The Critical Period - 979 Words

The Critical Period In 1781 the Articles of Confederation became the government of United States of America, a fragile new nation. This new government was just enough to hold the Country together in that period of time. Although, the effectiveness of these Articles can be debated. These Articles were in effective in the that it got the United States through a very Critical Period of time, but were also ineffective enough they had to eventually be replaced for the good of Country. Historians call this time period the critical period for the new nation. The country itself, could have fallen apart very easily during and after the Revolutionary War. This period was also called the stepping stone to the constitution, because the states†¦show more content†¦John Jay’s attention in this issue was fixed on the how the obstacles divided them which were, the navigation of the Mississippi and the territorial limits between them (Doc. F). The Mississippi river was something very important to trade with but was eventually put on the back burner because Jay’s requirements were not met. This eventually brought a sense of rebellion to Jay and he said in a letter to Washington â€Å"Our affairs seem to lead so some crisis, some revolution -- something that I cannot foresee or conjecture.† (Doc. G). It is like he sensed the weakness in the Articles and a rebellion coming. That is just what happened when a disgruntled farmer named Daniel Shay lead some debtors and poor farmers into Massachusetts in rebellion. He wanted to end imprisonment for debt, halt foreclosures, and demand the state to issue cheap money. Then, when Massachusetts called for help no one answered. This lead to the realization of the need for a stronger central government and correct the weaknesses of the Articles. Although people had different points of view on the matter of adopting the new constitution. Some people saw the Articles of Confederation the perfect kind of government, sure they needed repairs but they didn’t need to be replaced. In Doc. H a Report of Lowndes’ speech to the S. Carolina House debating the Constitution it states: A man possessing a magnificent building, upon discovering a flaw, instead of repairing the injury, should pull itShow MoreRelatedIn South Africa, adolescence is a sensitive period, and not a critical period, for identity1600 Words   |  7 PagesAfrica, adolescence is a sensitive period, and not a critical period, for identity development as it is â€Å"a period during which normal development is most sensitive to abnormal environmental conditions† (Bruer, 2001). When looking at South Africa particularly, the abnormal environmental conditions would be apartheid, and one will see its profound effects on identity development. Adolescence is a sensitive period rather than a critical period as a critical period focuses on a system that â€Å"requiresRead MoreEssay on Sensitive Periods in Developement1258 Words   |  6 PagesSensitive Periods in Developement The child does not grow uniformly and homogeneously like a crystal or a carrot, but by stages or phases, which succeed one another and which, differ from one another. For proper growth and development it is necessary that the potentialities for developing human relationships with which the infant is born be exposed to the organizing influences of another human being. Accumulating evidence indicates that there exist critical developmental periods during whichRead MoreThe Acquisition Of Child Language1010 Words   |  5 Pages Introduction The acquisition of child language has become a heated debate in which many discuss how and when a child is able to learn both their first and even their second language. The critical period hypothesis is a theory which claims that after a certain age children will no longer be able to achieve a native level of fluency in any given language. This essay aims to dissect the evidence which supports and contradicts this, and will draw upon studies and experiments conducted on both humanRead MoreHow Rapunzel Relates to Child Development Essay1297 Words   |  6 Pageschildren their age, and this is a critical period for learning to talk and socialize properly. This is a stage where branching and pruning happens. Which is when the neurons start branching and making connections to new things they are learning so they can develop properly. Then, the neurons that the children aren’t using prune away. If a child doesn’t experience social interaction, speech, or even something as simple as learning to walk properly in this critical period then it will make it very hardRead MoreHow Can Tie A Shoelace? Essay1644 Words   |  7 Pagesto the fact that Alex was missing out on exposure to language and sound – a lack of supervision and support. Since Alex had difficulty hearing, he was already far behind of his peers due to his lack of exposure to sound and language during the critical period of language acquisition. Although he was given visual clues of language by Denworth and her family, Alex was not exposed to as much language as other children who had no difficulty with hearing. Denworth argues in her book, I Can Hear You Whisper:Read MoreResearch On Age And L2a For Decades1287 Words   |  6 PagesThe critical period hypothesis has been the main focus of research on age and L2A for decades. This hypothesis originated with Lenneberg. In his 1967 study, he proposed that for language to develop fully, it must be acquired before the start of puberty. H is hypothesis was solely regarding first language (L1) acquisition. Johnson and Newport (1989) were among the first to question if and how this hypothesis applies to second language acquisition. They conducted a test with a group of 46 ChineseRead MoreThe Way Of Self Regulation1396 Words   |  6 Pagescan be influenced throughout life. A critical period is a period where a skill must be learned or it will never be learned. A sensitive period indicates that it’s easier to learn the skill in a certain time period, but it can be learned at other times. The sensitive period is used more often when dealing with humans because it’s less rigid (neurons to neighborhoods). The Berk book gives some great examples of the sensitive period. One describes a sensitive period for developing language. A group ofRead MoreSensitive Periods in Early Development Essay examples1346 Words   |  6 PagesSensitive Periods in Early Development From the moment of conception to the moment we are born and grow into adulthood, the timing of even the first beginning of our life journey is crucial. Even the timing of fertilization can be too soon or too late in which will cause the organism to be destroyed. (The Development of Children, 2nd ed). The mother carrying a baby has a responsibility to ensure enough nutrition is supplied for the rapid growth of the organism. HoweverRead MoreThe Effects Of Too Much Screen Time930 Words   |  4 Pageshighest plasticity and when our sensitive period for brain development is (Berk). During this sensitive period is when appropriate stimuli is vital to our brain growth and is also when our experiences play the most important role in our development. The infant and toddler years should be spent developing healthy bonds and relationships with the child’s parents, other family members, exposing children to new experiences, and creating healthy habits. Those critical years should not be spent in front ofRead MoreStudy Of Humanity : Feral And Neglected Children1636 Words   |  7 Pages(Shattuck 223). Although these two cases occurred more than a century and a half apart and under different circumstances, there are many similarities. The most important similarity is that Victor and Genie were deprived of human contact during the period which is, arguably, the most important in childhood development. One of the most detrimental effects of this deprivation in both cases was the struggle of language acquisition. Victor ultimately only learned how to speak two words: lait (milk) and

Parallelism in Writing for English Learners

Parallelism takes place when two similar phrases are joined to make just one sentence. For example: Tom plays the piano.Tom plays the violin.Parallelism Tom plays the piano and the violin. This is just a simple example. There are many types of parallelism and the important point to remember is that both forms must be the same. In other words, if you have two parallel verb structures the tenses must be the same. For example: Peter works hard and plays hard. NOT Peter works hard and play hard. Single Word Parallel Structures Both of the previous examples are single word parallel structures. Here is an overview of single word parallel structures: Nouns Jack eats fish and chicken.Sarah writes poetry and short stories. Verbs Our neighbors have moved and have sold their house.My sister walks or rides her bike to work. Adjectives The class is not only fun but also helpful.She is not only strong but also fast. Adverbs Peter drives quickly and aggressively.They work carefully and effectively. Phrase Parallel Structures Parallelism can also take place with phrases. This type of parallel structure can be more difficult to recognize as the sentences are more complex. Here are some examples: Having fun is as important as working hard.She advised me to get some sleep and take some time off work. Here are phrase parallel structures. Each type of structure includes a note about important points/problems to take into consideration. Noun Phrases Work is as necessary as play.Apples are as good for you as oranges. NOTE: Noun phrases are either singular or plural in nature and impersonal (it or they). Verb Phrases As soon as I arrive home, I put on my shoes and go for a run.Before she leaves for work, she usually eats breakfast and has a cup of coffee. NOTE: All verbs in a verb phrase with parallel structure have the same conjugation. Adverbial Phrases Peter and Tim will probably arrive in less than an hour and in time for the meeting.They want more time off in the summer and on weekends. (at weekends in British English) NOTE: An adverbial phrase is made up of more than one word which functions as an adverb. In this case, in less than an hour and in time expresses when something is going to happen. Gerund Phrases He enjoys playing tennis and working out.They dont mind waiting and talking while you get ready. NOTE: Make sure not to mix the infinitive (to do) and the gerund (doing) in parallel structures! Infinitive Phrases Jackson hopes to visit his parents and see his old friends when he goes home.She advised me to find some new friends and forget about the event. NOTE: Make sure not to mix the infinitive (to do) and the gerund (doing) in parallel structures! Participial Phrases Discovering her financial losses and not knowing enough about the current market, she decided to stop investing.Driving through the German countryside and speaking to the people, Mark began to understand the culture better. NOTE: This is a rather complex structure. Notice how a comma is placed after the parallel structure participial phrases that introduce the sentences. Clause Parallel Structures Finally, clauses can also be used to make parallel structures. In this case, remember that you must use full clause structure (subject verb objects) and that the subjects of BOTH clauses will be the same. This causes the verb conjugation to remain the same in both clauses. Noun Clauses She said that she was having fun but not that she was meeting people.Peter felt that he had made an excellent deal and that he had bought a masterpiece. Adjective Clauses She is a woman who is intelligent and, at the same time, who seems distracted.This is a product that is easy to use and that is simple to clean. Adverb Clauses As he didnt understand and because he refused to try, they let him go.Since it was easy to use and because it was cheap, it sold very well.

Aristotle And The Holy Grail - 1610 Words

In modern times, no film can be produced without being scrutinized by a number of paid movie critics who are chosen to tell the public what movies implement factors that constitute it as an acceptable film to watch. In Ancient Greece, this idea of a movie critic was nonexistent, due to the fact that the closest form of entertainment that they possessed were plays. However, Greek philosopher Aristotle was, among countless other professions, the first individual to become the ancient version of modern-day movie critics. Aristotle developed six main elements of a tragedy play. These six elements include plot, character, diction, thought, spectacle or scenic effect, and song or music. One theatrical phenomenon released in 1975 which†¦show more content†¦King Arthur’s first quest is to call upon all of the knights in the surrounding area so they can all congregate at his Round Table in Camelot. Thus, attempting to create the historical group known as The Knights of the Rou nd Table. One obstacle that King Arthur faces is his meeting with the Black Knight. â€Å"Arthur comes upon a sword fight between a green and black knight. The black knight triumphs and Arthur asks him to join his court at Camelot. The black knight refuses to answer. Arthur, disappointed, tries to pass, but the black knight won t let him. Arthur, whose authority fails him once again, fights the black knight, severing his left arm. The black knight, however, is unfazed and continues to fight until all of his limbs have been lopped off at which point he calls it a draw. Arthur and Patsy move on before he can try to bite their legs off†(Shmoop Editorial Team). Soon after defeating the Black Knight, King Arthur finishes his quest of assembling the knights. However, soon after the completion of this quest, the knights are called upon by God to initiate the quest for the Holy Grail. They then face obstacles such as a killer bunny and a bridgekeeper guarding the Bridge of Death. Whe n the knights arrive at the Bridge of Death, the bridgekeeper proves the hardest obstacle thus far, excluding only possibly the killer bunny. This is due to the questions asked by the bridgekeeper. â€Å"Stop. Who would crossShow MoreRelatedEssay about Kant ´s Philosophy of Ethics1823 Words   |  8 Pagesalso what defines freedom. In order to compare and contrast the values and beliefs of ethics held by both Aristotle and Kant one must first fully understand what Aristotle believed to be virtuous. In Nicomachean Ethics, Aristotle asked the reader what he considered good. Aristotle named common examples such as, having friends, experiencing pleasure, being healthy, and being honored. Aristotle furthered his argument by getting to the root of every good action. He remarked that if a man kept questioningRead MoreThe Pursuit of a Theory of Everything1489 Words   |  6 PagesA belief in the unifying principles that underlie all natural phenomena was first articulated by Aristotle, who proposed all matter stems from the four elements of nature: earth, air, fire, and water (Duft). The search for such principles has since evolved considerably, yet the firmly rooted interest in a fundamental unification persists. Unification is defined as attempts to explain several principles according to one definition or equation. This process occurs in all areas of science, from biologyRead MoreEssay on Life After Death Analysis2110 Words   |  9 Pagespaper however, there has been a long and steadfast tradition of Materialism, the primus inter pares of which is a Mr Gilbert Ryle. In 1949 when psychology was a young and nubile science, seen (as all new sciences are seen) to hold the Holy Grail to understanding the human mind, Ryle published â€Å"The Concept Of The Mind†. In this he dismissed the soul as a category mistake, or a misuse of language. He even went so far as to coin a scornful phrase for his nemesis â€Å"the ghost in theRead More Science and Religion: Our Attitudes Today Are Tomorrows Future3013 Words   |  13 Pagesfairness to science, Graham Farmello (2010), writes in The Telegraph, Feb. 2012, an interesting article that explains Steve Hawkings position on the science and religion debate as nearing an end: â€Å"He now suggests that the search for this particular Holy Grail is over, now that scientists have come up with a type of theory, known as M-theory, that may describe the behavior of all the fundamental particles and force, and even account for the very birth of the universe. If this theory is backed up by experimentRead MoreFeminism in The Wizard of Oz4177 Words   |  17 Pagespopular culture that television, print, and motion pictures focus on these focal themes regardless of the genre, and push normative values with which people can identify (Voytilla, 1999). One repetitive theme involves the quest the quest for the Holy Grail, the quest for the fair maiden, and, in The Wizard of Oz, the Quest for Oz and a way back to Kansas. There are multiple ways of viewing this quest, though. Once Dorothy gets to Oz she is the penultimate leader as opposed to the damsel in distressRead MoreSarasvathy, Causation and Effectuation-Toward a Theoretical Shift from Economic Inevitability to14504 Words   |  59 Pagesseveral centuries of continuing conversation about causation-from Aristotle down to more recent theorizing, such as John Mackie s INUS condition (Mackie, 1998). Mackie defines a cause as an Insufficient but Necessary component of an Unnecessary but Sufficient condition, offering potentially a more precise way of introducing plurality, nonlinearity, and contingency into causal reasoning without assuming away the qualitative variables. Aristotle argued that there are four causes to all phenomena-namely,Read MoreStrategy Safari by Mintzberg71628 Words   |  287 Pagesa figure was put forward . . . it soon became accepted as the agreed figure, since no one was able by rational argument to demonstrate that it was wrong And once the figures were called statistics , they acquired the authority and sanctity of Holy Writ (155). Of course, soft information can be speculative, and distorted too. But what marketing manager faced with a choice between today s rumor that a major customer was seen lunching with a competitor and tomorrow s fact that the business was

The Movement Of Undocumented Immigrants - 1308 Words

The movement of undocumented immigrants has been a major concern in both the United States and in Europe over the past few years. Frequently, politicians talk about this issue in broad, general statements that appeal to emotion as much as logic, if not more. This style of discussion is often not based on facts, research, or theory, but instead makes use of seemingly ‘invented’ data points and ungrounded opinions. In this paper, a number of potential policies the United States government could enact are reviewed for their economic effects in an attempt to separate true information from political abstraction, and are also applied to the agricultural sector to provide an example of specific effects. As a whole, pro-legalization policies provide positive economic benefits to the labor market and the American population at large, while restrictive policies harm the labor market and population. This paper considers both migrant-positive ‘legalization’ policies and migrant-negative ‘restrictive’ policies. Positive policies include increasing the probability that a worker will be able to gain legal status, immediately legalizing workers who desire a path to legalization or citizenship, and redesigning guest worker programs, especially within the agricultural sector, which will be discussed later. Negative policies include increasing border enforcement to decrease the number of illegal immigrants, â€Å"increasing the costs that illegal immigrants face when looking for a job† such asShow MoreRelatedRise Of The American Sanctuary Movement. Before Addressing1522 Words   |  7 PagesRise of the American Sanctuary Movement Before addressing the contemporary concerns surrounding immigration and undocumented immigrants, it is fundamental to address the historical antecedents to today’s widespread undocumented immigration population as well as the elicited political response carried out by the Reagan Administration during the 1980s. In the heart of the Cold War, the United States actively supported and funded the El Salvadorian government — a military government that ran deathRead MoreThe Immigration Act Of 19241732 Words   |  7 Pagesno foreigner to immigrants. From the pilgrims who came searching for religious liberation to African slaves that had lost their liberty, America’s history has been shaped by the influx of immigrants from different parts of the world. As America grew, it became, and still is, a promised land for many. As a result, immigration has become a pivotal topic in the American culture and with time, the dynamics of immigration has changed due to a shifting of focus between different immigrant groups. From theRead MoreSocial And Academic Performance Of Undocumented Mexican Women Essay1014 Words   |  5 PagesFor my research, I propose a literature analysis of feelings of guilt, anxiety and sense of separation from social inclusion and the family of undocumented Mexican women in contemporary period. In my research I plan to address the following questions: What propels guilt, anxiety and sense of separation in undocumented Mexican women, specially undocumented female Mexican students? How does intersectionalities and the Critical Race Theory play a role to address this issues? How does immigration patternRead MoreEthnic Minorities And The United States1712 Words   |  7 PagesIntroduction The increase in ethnic minorities’ immigrants has transformed the demographics of the United States in recent decades. The 2010 U.S. Census Bureau reports that almost 37.3 % of our population (approximately 308.7 million) is made up of ethnic minorities (e.g. Latino/as, African Americans, Asians, and American Indian/ Alaska Native). When compared to other ethnic groups, Latinos/as have showed an increase of about 43 % in the last 10 years; becoming one of the fastest growing populationsRead MoreThe American Immigration System is Broken Essay923 Words   |  4 Pagessociety, immigration reform is enjoying an increasingly high voice among people. American immigration system is broken. Too many employers take advantage of the system by hiring undocumented workers which currently are estimated at 11 million. This is not good for the economy nor the country. Imaging a day without these undocumented workers in United States. No bus driver, farm worker, cooker, nurse, construction w orker, waiter, house keeper, gardener or nanny can be found. Nobody drive bus, pick fruitRead MorePros and Cons of Illegal Immigration Essay example1493 Words   |  6 Pageshomeland. These immigrants, like those throughout U.S. history, are generally hard workers and make important contributions to the economy through their productive labor and purchasing power. America is considered a melting pot of many diffrent ethinic group. Immigrants should be able to enter America with little if any resistance from any border patrol. Immigrants in america take the low paying, hard labor jobs that , unfortunately, some americans dont want. Most immigrants usually fill essentialRead MoreThese Quotas Made It Very Clear On Who Was And Was Not1628 Words   |  7 PagesThese quotas made it very clear on who was and was not wanted in the United States. Certain countries had a quota number that was much lower than others. That difference in number was a game changer in how easy or how hard it was for distinct immigrants to come over. The 1920s exposed many fears for Americans already settled in the United States. Some people felt threatened by other religious groups, â€Å"Booker T. Washington, also wanted restrictions because they saw the new comers as added competitionsRead MoreThe Earliest Record Of Immigration Policy975 Words   |  4 Pagesmilestones regarding the immigrants rights movement. Starting with the thirteen colonies, and later the industrial revolution, and the ones most of us are familiar with such as the 1986 amnesty passed by President Ronald Reagan and the DACA policy put into place by President Barack Obama through his executive power. There have been many leaders, many protests, and many organizations both pro-immigration and anti-immigration. However, in the current stage of the immigrants rights movement, one of the mostRead MoreOrganization That Help Undocumented Aliens1022 Words   |  5 PagesOrganization that Help Undocumented Aliens As the number undocumented immigrants continues to rise in the United States much of what is communicated in the media has consistently taken on a negative tone. A negative tone giving many in the public the impression that undocumented aliens are without an advocate in the pursuit of streamlining the path to become legal and enjoy the rights and privileges that go along with being a member of American society and all that that entails. There exists howeverRead MoreUndocumented Border By Erin Clark1592 Words   |  7 PagesUndocumented Border Movement By Erin Clark Immigration, a controversial topic of the modern world, is often associated with illegalities of the Government. The topic continues to loom over the 21st century as more and more poverty stricken countries are under financial strain. It is the national movement of people into a country in which they are not natives or where they do not possess residency and citizenship as their own country has fallen due to possibly natural disasters, war and regime

Morocco Economy and Trade Free Essays

King Mohammed VI realized the need and potential in energy and the impact that it would have upon the government and the presiding society.   The process of redeveloping the country has taken over five years as the eco-system has suffered and the unemployment rate are holding at 20 percent of the population in the cities.   The US -North African Economic Partnership is only half of the global integration as the Morocco- EU Association Agreement has been developing since March of 2000. We will write a custom essay sample on Morocco: Economy and Trade or any similar topic only for you Order Now    The interglobal dependency is attending to the needs of 1) telecommunications/ information systems 2) electric power system 3) environmental technology 4) water and waste water treatment and 5) tourism.   These primary needs will develop the economy that had originate in the farms and crops that include wheat, feed grain, and crude vegetable oil. The restrictions upon the businesses of imports and exports has been used to develop the nations as quickly as possible. The restriction of any imports is nominal as the economy relies on the developing trade from the US and the EU.   The control that is imposed by their government has been reduced to alleviate any more problems from credit and foreign exchange allocution; reduce trade barrier; increase monitoring of governmental spending; and the introduction of new corporations. The previous stance as foreign trade has reduced by adhering to the Morocco’s World Trade Organization.   The public acceptance of the American goods and services as the time span for development will begin to change their society.   The   more products that are from the United States will allow great accessibility and the affect that it will have upon the economy.   Simplify the process by reducing the tariff and having the inspections   simpler.   Many companies such as Coco- Cola, Fruit of the Loom, Johnson and Johnson, and Pfizer will encourage the economy and have a positive result upon the society. Works Cited â€Å"Economy of Morocco† http://en.wikipedia.org/wiki/Economy_of_Morocco (18 March 2008). U.S. Embassy Rabut. â€Å"US Department of State FY 2001 Country commercial Guide: Morocco† www.state.gov/about_state/business/com_guides (July 2000). U.S. Department of State. â€Å"Executive Sumary of the Country Commercial Guide for Morocco Fiscal Year 20 How to cite Morocco: Economy and Trade, Essay examples

Nursing Practice COPD

Question: Discuss about the case study Nursing Practice for COPD. Answer: Introduction: The essay is a nursing practice case study that will give detail about medical conditions and social history about the patient in the case study. From the perspective of a primary registered nurse, it will analyze the etiology of the chronic diseases in patient and the medications that the patient is taking. It will describe the initial nursing care for the patient on admission and the education related to exacerbation that the nurse has to give to the patient. The nursing care for the patient will be based on the COPD guidelines provided by the Nursing and Midwifery Board of Australia, and the competency standards set by The Australian Nursing Midwifery Federation (ANMF) and the Australian Clinical Practice Guidelines. The essay will provide detail on the recommendation by a nurse for ongoing treatment and what services help the nurse will take from the community to give adequate care to the patient. The case study is about Mrs. Betty White, a 76-year-old Italian female who has been admitted to a medical ward for acute exacerbation of her COPD (Chronic Obstructive Pulmonary Disease) following a bout of pneumonia. She was never admitted before for her condition and has no known allergies. She had a lip replacement in 1997, a gallstone surgery in 2005 and a long term ulcer on her lower leg. When she was admitted, no medical findings were done related to spirometry test, blood test, blood pressure, check, ECG, etc. She has only one son living in Melbourne who visits her thrice a year, and she lives alone utilizing community nursing services. As the patient is suffering from COPD, it is necessary to know about the etiology of the disease. COPD is a progressive lung disease characterized by emphysema, chronic bronchitis, emphysema, and asthma (Fletcher Dahl, 2013). The symptoms of COPD include wheeziness, tightness in chest, frequent coughing and increased breathlessness. According to (Pauwels et al., 2012), the symptoms often develop in the advanced stage of the disease. According to the clinical COPD guidelines established by the Australian Clinical Practice, it is necessary for patients with COPD to monitor the symptoms and get the spirometry test done to confirm the condition so that timely treatment could be provided (Australian Clinical Practice Guidelines", 2015) According to (Joo et al., 2013), the primary cause of COPD is long-term exposure to lung irritants that damages the lungs and airways. The common irritants include cigarette smoke, cigar, second-hand smoke, etc. and environmental pollutants like chemical fumes and dust. These are the major contributing factors leading to COPD in patients (Budhiraja et al., 2015). According to the exploratory study by (Hodson Sherrington, 2014), rare genetic condition like alpha-1 antitrypsin deficiency also leads to the development of disease in patients even when they have never smoked or had ever been exposed to lung irritants (Fletcher Dahl, 2013). People with this condition have the low level of alpha-1 antitrypsin (AAT) protein in the liver which causes lung damage and COPD. In very rare cases people with asthma also has a chance of developing COPD (Pauwels et al., 2012). Therefore top three factors identified in Etiology of COPD are smoking, environmental factors and Genetic factors (Hodson Sherrington, 2014). About 90% patients diagnosed with COPD were found to be smokers (Vestbo et al., 2013). The WHO has also recommended that people with COPD should also be tested for Alpha-1. However, there may be other genetic predisposition to the development of COPD (Domenech et al., 2013). Apart from COPD, she also suffers from Osteoporosis and hypertension. As per the clinical COPD guidelines provided by the "Nursing and Midwifery Board of Australia", the primary care will comprise checking and monitoring the medications that Mrs. White had been taking (Lee Thomas Annie Butler, 2016). She has never been admitted to hospital before, so it is necessary to perform the required clinical tests such as lung function test, spirometry, chest CT scan, arterial and blood gas test (Australian Clinical Practice Guidelines", 2015). Lung function test will measure how air patient can breathe in and out. Spirometry is also a means to determine how fast one can blow out air. It will help in detecting the severity of the disease (Domenech et al., 2013). According to the guidelines of The Australian Nursing and Midwifery Federation (ANMF) related to COPD, the goal for primary care will include making Mr. White to be aware of ways of preventing bacterial, viral, bacterial, and parasiti c and lung infection (Lee Thomas Annie Butler, 2016). The next step is to manage all her medications that she has been taking for COPD, osteoporosis, hypertension, ulcer, and gallstone after hip replacement surgery (Australian Clinical Practice Guidelines", 2015). The patient will be explained about the procedure of spirometry and how it will be carried out. Patients with COPD face severe discomfort and embarrassment due to coughing. Therefore, a sympathetic approach to convince Mrs. White for a clinical test is needed. Once COPD is confirmed, the focus will be to provide care to the patient by marinating her vital functions and minimizing her symptoms as far as possible (Nurse Practitioner standards for practice 2016). COPD is a collective term for chronic bronchitis and emphysema. Comorbidities associated with the disease include cardiovascular disease, malnutrition, osteoporosis, and depression (Hodson Sherrington, 2014). Mrs. White was an active smoker for the past 50 years smoking about three packs which are reflected in the disease severity. As per the The Australian Clinical COPD guidelines, to manage symptoms and reduce complications bronchodilators like beta 2-agonist, anticholinergics, and methylxanthines is prescribed (Nurse practitioner standards for practice 2016). This will help in relaxing her airway muscle, and Hudson mask is also used. The client will be supported to maximize her essential functions and enhance self-care, to carry out her daily life activities. Mild COPD can be treated with short-acting bronchodilators, whereas severe COPD patients will require long-term oxygen therapy or surgical intervention (Australian Clinical Practice Guidelines", 2015). As this is Mrs. Whites first admission for her exacerbations due to COPD, the primary care includes client education related to keeping airways clear, nutritional therapy and pulmonary rehabilitation to adjust to her condition (Australian Clinical Practice Guidelines", 2015). According to the ANMC competency standards she must be taught as to when to contact the GP. As exposure to environmental pollutant is the major risk factor for the disease, it will be necessary for Mrs. White to develop good infection control habits such as frequent hand washing and avoiding crowded places (Nurse practitioner standards for practice (2016). According to Domenech et al., (2013), the treatment plan of COPD patients often have to take drugs via inhalers, so it is necessary for them to know the correct sequence of each medication to maximize its efficacy and know its adverse effects. COPD patients often have to take drugs via inhalers, so it is necessary for them to know the correct sequence of each medication to maximize its efficacy and know its adverse effects. Patients should also be aware of the amount of inhalers left so that they do not run out of them when it is required in an emergency. They must be cautious while taking medicines for other ailments (Nurse practitioner standards for practice 2016). It is necessary to teach her ways to reduce or control dyspnea. She can learn techniques of pursed-lip breathing which will reduce respiration by increasing the laminar flow of expired air (Australian Clinical Practice Guidelines", 2015). Proper positioning exercise will also be necessary for Mrs. White. It is essential to provide training tripod positioning (Australian Clinical Practice Guidelines", 2015). This will involve making Mrs. White sit or stand to lean forward with support on arms, telling her to force her diaphragm down and stabiles the chest while breathing at a controlled rate. The COPD patients require training related to energy conservation techniques. Therefore, Mrs. White is advised to manage her activities by taking frequent rest, using assisting devices and dividing her activities into the small task so that it reduces the chance of dyspnea. According to The Australian Clinical COPD guidelines she will be provided nutritional guidance and monitoring hemoglobin and serum albumin levels (Lee Thomas Annie Butler, 2016). It will also be necessary for her to take frequent meals high in protein. The patient is advised to avoid any gas producing foods and to monitor her weight regularly (Australian Clinical Practice Guidelines", 2015). The recommendation about the ongoing treatment option for Mrs. White is pharmacological management. She has developed edema which is a serious complication of COPD. It occurs due to pulmonary hypertension meaning her blood pressure is higher than normal in heart and lungs. She is taking Coversyl medicines, and it is useful for treating high blood pressure. I will make her aware of side effects of medications like a cough, diarrhea, drowsiness, weakness, etc. (Agusti, 2014). Oxygen therapy will also be a necessary treatment for Mrs. White. This therapy will improve survival rate in hypoxemic patients. The prescription for Oxygen is determined by patient's arterial blood gas values and nocturnal desaturation rates. Oxygen therapy is delivered by liquid oxygen, compressed gas, etc. Portable oxygen concentrator will be highly beneficial for Mrs. White as it will not require her to carry oxygen (Australian Clinical Practice Guidelines", 2015). Another treatment option is pulmonary rehabilitation. It will reduce the disability and quality of life of Mrs. White. This multidisciplinary program is tailored according to individual patients health care needs and based on the The Australian Clinical COPD guidelines. As per the literature evidence, very few patients require surgical interventions after assessment by experienced thoracic medical and surgical team. Some need lung volume reduction surgery or lung transplantation (Philpott, 2015). Patients like Mrs. White will also need detailed medical and psychological assessment to prevent the chronic exacerbation of the disease (Australian Clinical Practice Guidelines", 2015). COPD may also have the effect on patients sleep efficiency, and intranasal oxygen administration is helpful in improving sleep patterns (Philpott, 2015). Osteoporosis is also a comorbidity associated with COPD. Mrs. White was also diagnosed with osteoporosis due to lifestyle changes, genetic factor, treatmen t with corticosteroids and impairment of skeletal muscles. Such patient has more chance of fractures, and this will lead to the economic burden of the disease (Polit Beck, 2013). The possible treatment procedures for osteoporosis will include a use of bisphosphonates, hormone replacement and calcium supplementation to prevent fracture in COPD patients (Australian Clinical Practice Guidelines", 2015). To ensure that Mrs. White get continued care even after discharge, certain health services in the community will be helpful for her. More than half of the Australian population is expected to suffer from the burden of the disease (Nordn et al., 2015). It is the fourth highest cause of death in Australia. Mrs. White may seek the option of home care services and community care in Australia to manage her complications related to COPD. The Australian Lung Foundations project better living with COPD is also a COPD national program in Australia that ensure improved quality of life for such patients (Johnston et al., 2013). It is a joint venture by COPD Respiratory Network, Clinical Practice, and Australian Lung Foundation. This program guides to patients on how to live well with a chronic lung condition and giving support to people living in remote areas too (Nordn et al., 2015). The Queensland Health is also committed to providing care to patients. Hospital and community health services i n Australia will help Mrs. White to get continued care for her condition even after discharge (Philpott, 2015). Conclusively, COPD is a major health concern in many parts of the world. Through the analysis of a case study on Australian women, Mrs. White, the essay gave detail about the etiology of the clinical conditions and the risk factors associated with the disease. It gave useful insight into the role of registered nurse in the primary care of such patients. The essay explained the key client education that nurse gives to the patient for exacerbation of COPD. 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