the dependence of borrowed resource, interest payments with plod of principal payments and a lot of harass for the next generations of any particular country. Pakistans Economic Crisis and the IMF Bailout Package explains the significance of the International Monetary Fund that has already approved a bailout package of $7.6 Billion in order to help Pakistan avert from getting a default on its repute as far as the external debt is in question. Various meetings have been conducted in which IMF put is condationalities and imposments inorder to make a mechanism to get back the sum of many it lends to the country. Immediate pacts were agreed in providing an immediate $3.1 Billion sum to reinforce the countrys speedy weakening foreign exchange treasury. The ultimate goal of the arrangements to in ensure socio-economic firmness and re-establish investor assurance in Pakistan by looking keenly on the macro-economic unevenness and problems in the country. At the same time it also sends a message to the outer world that Pakistan has lost much in the war on terror and needs money in order to gain its original status of early 2000s. The country needed around $20 billion in order to prevent itself falling in the default list of Balance of Payment. Initially Pakistan was always reluctant to ask for help from the IMF due to their tough conditions on the subsidies and developmental expenditures but it was the last resort as Plan A and B did not work form the multilateral institutions and friendly countries. Going to the IMF was the need in time as there is a huge and persistent Balance of Payment and secondly, there is tax-to-GDP ratio sticking below 1o percent which is more than 17% in many of the developing countries. Furthermore there are sky high capital budget followed by public debt remaining as high as 55 percent of GDP. The arrangements made by The international Monetary funds if turns into a successful venture, it will help Pakistan in general to gather the goals and objectives in the field of fiscal and monetary deficit to some degree, mainly the phasing out of financial backing to the poor people from the government in th e form of subsidies and developmental budget. All this will help the Finance ministry to increase the revenue base of the government as reforms in tax administration will be there which will be causing 1% increment in the GST from fifteen to sixteen percent implemented in the FY2009 budget) will assist lift tax-to-GDP ratio. In the medium-term, the government will have to go for numerous steps such as eliminating exclusion in GST and the income tax and imposing Agriculture tax. A Comprehensive U.S. Policy to Pakistan states the mismanagement of Pakistans case by the Americans authority in monetary terms. It explains the current economic misery being faced by Pakistan due to its involvement in the War on Terror and other problems like political instability and terrorism. It explains that USA has put millions of Dollars in to Afghanistan and Iraq but Pakistan is the ally and much more important to the American objectives in Asia. Americas assistance to Pakistan is not up to the mark and there is growing anger of the people of Pakistan in the current democratic government and The US. Even the massive Kerry-Lugar bill was rejected by the people of Pakistan on the same grounds. There come the IMF, where Pakistan could go to. The irony of the situation is in the presence of USA, Pakistan still has to goto the IMF where it is always clear that there will be more problems coming up in the country due to the hard rules and regulations imposed by IMF. Thus there is a n immediate need that should be showed by USA in consultation with International Financial Institutions and other donors which should also take their part in providing Pakistan with significant balance of payments and budgetary support designed to prevent financial collapse and to alleviate the immediate humanitarian effects of high food and energy prices. Funds obtained from The International Monetary Funds are catered in the budgetary financing and is to be included in the respective fiscal year. On the other hand, Total Public Debt (TPD) includes domestic debt payable in Pak Rupee as well as the short, medium and long term Public Debt portion of External Debt Liabilities (expressed in Rupee term). Internal debt of Pakistan is also not showing a good picture. It is increasing day-by-day. Total Public Debt (TPD) showed a growth of 12.2 percent during the first nine months of the current fiscal year and reached Rs. 8,160 billion at the end of March 2010. Pakistans government takes again internal and external debts to service back the public deb. As far as the internal debt is concerned, government do have some grip on it but the moment the external debt comes in it, government loses its grip on the grip. In spite of the risks of extreme dependence on domestic debt, it is significant in nature to observe that government debts through l ocal aspects is fundamental in motivating investment and personal savings, as well as intensification of native financial markets, since it provides deepness and liquidity; the important aspect to run the business. The outstanding amount of IMF debt now stands at $ 7.2 billion where it was just $ 5.1 billion at the end of FY09, which shows an increment of 40 percent. Moreover, the IMF authorities have agreed to make it $11 Billion. Out of this unpaid sum; approximately US$ 1100 M is kept for the use of budgetary deficit, where the remaining should be used on the negative Balance of payment. The latest installment of approximately US$ 1.13 Billion was received on May 19, 2010.

The House on Mango Street Reflection Paper

February 6, 2013Cynthia Cotto [email  protected] edu Response Paper In the very first vignette Esperanza discusses how her family moved around a lot and even though the house on Mango Street was not the house of their dreams, it was a great achievement to own it. Although Esperanza knew they were not moving anytime soon, she recognized one advantage; her family was free of landlord management. In my community home ownership is a constant battle and for many simply a dream.I learn the value of home ownership in a similar sequence as Esperanza. My little sister and I were moved to and from apartment to family member’s houses until our first small home. A home with no back yard and only four stairs and side walk out front. None the less, a home to call our own; it was then that I knew one day I will own my home painted â€Å"white with trees around it, a great big yard and grass growing without a fence. † Setting this goal meant one thing to me, out; out of Philadelphia like out of the House on Mango Street.How to get out and leave my home, my Philadelphia that is so much a part of my maturing process that has molded who I am today is the challenge. Poverty is the drive behind my force on getting out, like Esperanza, poverty is a constant scene that drives my motivation to rise out from my community in Philadelphia. For many families it is not unusual to live in a row home next to an abandoned home or open lot where houses use to be; look around and see no grass only concrete, see no trees only stumps of where trees use to be and garbage carried by the wind collected alongside stoop of houses.The tricky part of growing up with this experience is realizing it molds character and influences a sense of direction. My experience in poverty directed my ambition in education therefore strengthening my chances in attaining my goals. Ultimately what was said to Esperanza by the three sisters, â€Å"You can’t erase what you know. You can’t for get who you are† is valid in the sense that no matter which path one is headed, their past is part of who they are, it is where they have been.Even though leaving Philadelphia is a dream of mine, I know there is no other place in the world I would rather be from; it has prepared me to be brave and define what I desire for my life and what is undesired for my life. Self-exploration is hindered in this book and my life. I can very much identify with Esperanza perspectives on societal issues that Latin women face. A society dominated by men and women relying on them, whether it is a father, spouse or friend. Men are considered the strong reasonable as where women are weak and emotional, in turn women need men for protection.A young girl may have two story paths, one where she relies on the protection of her father while she watches her mother cater to him or two, witnesses the struggles of a single young woman and absence for a father. This book describes marriage as priority for every girl or else how could she survive; appearances and physical features are highly valued traits. This attitude is not one that Esperanza agrees with, nor do I. For example, Marin she is the girl standing on the street just â€Å"waiting for a car to stop, a star to fall, someone to change her life. This character implies that she does not dream of actively setting life goals for herself and working to earn them, instead she will wait until a man makes it happen for her. The ideology behind this thought being that as a woman she must thrive to be as attractive as possible to heighten her chances of marriage and acquire worthiness. First women are to become wives, then mothers this is to be success enough. The thought of a woman exploring her independence not only from her family but from men is not an appreciated ideal.Esperanza mentions many women that are prisoners in their marriages and trapped in their homes due to such bias. This is an important issue and should be addres sed because reflecting on Esperanza’s perspective and my personal opinion; Latin women are not encouraged to explore independence much less through education. Sally is a great example that can express my reason for writing about this issue, her father sheltered her all her life and she married before eighth grade.Practicing those societal values leads Sally’s life to be encaged by her husband and home accompanied by nothing but the things she owns; this to which Esperanza understands that even though Sally has all the material things that her husband can buy, that is not worth much if there is nothing to do, no social interactions, or no self-respect. Esperanza absorbs her surroundings, contemplates her neighbor’s situations and visualizes her life and the thought of her life sadly gazing out of a window, this was all the motivation she needed to decide that she will not be end her story in the same manner; this I have done throughout my life as well.Being born and raised in the heart of Philadelphia I am consistently expose to the abundance of inequality, injustice and overall hardships that seem to walk hand in hand with this territory and culture of my community. Esperanza introduces Alicia, a girl that has a strong quality in common with Esperanza as well as I; the virtue of education. Alicia’s circumstances are very relatable to young Latin girls today in my life for example, I can recall positive reinforcement when I received good grades but there was rarely any encouragement to have me participate in extracurricular activities or educations competitions because there were chores.My family believed the transition would be easier if I did not move away for college and so I did not; I am encouraged to live home until marriage, therefore I have been. Things such as living on my own is addressed with the attitude of â€Å"why waste money, you minus well wait until you get married to move out,† but my education is my future; it is my gateway out of Philadelphia and into the path of my home with trees and grass to come home to after a day with my second grade students. With independence from my family and men is born a woman that can support herself and does not need to rely on a man.I am writing about the inequities regarding Latin women addressed in this novel as it is connected to my life. I like Esperanza, refuse to accept the limitations surrounding me like fog in the night discouraging me to pursue new paths. Most of the women characters Esperanza describe have strong personalities yet are unable to escape from their suppressing community and culture. I am neighbors with Mothers the age of fifth-teen and grandmothers the age of thirty-two. There are women that are raising their grand-children and mothers hoping to complete high school.Yet somehow this has become a norm it is not surprising to see a Latin woman have children at a young age as well as marriage. I personally never get tired of being asked: Do you have children? Are you married? You are in school? (in a very sarcastic tone); in that specific order. The expectations in this novel for young Latin girls are to find a man to support them and the way to find a man is through physically looking as attractive as she can and in order to become a loyal wife and mother. This is a society where a woman leaving their families to seek self-identification is not a natural thought.Esperanza was strong enough to fight through the society norm and pursue her talent and not become trapped in a house ruled by a man. Today I fight the same battle as do many Latin women do, we are strong and it takes bravery to go after one’s happiness in life. We strive to rise above poverty and community inequities through hard work and self-dedication to one’s ambitions. As The House on Mango Street is part of Esperanza, my Philadelphia community is part of me; without what I have seen I would be blind to what I want.

Advanced pathophysiology Essay

If available lab results, I would like to see the resulted complete blood count with differential and complete metabolic profile. Possibly supplying the patient with supplemental oxygen if deemed so by her oximetry and perfusion status review. As such the following would be the initial assessment and treatment: Obtain vital signs: blood pressure, temperature, pulse, respiratory rate with auscultation, as well as pain scale rating Note her capillary refill time and skin color and turgor, especially around lips for color and for turgor Seeing if she has sunken eyes or dry mucous membranes indicative of dehydration. Place a pulse oximeter on her finger for oxygenation levels. Place EKG monitor for heart rate and rhythm analysis. Place IV for obtaining blood works and order stat CBC, CMP, PT/INR/PTT, ABG, CXR, cardiac and liver enzyme profiles. Perform blood glucose monitoring with glucometer for immediate assessment of her diabetic state, is she hypo or hyperglycemic. Review airway for any obstruction as she is dyspneic. While conscious review pain level, duration and site of pain and medical history-hopeful to review current medications, with attention to evaluate current mental status such as orientation to person, time and place. Note that she is in acute distress with disorientation that is progressing to unresponsiveness (Gerontological nursing, 2010). If unresponsive at the time of arrival, the nurse needs to be vigil in looking for clues to how she is experiencing pain by looking for signs such as moaning, agitation, restlessness and facial grimacing. Assess skin is intact with no abscesses or open wounds or sores. Consider value of inserting a urinary catheter. Tools that will be utilized in the assessment of Mrs. Baker may include: Stethoscope- will be used for listening to heart beat to ascertain dysrhythmia above 90 beats/minutes would be indicative of concern and comparing radial/peripheral pulses with baseline of heart apex rate to ascertain if variance exists , auscultation of lungs for clearness of lung fields and respiratory rate should be 16 per minute if she is over 20 breaths/ minute concern for hyperventilation and oxygen delivery and consumption would arise . Tachypnea and dyspnea are noted, oxygen would be applied. blood pressure cuff (sphygmomanometer)- The blood pressure cuff will determine if she is normotensive or hypo-hypertensive, expected range is 120/80 mmHg if below 90 mm hg systolic or 70mm hg diastolic is cause for concern. Glucometer-ascertain rapidly, serum blood glucose level range expected 70 – 130 (mg/dL) before meals, and less than 180 mg/dL after meals (as measured by a blood glucose monitor). blood tubes with needle access for blood testing (vacutainers)-to conduct CBC- to monitor white blood cell, red blood cell and platelet counts, CMP- for fluid and electrolyte imbalance, kidney and liver function, ABG-, analysis for acid/base imbalance liver and cardiac enzyme for indication of liver or cardiac impairment as well as blood coagulation profile such as PT/INR/PTT- for elevation in bleeding time . Blood cultures and antibiotic sensitivities for sepsis pulse oximeter-to rapidly measure the oxygenation of her hemoglobin saturation 95 to 99 percent expected. continuous cardiac monitoring via electrocardiogram(EKG)-to examine rhythm and rate-expect normal sinus rhythm and rate 80-100 beats per minute. Thermometer-measure the core temperature which should be 37 c if above 38 c or below 36 c if hypothermic bladder catheterization kit chest x-ray- cardio pulmonary function The benefits of using these tools, as time is critical for an older patient who has multiple organ dysfunction syndrome(MODS), is to have precise and state-of-the-art information to effectively treat the patient. Maintaining and monitoring tissue perfusion would be key goals in her care and I would utilize these tools to evaluate blood pressure and respirations, monitoring pulse and assessing for any cardiac arrhythmias. To evaluate for any underlying respiratory disease, pneumonia, PE, or pulmonary edema a chest x-ray would be advantageous. A bladder catheter would give accurate accounting of urinary output. The patient became unresponsive; her respirations became more labored, so breathing became the main priority while reading the scenario. The patient is unable to verbalize how she is feeling and with her dyspnea it is clear she is in respiratory distress. Evaluating the electrocardiogram would be done to ascertain if there are any dysrhythmias that could be causing the symptoms. I would review the vital signs, is the patient having hypo- hypertension? Review the patient’s pain assessment, is the patient experiencing any pain? I would then review lab results, focusing on abnormal results. The prioritization was done with basis for basic needs first, that of breathing effectively to promote oxygenation then focus of vital sign monitoring that is compatible with sustaining life. I would assess pain in a geriatric patient who is alert by questioning the patient directly, do they have any pain, asking them where the pain is, what is the duration of the pain and when was onset. On a numeric pain scale 0 to 10 what is their level of pain. Are they taking any pain medication at home? In a geriatric patient who is not alert, I would need to assess the patient based on signs such as moaning, agitation, restlessness and facial grimacing. I would manage the pain in a geriatric patient experiencing multisystem failure and showing signs of pain but not alert with caution. The elderly are susceptible to polypharmacy and often have impaired renal function that increases risk or potentiates the medication such as barbiturates. Knowing I have a standing order for acetaminophen and by judgment of the pain with a lot of moaning, restlessness and grimacing, I would elect to give the morphine 0.1mg/kg IM. She cannot take the acetaminophen by mouth as she not responsive, the 0.05 mg/kg Morphine IV will likely obtund the patient with the rapid absorption and likely decrease her blood pressure severely as she is dehydrated. The patient’s pain level would need to be reevaluated approximately 20 minutes after administration for effectiveness and then again in one hour. It is likely with her being unconscious , I would assess by a presence or lack of grimacing, moaning or agitation. I found her to have been relieved of pain when reassessing her I have learned it is very important to recognize the fragility of the elderly related to polypharmacy, agedness of vital organs, key focus on concern of cognitive ability and its role in assessment by nursing. It is likely that the metformin (Glucophage) can have decreased effects when combined with Hydrochlorothiazide (diabetes forum, 2012). The patient recently added lisinopril to her regimen and this in the form of Zestoric has hctz in it as well. It is possible she has had too much hctz and the prescribing physician needs to be alerted. The recommendation for this possible interaction is to monitor blood sugar levels when taking all three of these medications. This is especially important when starting, stopping or changing the dosage of your lisinopril/HCTZ. The collaborative team members pertinent to her care are the emergency room physician for immediate assessment, diagnosis and treatment recommendation, the medical physician involved in her current care, possibly an endocrinologist who is managing her diabetes, a pulmonologist or intensivist who is caring for her current state as a consultant and the radiologist and cardiologist who will review her lab, radiology and EKG results. In the event where her status became unconscious the respiratory therapist and emergency room physician and ER code team responded to facilitate returning her to stable vital signs. It is likely she will need social work involvement and discharge care planning as she will be admitted until the current situation is diagnosed, treated and stabilized. References Gerontological Nursing: Competencies for Care, Second Edition, 2010. http://www.diabetesforums.com/forum/type-2-diabetes/48316-lisinopril-hctz-20-12-a.html accessed November 24, 2012.

Policy Analysis Iii- Compare and Contrast Paper - 809 Words

Policy Analysis III- Compare and Contrast Paper Brandy Alston University of Phoenix Criminal Justice Management Theory and Practice CJA/464 Professor Leroy Hendrix October 10, 2013 Policy Analysis III- Compare and Contrast Paper The reason for policy analysis reflects around the assessment of policies from the government by critiquing the failures and successes. The United States implement several policies to deal with criminal activity and social issues, for instance The United States Human Trafficking Policy, this policy is not a successful one but this policy is steadily improving with sustainable reform. The criminal justice system practice the model of Packard’s Due Process, established with the promise†¦show more content†¦According to Siskin Wyler (2012), in additionally the United States Homeland Security, State, and Labor Department assembles a list of issues made up by banning the United States imports and child labor. The United States Justice (2001) defines human trafficking as focusing on the act coercing or compelling an individual to commercial sex, services or labor act. The coercing could be clear or restrained psychological or physical, but used in coercing an individual to perform commercial sex, services, or labor acts. These regulations are based on the United States Constitution XIII Amendment bans involuntary servitude and slavery, and the Civil Rights Division also enforces the regulation with law enforcement agencies and the United States Attorney offices. Stubborn to the misconceptions dealing with human trafficking acts does not demand any movement or smuggling the individual. While illegal immigrants are uncommonly liable for coercion for the fear of authority, trafficking shows the power to take advantage of other unprotected populations and grabs offensively documented individuals working in the United States and America citizens. 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