How to balance Penn Foster studies with work and/or family demands Essay

Ther is a saying: â€Å"My purpose in life is to have a life with purposes† is a quote I lived by throughout many years. I think it is very important to have goals and to accomplish those goals a well as you can. I am forty seven years old, I am married and Father of two children, We have many purposes, one of them is their education , their health, but we also know that we don’t have enough time nor enough education to supply all their demands, and the many things that the current system demands. My new purpose is my graduation as Electrical Engineering Technology in Penn Foster College, perhaps It gives me the opportunity to study at distance in my own pace, and to make enough money to realize one of my dreams, â€Å"One of my purposes† without having to leave and still be able to be with my family, is very important to me. Our Daughter is Sixteen years old, She is currently a Junior in High School, where she is a part of important clubs and is on the varsity lacrosse team. Just like many teenagers Karen is very friendly and has a lot of different things happening in her life. She demands a lot of time from us; we have to getting her to and from school or practices everyday, there are also social events she attends. Our Son is ten years old; he is in elementary school and just started Karate classes. My Wife and I help each other out by taking turns with each of our child’s individual demands so we each have time to study. Even though it is not easy, it is worth it. We know that the sacrifices we make won’t only help our children with their future, but it will help ours too. Some day my plan is to retire as professional; and the Penn Foster studies is a great investment for the future of my family and I. Sometimes it is very difficult to make them understand why I am so busy. Why we do not go away for vaction as frequent as we did. Same thing occurs with my sisters and mother, they ask why I haven’t been attending a lot of the family events or why I don’t call as much as before. But there is just so many things I need to care for, and so many going through my head all through out the day, that when I do finally have free time, my main focus is too get in as much studying as possible. I decided to bring the books every where, to my work place, to my children practices, to some places that we are used to it, even to my bathroom. I installed shelves just to have them close to me. My son is always looking for me and ask me why take me so long in the bathroom when I don’t get out soon. My job demands many times to make more work hours over time or even on weekends, I try to do it, but I know that I have to dedicate some time to my studies and to my family, perhaps the more soon I can graduate, more soon We can see the results, and even more more soon I will dedicate more time to my family, because at the same time I will make more money as a professional Electrician. I hope some day, I can have my own electrical company, to get the licenses necessary to run it or who knows to apply for electrical inspector. I am thinking to have an administrative job as I am getting older.

Should Sexual Education Be Mandatory - 877 Words

Should sexual education should be taught in schools? The answer is simply yes. Sexual education should be taught in schools because it can help many teenagers prevent life threating things that come without knowledge of the subject. Without any knowledge on the subject of sex, many teenagers can put themselves in danger that can easily be prevented. Should this class be mandatory? Sexual education should be mandatory simply because of the benefits that come with it. Without knowledge on sex, teenagers can get themselves in a world of trouble. But, if this class is taught, the students can be educated on why not to have sex at an early age, and if they intend to, to use protection. Many teenagers are now becoming parents these days. In fact, from the ages of 15-19, there were 249,078 babies born in the United States. (1) Many of these unwanted pregnancies can be prevented with the help sexual education. Yes, in some schools there is sexual education. But, if it was in every school man y of these could have possibly been prevented. At the school I attend, sexual education is not offered. We are faced with several unwanted pregnancies, and with sexual education, I think these could be prevented. Without any knowledge of sex, there are many possible things that could go wrong. If you plan on having sex, especially in high school, you need to make sure you have an understanding of it. If sexual education was taught in schools, it could help prevent the unwanted consequencesShow MoreRelatedSexual Education in Public Schools760 Words   |  3 PagesSexual education has long been a topic of debate among many different in our American society.  The public schools system offers sexual education or sex ed to all students, and offer parents the option to exclude their children from these class rooms.  Discussions to making these classes mandatory has drawn some positive supports and negative supports in the forum disputes of sex education topic.  Due to the high numb er of teen pregnancies (As of 2012, the teen birth rate was 29 births per 1,000 teenRead MoreSexual Education And Sex Ed1697 Words   |  7 PagesSexual education (sex ed) in public schools has long been a controversial and debated topic in society. There are several questions when it comes to approaching sex ed in schools. These questions include: appropriate age for introducing sex ed; should sex ed be mandatory or optional; and whether sex ed programs should be comprehensive or abstinence-based. Sex ed is a necessary subject to teach in schools. It should be appropriate to the grade level and taught in a knowledgeable, unbiased manner.Read MoreThe Significance Of Sex Education982 Words   |  4 PagesOctober 2017 The Significance of Sex Education As teenagers start to grow up, they face with many difficult decisions about relationship and sexual behavior in their lives. It can impact their lives, health and behavior. To make sure that your children follow the right path to live a healthy life, sex education can prepare them to make good decisions. If you are not sexually active, that doesn’t mean you shouldn’t give up your chance to learn about it. Sex education shouldn’t be limited to teenagersRead MoreSexual Education And Sex Education1358 Words   |  6 Pagesadults know the results of their choices? Sexual education teaches all of the following, and kids in the curriculum are more likely to defend themselves in a plot when they were approached by a stranger (â€Å"Teaching children in schools†¦Ã¢â‚¬ ). Sexual education teaches students about sexual health, abstinence, and information such as contraception, condoms, unplanned pregnancies, and sexually transmitted diseases (â€Å"Sex Education Programs†). Comprehensive sexual education provides students with tools they useRead MoreHigh School And College Campuses947 Words   |  4 PagesTake Home Exam II Several education, prevention, and punishment programs can be enforced in high school and college campuses to discourage and prevent: extensive use of alcohol to the point of alcohol poisoning potentially leading to the death of the individual(s), prevention of reckless sexual behavior, date rape and other sexual violence. By enforcing more and effective programs through means of education, prevention and punishment the frequency of these actions in high schools and college campusesRead MoreThe Best Kind of Sex Education708 Words   |  3 Pages There is much controversy over which form of sex education should be taught, comprehensive sex education, or abstinence-only sex education. The definition for comprehensive sex education is responsible and balanced sexuality education that seeks to assist young people in understanding a positive view of sexuality, provide them with information and skills about caring for their sexual health, and help them acquire skills to make decisions now and in the future. It is medically accurate and providesRead MoreSexual Education As A Mandatory Course Necessary For Young Adults940 Words   |  4 PagesSex education is quite a controversial topic in the world of education today. The act of informing young adults about sexual orientation, sexual health, sexual reproduction and the safety precautions in order to stay safe are all things that these young adults should know, but the problem is, who should have to teach them such a controversial topic? Should parents have to overcome the uneasy a nd uncomfortable feelings they face when mentioning such a topic to their children, or should the responsibilityRead MoreGraduation Speech : School For Twelve Years And Not Learning Basic Lessons Essay1290 Words   |  6 Pagesto and apply when in middle school. High school should be where every student learns complex lessons and strategies that they will apply to real life situations as they grow older. Teachers give lessons on math equations, encoding poems, and mixing music. As the students soon graduate, they take these lessons with them with and use them in life. Even though we learn most of these necessary lessons, there are many high school students that should be learning what they need to know in life. AfterRead MoreSex Education : Comprehensive Sexual Education972 Words   |  4 PagesSex Education Comprehensive sexual education has long been a contentious issue within the United States of America. Owing largely to America’s history and culture, sexual education has long been stigmatized as unnecessary involvement in the private life, or even misattributed to rising rates of pregnancy and sexually transmitted infections. A U.S. review article, however, poses the opposite argument – â€Å"The overwhelming weight of evidence reveals that sex education which discusses contraceptionRead MoreThe Unspeakable Word: Censorship in Schools Essay725 Words   |  3 Pagesmake it mandatory to take a Sex education class while attending a public high school. If you are going to engage in sexual activity, one should at least know what consequences can happen or what is really going on. Some of the most common risks and affects of sex include pregnancy, STDs and STIs, and emotional scars. Having a baby can ruin the couple’s lives that are not ready. Having a baby is exp ensive and time consuming. STDs and STIs â€Å"are infectious diseases that are spread through sexual contact

Analysis Of Ketchum s The Fall And Winter Of 1776

Ketchum begins in the fall and winter of 1776 in describing the events of the campaign. At the time, the future of the Revolution was in serious doubt---men were freezing, starving, and the Continental Army was dissolving around General Washington. More than anything else, he needed a victory. Ketchum displays to the reader how exactly the colonials got into such a distressing situation in the first place. Traveling back to 1774 and 1775 Ketchum explores the reason behind why and how the entire situation occurred in the first place. The motivations of both the English crown and the colonials are explored throughout the book. For example, the motivations of King George III are explored in the section â€Å"Everyone Who Does Not Agree With Me Is A Traitor†. Ketchum describes the early life of George III which would motivate his latest moves against the colonies. George III felt he had to almost be â€Å"more English than the English themselves†, to paraphrase---the honor of England and the crown were his preeminent concerns. Ketchum also described the wide variety of ailments, mostly hereditary ones, which plagued the king. Put these together and it’s no surprise he was less than willing to listen to the pleas of his colonial subjects. Ketchum also went into a good deal of detail as to the workings and motivations of the British government at the time. Finally, he lists the events leading up to the actual winter of 1776, the conditions on the ground and then goes over the actual

Is the Killing of Animals for Research Okay Essay

Vivisection nbsp;nbsp;nbsp;nbsp;nbsp;Many people today, including scientists and doctors, are questioning the suffering and killing of animals for the sake of human beings. Is it morally correct to dissect a frog or a worm for the purpose of educating a high school student? On the other hand, must quot;We study life to protect lifequot; (1:131) The issue of killing animals for the use of biomedical research, education, and cosmetics can be referred as quot;vivisectionquot;. Twenty-five to thirty-five million animals are spared in the U.S.A. each year for the purpose of research, testing, and education. Although vivisection serves as an important tool for scientists and doctors to work in research and may benefit humans, the†¦show more content†¦However, he does not say that humans and animals have an equal moral status, for he believes that quot;humans are superior to their fellow animals by virtue of God-given soulquot; (12:37). Regan, another opposer to Descartes view, feels that animals do feel pain and have desires as well. He believes that animals are quot;Subjects of a life just as human beings are and a subject of a life have inherent valuesquot; (1:26). He also feels that animals should not be tested for toxic substances, instead one should use cell tissue cultures (5:26). nbsp;nbsp;nbsp;nbsp;nbsp;The people who favor animal experimentation feel that research is for the purpose of humans. Research is a cultural value to acquire knowledge for knowledges sake. In other words, the means justifies the end if the end benefits society. (4:62). They also believe that humans are superior to all other creatures (1:28). Research is for biomedical purposes; 1) to add scientific understanding of basic biological behavior, functions, and processes 2) to improve human or animal health by studying the natural history of the disease (1:22). Henry Foster, the founder of Charles River Breeding Laborator, said that quot;the use of animals in experiments is all for the benefit of mankind. If you dont use animals you dont do research!quot; (2:45). nbsp;nbsp;nbsp;nbsp;nbsp;Most of the times by doing research one performsShow MoreRelatedThe Implications of Different Views on Animal Rights Essay1285 Words   |  6 PagesShould animals and humans have the same rights? Or, the same penalty for their abuse? Have you just sat back and wondered how we got where we are today? Should animals be lower than humans or the same? With the advancing of new technology, medications and medical advancements haven’t we gained this knowledge by animal testing/ animal cruelty? Do we, as humans, think animal testing/ animal cruelty and domestic violence all have similarities and should all of them have the same fines? Many peopleRead MoreAnimals for Research and Experimentation678 Words   |  3 Pages100 million animals are used for research and experimentation on around the world every year. Apart from all the benefits of animal testing there are many good reasons which support banning the experimentations on animals such as: animal cruelty, selfishness, and danger of using the experiments result. Therefore animal experimentation should be banned. These days, animal testing has brought a lot of issues in the society. The first and foremost argument that is presented against animal testing dealsRead MorePersuasive Essay On Animal Testing704 Words   |  3 PagesAnimal testing has been a around since 384 BC. â€Å"Some testing methods require the animal to; die, be exposed to radiation, remove or expose organs, or subject animals to trauma to create depression and/or anxiety.† (â€Å"THE LEADING SOURCE FOR PROS CONS OF CONTROVERSIAL ISSUES†) Animal tests and human results only coordinate about 5- 25% of the time. Not only is it inhumane, but it isnt even all that reliable. Not to mention, it`s an insufficient waste of government money. Yes it has helped us in vaccineRead MoreAnimal Abuse During The 1900 S1384 Words   |  6 PagesAnimal Abuse Movies, TV shows, circuses, and illegal gatherings in an old car garage are all places that animal abuse has taken place for the entertainment of humans. Since the 1900’s movie producers have been using animals in their productions (Dugas). Inhumane and unnecessary, are just two words that describe animal abuse, the use of animals for human entertainment is cruel and injustice. â€Å"Bite the Bullet†, a movie in the 1906 about a race through the American west, focused on the treatmentRead MoreAnimal Testing Should Not Be Banned1114 Words   |  5 Pagesthe field of science has used animals in medical experiments worldwide, because of this innocent animals are being killed everyday. They are being tested with new drugs, new treatments, and by many makeup companies. Connecticut recently celebrated the passage of the â€Å"Beagle Freedom Law†, a law that requires laboratories to work with charities and rescue groups to find homes for research cats and dogs. Animals are being tested so humans do not have to be but animal tests do not reliably predict resultsRead MoreEssay on It is Better to be a Vegetarian1113 Words   |  5 Pagesof eating meat from animals. A lot of the reasons for not eating meat have to deal with religious affiliations, personal health, animal rights, and concern about the environment. Vegetarians have a greater way of exp ressing meats negative effects on the human body whereas meat eaters have close to no evidence of meat eating being a positive effect on the human body. Being a vegetarian is more beneficial for human beings because of health reasons, environmental issues, and animal rights. The first benefitRead MorePersuasive Essay On Animal Testing1155 Words   |  5 PagesAnimal Testing Animal experiments happen all over the world, but are they necessary? Animals are tested for medical research as well as for cosmetics. Some say that these experiments are not painful, so they are justified. Where others believe that all these experiments are inhumane and nothing can justify torturing and killing innocent animals. Although many believe that animal testing is the best way to improve human health by finding new treatments and tests for the safety of the productsRead MoreAnimals Should Not Be Bred1585 Words   |  7 PagesAnimals that are born into this can spend most of their lives in cramped cages, with no room to exercise and play. Often times, the water and food provided for the puppies is contaminated, crawling with bugs. And most of the time the puppies can even be malnourished. Puppies in mills are found with bleeding or swollen paws, feet falling through the wire cages, severe tooth decay, ear infections, dehydration, and lesions on their eyes, which ofte n lead to blindness. Living this unhealthy life is abuseRead MoreAnimal Testing Outline1616 Words   |  7 PagesWeldon 1 Animal Testing Introduction Thesis Statement: Animal testing is wrong because it is inhumane, costly, and unpredictable. I. Animal testing is inhumane A. Torture B. Type of testing C. Effect on the animal II. Animal testing is costly A. The cost of testing B. The cost of research C. What else we could be spending money on III. Animal testing is wasteful and unpredictable A. Mass Murdering of animals B. Endangered species C. If it works on animals it may not work on humans ConclusionRead MoreEssay Animal Testing730 Words   |  3 PagesExploratory Essay: Animal Testing Animal testing is an extremely controversial topic because it deals with delicate matters and matters of humanity. Animal testing is intended to help consumers buy safe and healthy products, but they are torturing innocent animals by doing so. People that are in favor of animal testing usually are also advocates for medical research and progress, though there have been other proven methods of research. But they don’t think of it as tormenting and killing animals. On the

Heart Of The Matter Essay Research Paper free essay sample

Heart Of The Matter Essay, Research Paper Heart of the affair Any Human Heart William Boyd 503pp, Hamish Hamilton A citation from Henry James furnishes the rubric of William Boyd # 8217 ; s new novel: # 8220 ; Never say you know the last word about any human heart. # 8221 ; These # 8220 ; intimate diaries # 8221 ; of Logan Mountstuart ab initio seem ready for the challenge. But, as becomes clear, both world and art have a manner of infinitely bifurcating the whole truth into many. Born in 1906 and brought up in South America, Logan is the boy of a Scots beef baron, Francis Mountstuart, and his secretary, Mercedes de Solis. # 8220 ; I stir the memory soup in my caput trusting gobbets of Uruguay float to the surface. I can see the frigorifico # 8211 ; a huge white mill with its rock breakwater and looming chimneystack. I can hear the lowing of a 1000 cowss waiting to be slaughtered, butchered, cleaned and frozen. # 8221 ; Logan # 8217 ; s life # 8211 ; either as diary entries, or redacted into little, third-person br idging transitions # 8211 ; is likewise prepared for public ingestion by Boyd. We see him at public school in England in the 1920s with his friends Peter Scabius and Benjamin Leeping, and so at Oxford, where he falls in love with the cryptic Land Fothergill. A public, historical narrative shadows the personal 1: # 8220 ; Coffee with Land Fothergill at the Cadena. She was have oning a velvet coat that matched her eyes. We talked a small stiffly about Mussolini and Italy and I was embarrassed to observe how much better informed she was than I. # 8221 ; Embarrassment turns out to be Logan # 8217 ; s cardinal note, as we follow him into a literary calling, several matrimonies, and meetings with a host of celebrated common people through the century. But the flipside of modest, retiring Logan is sexual staggishness and a refusal to be cowed by expansive public figures. After a monograph on Shelley and a bestselling novel about a Gallic cocotte, he drifts into intoxicant, criminal conversation and literary unfavorable judgment. A peaky brush with Virginia Woolf i s followed by meetings with Picasso and Joyce in Paris. A enchantment as a newsman in the Spanish Civil war brings him into contact with Hemingway and into ownership of three Braque canvases. The pictures are finally sold by Logan # 8217 ; s old schoolfriend Leeping, now a successful gallery proprietor # 8211 ; who will, in clip, offer Logan a occupation as his New York representative. In the interval come both the book # 8217 ; s most entertaining and agonizing subdivisions. Working for Ian Fleming ( another womanizer ) in naval intelligence during the 2nd universe war, Logan is posted to the Bahamas to maintain an oculus on the Duke of Windsor and Mrs Simpson. Edward is suspected of links with German moneymans. The slaying of a Bahamian kingpin seems to affect the Duke, and Logan feels honour-bound to look into. But the whole thing is hushed up. Recalled to London, he is parachuted into Switzerland, where he is to present as a Uruguayan shipbroker offering transition to flying Nazis. Picked up about at one time by Swiss intelligence, he spends the remainder of the war in prison. On returning to England, he suffers a nervous dislocation. It subsequently turns out that his treachery to the Swiss may hold been Edward and Mrs Simpson # 8217 ; s avenge upon him. Logan runs into them again on New York’s 5th Avenue in the 1960s. â€Å"I can’t resist it and shout out: ‘WHO KILLED SIR HARRY OAKES?’ The look of terrified panicked shock on their faces is adequate compensation for me – for everything they did to me, for all time. They can do their worst now. They scramble into their limousine and are swept away.† The characterisation of these public figures is superb – especially Mrs Simpson as a kind of nightmare granny – but unknown characters also spring to life. There are some wonderful vignettes of Logan’s mother in increasingly reduced circumstances. She eventually has to take in lodgers. Logan himself – as his friend Peter Scabius rises to literary stardom – also suffers a mighty fall. By the 1970s, after a period as a schoolmaster in Biafra, and now quite forgotten as a writer, he is living on dogfood and selling revolutionary newspapers in London – a profession which leads him into involvement with the Baader-Meinhof Gang. Inconceivable as it may seem, the links between these different lives are plausibly entwined. The only false thread is the introduction into the New York art-scene sections, alongside Jackson Pollock and Frank O’Hara, of the bogus American painter Nat Tate, whose â€Å"biography† Boyd published as a hoax in 1998. The device punctures the realism Boyd has so carefully built up in the rest of the novel. At the same time, however, the Tate references remind us that Any Human Heart is a created work expressing the concerns, passions and hobbyhorses of its begetter – just as, in one sense, Logan’s journal does. As he puts it: â€Å"We keep a journal to entrap the collection of selves that forms us, the individual human being.† Yet while it proclaims its own internal flux (†the true journal†¦doesn’t try to posit any order or hierarchy, doesn’t try to judge or analyseà ¢â‚¬ ), Any Human Heart is actually a highly ordered and controlled encounter with that classic French literary form, the journal intime. If it is not quite as successful as what might be taken as its companion among Boyd’s other volumes, The New Confessions (1988), which used Rousseau as a sounding board to recount another 20th-century life, that’s because that book was one of the best novels of recent times. And while both have French models, it is Anthony Powell and Evelyn Waugh who are Boyd’s true ancestors. Both writers appear in Any Human Heart . Powell is â€Å"affable†; Waugh, or a drunken man at a party who Logan thinks is Waugh, â€Å"stuck his tongue in my mouth†. Logan’s true secret sharer, the real tongue in his mouth, is Boyd himself, of course. From his 1981 debut, A Good Man in Africa, onwards, he seems constantly to have been searching for a unifying identity across different fictions, trying to make sense of a life compris ing a brutal public-school education, Africa in wartime, Oxford (where he did a PhD on Shelley), literary London and New York glamour: to a large degree, the plot of Any Human Heart . So when all is said and done, the heart the novel tries to dissect is the author’s own. It is, as ever, an enjoyable spectacle for his readers. Giles Foden’s new novel, Zanzibar , is published by Faber in September.

The Apollo Program Essay Research Paper The free essay sample

The Apollo Program Essay, Research Paper The Apollo Program ( 1963 # 8211 ; 1972 ) # 8220 ; That # 8217 ; s one little measure for a adult male, one giant spring for a mankind. # 8221 ; The national attempt that enabled Astronaut Neil Armstrong to talk those words as he stepped onto the lunar surface, and fulfilled a dream every bit old as humanity. But Project Apollo # 8217 ; s ends went beyond landing Americans on the Moon and returning them safely to Earth. Some of the chief ends of this experiment were: to set up the engineering to run into other national involvements in infinite ; to accomplish distinction in infinite for the United States ; to transport out a plan of scientific ex- ploration of the Moon ; and to even more develop adult male # 8217 ; s already first-class capableness to work in the lunar environment. Six of the missions achieved the end of set downing on the Moon, and safely returning to Earth. Apollos 7 and 9 were Earth revolving missions to prove the Command and Lunar Modules, and did non return lunar informations. We will write a custom essay sample on The Apollo Program Essay Research Paper The or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Apollos 8 and 10 tested assorted constituents while revolving the Moon, and returned picture taking of the lunar surface. Apollo 13 did non set down on the Moon at all due to a malfunction, but besides returned exposures. The six missions that landed on the Moon returned a wealth of scientific digital audiotape a and about 400 kgs of lunar samples. Experiments included dirt mechanics, meteoroids, seismal, heat flow, lunar ranging, magnetic Fieldss, and solar air current experiments. Apollo was a three-part ballistic capsule: the bid faculty ( CM ) , the crew # 8217 ; s quarters and flight control subdivision ; the service faculty ( SM ) for the propulsion and spacecraft support systems ( when together, the two faculties are called CSM ) ; and the lunar faculty ( LM ) , to take two of the crew to the lunar surface, back up them on the Moon, and return them to the CSM in lunar orbit. The flight manner, lunar orbit rendezvous, was selected in 1962. The supporters for the plan were the Saturn IB for Earth orbit flights and the Saturn V for lunar flights. Between the 1940 # 8217 ; s and present twenty-four hours, some 30,000 innovations have been conceived, spawned, nurtured and developed in one manner or another as a direct consequence of infinite geographic expedition. Telecommunications, medical research, computing machine engineering, agribusiness, weather analysis prediction and tonss of other industries have profited via the accelerator of infinite geographic expedition. Not a batch of people would detect this, but every aspect of life on Earth has been dramatically affected by what we # 8217 ; ve learned from the survey of infinite.

Physical Examination Health Assessment in a Rheumatoid Arthritis Patient The WritePass Journal

Physical Examination Health Assessment in a Rheumatoid Arthritis Patient Introduction Physical Examination Health Assessment in a Rheumatoid Arthritis Patient IntroductionA. BackgroundB. HistoryB1. Biographical DataB2. Reason for Seeking CareB3. Health HistoryB4. Family HistoryB5. Physical ExaminationB6. InterviewC. Health Assessment and ResultC1. InspectionC2. PalpationC3. Range of MotionC4. Pain AssessmentConclusionReferenceRelated Introduction Physical examination and health assessment are major components when you first meet your patient every time he or she admitted.   They are important in the aid of collecting patient’s data, designing care plans, giving treatments, and evaluating the outcomes. Physical examination is a process during which you use your senses to collect objective data. Know normal findings before you begin to distinguish the abnormal ones.   Effective communication skills are essential in establishing the trust needed to proceed with the examination.   Physical examination provides another perspective; whereas the health history allows you to see your patient subjectively through eyes, the physical examination now allows you to see your patient objectively through senses.   The objective data complete the patient’s health picture. Health assessment is an important component in clinical settings.   Health assessment is to collect data relevant to the patient’s health status, to identify deviations from normal, to discover the patient’s strengths and coping resources, to pinpoint actual problems, and to spot factors that place the patient at risk for health problems. Following is a case study of a patient with rheumatoid arthritis, who was admitted because of swelling and burning pain.   We will look into how health assessment is important to her and what is the difference in the outcome of care to the patient. A. Background Rheumatoid arthritis is an autoimmune disease where the bodys immune system attacks normal joint tissues, causing inflammation of the joint lining.   This inflammation of the joint lining, synovium causes pain, stiffness, swelling, warmth, and redness of the affected area.   The affected joint may also lose its shape, resulting in loss of range of motion.   Rheumatoid arthritis is an ongoing disease, with active periods of pain and inflammation, which is called flares or flare-ups, alternating with periods of remission, when pain and inflammation disappear.   Rheumatoid arthritis can affect many different joints.   It can even affect parts of the body other than the joints, including the eyes, blood, the lungs, and the heart in some people (Pfizer, 2010). B. History B1. Biographical Data Ms. Li Ho Lam was born in 3rd December 1959; she is now 52 years old.   Ms. Li’s education level is up to Form three in secondary school.   She quitted her job as a salesperson 5 years ago, and she is now a housewife.   Ms. Li is married and has two daughters which are 20 and 17 years old.   The four of them live together in an apartment in Shek Kip Mei.   Her cell phone number is 99871256 and her husband’s cell number is 91235520. B2. Reason for Seeking Care Ms. Li complained that both of her hands are swelling and have burning pain for one day.   Her pain scale is 8, and she did not take any medication. B3. Health History For health history, Ms. Li is allergic to seafood.   After taking any kinds of seafood, rashes will appear on Ms. Li’s body and they will be itchy.   Ms. Li was diagnosed with rheumatoid arthritis in year 2010.   She is taking aspirin to relief her flare-ups, but she has stopped for a few days.   She does not have any other health problems besides this. Ms. Li had chicken pox in year 1965, and had recovered in two weeks.   For hospitalization and operation, Ms. Li has had two times of caesarean section with general anaesthesia done in QueenElizabethHospital in year 1991 and 1994. B4. Family History Ms. Li’s mother had a history of rheumatoid arthritis; and her father had a history of hypertension and high cholesterol. B5. Physical Examination Ms. Li is 155 cm tall and weighs 59 kg.   Ms. Li’s vital signs are taken.   Her blood pressure is 140/86 mmHg; pulse rate is 66/min; respiration rate is 16/min; and temperature is 37.2â„Æ' B6. Interview Since Ms. Li was diagnosed with rheumatoid arthritis, she has flare-ups every six to eight months.   Acute episodes involve hand joints are treated with aspirin which gives relief.   She experiences morning stiffness, which lasts half an hour to one hour.   Her joints feel warm, swollen and tender.   She had lost 5 kg over last three years and feels fatigued much of the time.   Ms. Li could not sleep well and did not rest more.   She was encouraged to do daily exercises, but she did not do them regularly due to her fatigue.   She took aspirin for acute flare-ups, but when she feels better in a few days, she decreased dose by herself. C. Health Assessment and Result C1. Inspection Inspection has to be done because swelling, masses, and deformity at joints greatly affect range of motion and activities of daily living. First, Jarvis (2004) stated that note the size and contour of Ms. Li’s joint.   Inspect her skin and tissues over the joints for color, swelling, and any masses or deformity.   Presence of swelling is significant and signals joint irritation. Ms. Li’s hands are swelling; it may be due to excess joint fluid, thickening of the synovial lining, inflammation of surrounding soft tissues, such as bursae and tendons, or bony enlargement.   Deformities include dislocation, subluxation, contracture, or ankylosis, but it does not present in Ms. Li’s case.   She might have to take Aspirin as prescribed to relief pain and to reduce inflammation (Poulis, Kretsi, Apostolopoulo, Zeeris Vagenas, 2003). C2. Palpation Palpation is an important examination tool as it can help to find out many abnormalities, such as fluid accumulated in joints and tenderness.   Patients might feel pain, flare-ups, and hard to move the joints. Tijhuis, Zwinderman, Hazes, Breedveld, Vlieland (2003) stated that, to start palpation, palpate each joint of Ms. Li’s hands, including its skin for temperature, its muscles, bony articulations, and area of joint capsule.   Notice any heat, tenderness, swelling, or masses on Ms. Li’s hands.   Joints normally are not tender to palpation.   If any tenderness does occur, try to localize it to specific anatomic structures, such as skin, muscles, bursae, ligaments, tendons, fat pads, or joint capsule.   The synovial membrane normally is not palpable.   When thickened, it feels â€Å"doughy† or â€Å"boggy†.   A small amount of fluid is present in the normal joint, but it is not palpable.   Palpable fluid is abnormal, as fluid is contained in an enclosed sac.   If you push on one side of the sac, the fluid will shift and cause a visible bulging on another side. Ms. Li’s hands are tender, but no masses found in her joints.   However, fluid is palpated as â€Å"boggy†.   This can also be shown by her swelling hands.   She might have to take Aspirin as prescribed to relief pain and to reduce inflammation as mentioned above (Karlsson, Berglin, Wa Jonsson, 2006). C3. Range of Motion Assessing the range of motion is important too because it extremely affects the activities of daily living when the range of motion is decreased, and limitations occur.   Patients might have to refer to physiotherapist to learn some exercises in order to improve the range of motion and back to normal again. Codd, Stapleton, Veale, FitzGerald Bresnihan (2010) stated that when assessing for the range of motion, ask Ms. Li for active range of motion while stabilizing the body area proximal to that being moved.   Familiarize with the type of each joint and its normal range of motion in order to recognize limitations.   If there is a limitation, gently attempt passive motion.   Anchor the joint with one hand while the other hand slowly moves it to its limit.   The normal ranges of active and passive motion should be the same.   If any limitation or any increase in range of motion occurs, use a goniometer to measure the angles precisely.   Joint motion normally causes no tenderness, pain or crepitation. Ms. Li’s range of motion of her wrists and fingers appear limitations, but they can be moved in passive motion slowly.   It might be affected by her swelling hands and the accumulation fluid in the joints.   She might have to consult physiotherapist for exercising since she did not exercise regularly and has a decreased in range of motion (Palmer, Gaafary Miedany, 2007). C4. Pain Assessment Patients’ self-report is considered the most accurate way to detect and measure pain. Pain can be categorized by duration, site of pain (location), cause (etiology), or qualities (severity).   Use the mnemonic COLDSPA to recall and assess the current symptoms of Ms. Li by asking the following questions: 1. Character: What does it feel like? 2. Onset: When did the pain begin? 3. Location: Where does it hurt? Can you point to where it hurts? 4. Duration: How long does it last? 5. Severity: Rate severity by using appropriate pain scale. 6. Pattern: Does anything make it better or worse? 7. Associated Factors: What other symptoms occur with it? Ms. Li answered by saying the pain on her hands feels like burning; it began yesterday when she woke up in the morning; it hurts both of her hands, especially fingers and wrists; the pain lasts forever and does not go away; pain scale is 8; resting is better, but it became worse when she moves her hands; there is no other symptoms with it. After understanding the situation of Ms. Li, medication prescribed can be given to her, such as Aspirin which can help to relieve pain and reduce inflammation. Conclusion Physical examination and health assessment are very important in understanding patients’ health condition as shown in the example above.   However, it only showed a few of them, there are much more ways of physical examination and health assessment to look at. Reference Pfizer Inc. (2010). What is Rheumatoid Arthritis? Retrieved March 15, 2011, from arthritis.com/rheumatoid_arthritis_symptoms.aspx Jarvis, C. (2004). 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Codd, Y., Stapleton, T., Veale, D. J., FitzGerald, O., Bresnihan, B. (2010). A qualitative study of work participation in early rheumatoid arthritis. International Journal of Therapy and Rehabilitation, 17(1), 24-33.