Milkshake with a side of CABG

Once upon a time there was a 60 year old man who really liked milkshakes and cigarettes. He liked them so much that every time he smoked a cigarette he drank a milkshake, he smoked a pack a day. He had complaints of unresolved chest pain, jaw pain, left arm pain, shortness of breath at rest, fatigue (especially with exertion). One sunny afternoon, after these symptoms progressed, he came into the ER with a STEMI and had a CABG surgery. After his CABG he was transferred to the SICU where Kelis, his nurse assessed him. First Kelis attached the cardiac monitor, pressure lines, noted existing drips, attached the ventilator and end-tidal carbon dioxide and pulse ox monitor. Peripheral pulses and signs of perfusion were checked as well as the chest tube placement and output (<150ml/hr). Body temperature was recorded and rewarming occurred because the body temperature was less than 96.8F. The nurse began by oxygenating the patient to maintain adequate SpO2. She increased room temperature and used a warming blanket to prevent hypothermia. Pain was managed by splinting the incision and using a PCA pump. Cardiac output was maintained by giving fluids and blood products. An ECG monitor was used to monitor for dysrhythmia. As a result of these actions the patient was free to return home after copious amounts of education were given, “I can teach you, but you have to change.”

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CHF-er Patient

imagesCHF—Once upon a time there was a 69-year old caucasian man named Donald Trump who had an orange comb-over. He was very angry. He reported high levels of stress. His favorite food was Freedom Fries and he ate them at almost every meal.

His health history included hyperlipidemia, a sedentary lifestyle, hypertension, obesity, heavy alcohol use and probable drug abuse. He had complaints of frequent awakening a night with shortness of breath, his favorite pink socks not fitting, recent weight gain of 7 lbs in the last week, dizziness, fatigue, weakness, a cough, chest pain, and heart palpitations

The nurse assessed the patient, finding dependent pitting edema, nocturnal paroxysmal dyspnea, confusion as evidenced by incoherent ranting about building walls and healthcare. He had obvious bilateral JVD with wheezing and bibasilar crackles. He appeared anxious and was leaning forward breathing heavily. He had a decreased urine output since admittance. His vital signs were:

Heart Rate: 127

Blood Pressure: 190/120

Spo2: 92%

Temp: 98.7

Resp Rate: 26

The nurse began to do a thorough medication history. Due to his recent stress and confusion, Trump had not been remembering to take his Carvedilol for his hypertension. He had been taking 800 milligrams of Ibuprofen 3 times a day for headaches. The patient was put on Lasix and Spironolactone. He was given oxygen via a nasal cannula. The head of his bed was elevated. The nurse educated the patient about taking his medications and lifestyle and diet changes.

As a result of these actions, the patient began to urinate, was able to sleep, maintained a normal blood pressure, reported no chest pain or shortness of breath and his lungs were clear. He lost the 7 lbs of weight he had gained over the next several days.

 

Unstable angina for K. West…

kim-kardashian-and-kanye-west-fat-photo

Once upon a time there was a 50 year old African American male who had a history of hypertension, hyperlipidemia, with BMI of 32, and family history of father passed away at age 55 with Acute MI. He presented to the ED with signs of/complaints of severe chest pain at rest, starting 30 minutes ago, shortness of breath, fatigue, and nausea. The nurse assessed the patient finding HR-110 regular, BP-145/90, Resp-21 shallow, Sat02 92% on room air, temperature- 98.6, chest pain 7/10, pressing, radiating to left arm and jaw, diapheretic, pale, and cap refill 4 seconds.  Nurse ordered 12 lead EKG and drew Labs, began to administer morphine sulfate 2mg IV, Oxygen 4L nasal cannula, nitroglycerin 0.4mg sub-lingual, and aspirin 325mg PO. Patient was re-administered nitroglycerin 5 minutes later and 10 minutes later. As a result of these actions the patient presented with HR 120, BP 90/60, Resp 25, Sat 02 88% with 4L O2, temp 98.6, pain unrelieved at 8/10, shortness of breath, ST elevation on EKG monitor, now prepare for cath lab.

Primary Source Documents

 

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Harold ‘Bizz’ Johnson received a letter from July 31,1972 from one of his constituents in Susanville, California. The body of the letter is to voice out one man’s opinion over what should be done with regards to the Vietnam War. Robert Woods write in his letter about the upcoming foreign aid bill that will be voted on by Congress. Woods acknowledges that his support for the war efforts has ended wit the Nixon Administration. He states, “I supported LBJ’s (Lyndon B. Johnson) policies on the war, but I think it’s time both of us made a change.”
This call for change is to Bizz. Many who from the beginning supported this war for half a decade started to realize that it was no longer necessary to occupy a foreign sovereign state. Robert Woods shared this sentiment with those in his community and in the nation.

The upcoming vote on the foreign aid bill would approve a provision stating,

” the involvement of United States land, sea, and air forces, for the purpose of maintaining, supporting, or engaging in hostilities in or over Indochina shall terminate and such forces shall be withdrawn not later than October 1, 1972, subject to a cease-fire between the United States and North Vietnam and those allied with North Vietnam to the extent necessary to achieve safe withdrawal of such remaining forces, and subject to the release of all American prisoners of war held by the Government of North Vietnam and forces allied with such Government and an accounting for all Americans missing in action who have been held by or known to such Government or such forces.”

The primary function of Congress is to create and modify laws. In the legislative branch domestic and foreign issues are brought up and voted upon by elected representatives. Congress holds the power and authority to approve or reject these laws. It was amended and passed. It would take six months for Robert Woods and the rest of America to see the war come to an end.On January 23 1973, the U.S and the Republic of Vietnam signed a peace agreement and ended the war.

Works Cited

Belasco, A., J., C. L., Fischer, H., & Niksch, L. A. (2007). Congressional Restrictions on U.S. Military Operations in Vietnam, Cambodia, Laos, Somalia, and Kosovo: Funding and Non-Funding Approaches . Washinton D.C: Congressional Research Service.

Project Vote Smart. (2015). votesmart.org. Retrieved September 13, 2015, from Vote Smart: https://votesmart.org/education/how-a-bill-becomes-law#.Vfmr97RRe-8

’73 Foreign aid authorization dies in conference. (1973). CQ almanac 1972 (28th ed.). Washington, DC: Congressional Quarterly. Retrieved from http://library.cqpress.com/cqalmanac/cqal72-1250890.

HR Bill 16311

Sanad Hawatmeh
Pols 300

Bill HR 16311
On April 30, 1970, Mathew M. Chuchel of Chico, California wrote a letter to Harold T. Johnson about his concern on a bill named Bill HR 16311. Mathew is completely against this bill which would guarantee a minimum income to all people in this country. Mr. Chuchel states that if this bill is passed it would have a devastating effect on the country. How exactly does this bill mean? Also, Mr. Chuchel writes about the free enterprise system that this country has been built on. At the time in 1970 there were other welfare programs that helped the poor and Mr. Chuchel says that would be enough to help those in need.
Bill HR 16311 was a bill that would bring into action a welfare program that included the minimum income allowance of $1600 for a family of four who did not work and needed the assistance. President Richard M. Nixon suggested this bill to congress and it was passed in April of 1970. The bill was to help families survive until they found work of some sort. If families started earning income, the amount of assistance would be decreased by 50%. http://www.jstor.org/ Mathew Chuchel was concerned that this would ruin the free enterprise system that this country was built on. A free enterprise system is an economic system where a government places very little restrictions or rules on business activities or ownership that citizens want to partake in. This is basically known as a free market system. One is free to pursue any type of work that he or she feels comfortable in. This system gives the average citizen the right to open any business and spend their money any way they would like. In a free enterprise system the government allows one to choose any type of business or job that they are interested in. Mr. Mathew Chuchel believes with this Bill that this system will be greatly affected. Allowing people to receive a minimum income in every household can affect the economy greatly because people will become lazier and take away from those who work hard for their earnings. http://study.com/academy/ . The letter that Mathew Chuchel wrote to Mr. Johnson is a primary source. Its written by Mr. Chuchel and he feels that with the passing of the bill it would lead to negative affect in the economy. Mathew Chuchel is a personnel manager at REX CHAINBELT INC. and hopes that Mr. Johnson will voice his opposition to this bill.

pols 300

Contextualizing a Primary Document

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     In the April of 1970, President Nixon announced the United States involvement and expansion in Cambodia to end the Vietnam War. At this time, there had been many opposing sentiments about the war, particularly among students who wanted to avoid further foreign conflict and drafts. On May 4th, 1970, while students gathered to demonstrate at Kent State University against the President’s decision, National Guardsmen shot and killed four students while injuring many others during the protest. This awakening experience further antagonized and unified the nation against the Vietnam War as the betrayal of the government to protect its citizens fueled a crusade for justice. (http://www.jstor.org.summit.csuci.edu:2048/stable/23380315?seq=1#page_scan_tab_contents).This document calls attention for a national student strike in which three “demands” are made to end repressing incidents like that of Kent State by the students of American University in the Committee for Community Involvement. According to the committee, the Paris Peace talks, the repression of the Black Panther party and using the National Guard on students have all exceeded the powers government should have over its people. The document serves as a template to reason with the reader why a mass rally is essential in maintaining free will and basic rights with protection against the government.

   The committee writes in their first statement that the Paris Peace talks had been weakened due to unceasing bombings in North Vietnam, also insisting to withdraw from the war. Right before the university incident, the Paris Peace talks were negotiations being held by the U.S. government as well as with the North and South Vietnamese leaders to end the war in Vietnam. These peace talks started with President Johnson in 1968 after the escalation of war seemed better fit through the arduous process of diplomacy.(http://www.jstor.org.summit.csuci.edu:2048/stable/41392953?seq=1#page_scan_tab_contents).The peace talks occurred over the course of years, with new negotiations and conditions being altered or stagnant depending on the how the other parties would respond. When Johnson pronounced that there would be no more bombings in North Vietnam, there was hope that this would be the beginning of the end until Nixon came into office and approved the expansion into Cambodia. In the U.S., college students were overwhelmingly against the decision to invade Cambodia because of the draft they considered unnecessary. The students at American University considered Nixon’s approach a threat to their liberties and they wanted to show their disapproval through a strike.

   The second reason why the students are rallying in this document is to end political repression domestically. According to the Committee, the Nixon administration has breached the Constitution to object any challengers of their policies. In their example, the Black Panther party has been constrained by the administration because they are considered “radicals” although they help protect the people from the government. The Black Panther Party was an institution that brought the African American community together in times when the government did not and that unity really threatened the system. In the 1960’s when civil liberties and racial tensions were high, the banding of African Americans was seen as militants trying to take over by the non-minority mass. For the minorities, the black panthers stood as an organization that aimed for the equality of the oppressed. The FBI however did not see the social movement that way and in 1968 the Panthers were declared to be the “single greatest threat to the internal security of the United States”. (http://www.jstor.org.summit.csuci.edu:2048/stable/41392953?seq=1#page_scan_tab_contents). The students at American University are on the side of the organization and call for an end to the oppressive interfering government.

   The final reason why they were holding a national student strike was to protest the involvement of the educated becoming the leaders of the CIA as well as other agencies and taking lives abroad and at home. The document ultimately shows the student’s disapproval of Nixon’s foreign and domestic policies by pointing out the injustices that have occurred under his term.

Vietnam War

A woman named Leitha Van De Grift wrote to Harold T. (Bizz) Johnson on April 15, 1970. She was opposed to the Vietnam War that was taking place at this time, but she did not condone how protesters and demonstrators were expressing their distress with the government. Her letter sounded concerned but still very respectful as she addressed multiple controversies pertaining to the Vietnam War. Some of the affairs mentioned in her letter included the Moratorium, the demonstrations and protests of the war, and the My Lai Massacre. Johnson’s response to Mrs. Van De Grift explained that he wanted peace with Vietnam as well, but he also wanted a peace that would last and this had the potential of taking longer to come to an agreement upon. He also asserted his worries about the violent behavior of the Vietnam War protesters.

In her letter, Mrs. Van De Grift, mentioned some national events that took place during the war that today’s reader might not understand.

  1. The first ambiguity revealed in her letter referred to a national student strike referred to as the Moratorium. Moratorium, as described by dictionary.com, is a suspension of activity, which in this case referred to the suspension of classes. During the Moratorium, students organized marches and demonstrations, did not attend class, and held “we won’t go” petitions, in an attempt to portray their contempt for the war, it’s draft, and the poor economic status the nation was left in due to the war. Twelve days preceding Mrs. Van De Grift writing in to Johnson, on April 3, 1970, Nixon disclosed to the nation that the military would once again begin the bombings in Vietnam, only adding fuel to the student striker’s fire (Amherst, Hampshire, Mount Holyoke and Smith, pars. 1).
  2. The second ambiguity presented in Mrs. Van De Grift’s letter made reference to the protests going on. Protests began after the military began the bombings in Vietnam in 1965. These liberal protesters were made up of mostly students and artists all in opposition of the war. Increasing casualties, cost, men called to service, and Martin Luther King Jr.’s opposition elevated tensions. More than 100,000 protesters congregated at the Lincoln Memorial on October 21, 1967. 30,000 of these protesters advanced to the Pentagon to be affronted by soldiers, leading to the arrest of hundreds of protesters (History.com Staff, pars. 1).
  3. The last ambiguity brought up in the letter was the My Lai Massacre. At this point in the war, the energy and attitudes of the soldiers were at an all-time low due to the Tet Offensive (History.com Staff, pars. 2). The Tet Offensive was a sequence of attacks on numerous South Vietnamese cities by North Vietnam (U-S-History.com Staff, pars. 1). On March 16, 1968, Charlie Company was set lose by a Lieutenant William L. Calley to destroy the village of My Lai. All of its residents were considered opposition, and troops were given orders to kill all its inhabitants. This was done so in a brutal, unjust, and cruel manner that would now be considered excessive and unnecessary. Throughout the entire search-and-destroy process, there was no return fire aimed towards United States troops (History.com Staff, pars. 2-3). It was not until eighteen months later that this event and its details were revealed to United States citizens. Once brought to light, this event was later investigated and numerous soldiers were held responsible (Hersh).
  1. Amherst, Hampshire, Mount Holyoke and Smith. “Student Strike of 1970 Files, 1968-1971 : Biographical and Historical Note.” Student Strike of 1970 Files, 1968-1971 : Biographical and Historical Note. N.p., n.d. Web. 16 Sept. 2015. http://asteria.fivecolleges.edu/findaids/smitharchives/manosca31_bioghist.html
  2. Dictionary.com. Dictionary.com, n.d. Web. 16 Sept. 2015.
  3. http://dictionary.reference.com/browse/moratorium
  4. History.com Staff. “Vietnam War Protests.” History.com. A&E Television Networks, 2010. Web. 16 Sept. 2015.
  5. http://www.history.com/topics/vietnam-war/vietnam-war-protests
  6. “Anti Vietnam War Protest -.” YouTube. N.p., n.d. Web. 16 Sept. 2015. https://youtu.be/Bk09F1fTs1E
  7. History.com Staff. “My Lai Massacre.” History.com. A&E Television Networks, 2009. Web. 16 Sept. 2015.
  8. http://www.history.com/topics/vietnam-war/my-lai-massacre
  9. Hersh.”My Lai Massacre.” YouTube. N.p., n.d. Web. 16 Sept. 2015. https://youtu.be/VWchy6ykNnQ
  10. U-S-History.com Staff.”Tet Offensive.” Tet Offensive. N.p., n.d. Web. 16 Sept. 2015.
  11. http://www.u-s-history.com/pages/h1862.html

Assignment 3

 

In a letter addressed to California Member of Congress Harold T. “Biz” Johnson, a constituent by the name of Dr. Donald L. Gerber expresses his concern regarding the United States ‘obligatory’ involvement in the war in Vietnam.

1967 Letter to Biz Johnson regarding legislation on the War in Vietnam.

To preface his concern, the United States alongside the United Nations had worked together to eliminate the remainder of communist states still present in parts of the world, specifically Southeast Asia. Because China was the largest adopter of communism, bordering countries had also turned to establish their own communist society, politics and economy. Collective security as a deterrent of communism for the U.N. was the leading premise and principle in the process of dealing with communist countries and thus restoring balance of power in the area. To further facilitate that notion of collective security and containment, the Southeast Asia Treaty Organization or SEATO had formed. As explained in a response letter to Gerber, Congressmen Johnson states the overall purpose of what SEATO is attempting to accomplish.

“The purpose of the SEATO treaty is to uphold the principles of individual liberty and the rule of law; To Provide mutual defense against armed attack and internal subversions; and to promote the well being of the peoples of the treaty area, in accordance with the provisions of the United Nations Charter.”

Gerber, in his letter to congressman Johnson, specifically claims that the United States has inexplicably been obligated to carry out military presence in Vietnam. However, Gerber fails to realize and understand the larger picture as to what is going on in the instance of containment and collective security. Johnson justifies the presence in Vietnam by explaining that all processes leading up to involvement were “lawful” had been carefully followed by: International Law, The United Nations Charter, the U.S. Constitution and the legislative authority granted to the President. In addition was the support of the past three U.S. presidents (Eisenhower, Kennedy, and Johnson)

Because of the communism gaining traction in the Southeast; preventing aggression fueled by communist ideologies and was the overall reason for U.S. military involvement in Vietnam under SEATO. Rather than a way to conquer another land which was often believed by ill-informed constituents, the explanation to our necessary military presence is to defend social positions so that aggression is subsided and peaceful political talks can be carried out.

Erik Jon Brenner

Student, Cal State Channel Islands