Spanish

 This is a beautiful book for children of ages 4+ to learn  SPANISH ALPHABET (Vowels/Constants).

Alfabeto Español

SPANISH ALPHABET Picture Book with English Translations

The book details each SPANISH  alphabet(Vowels and Consonants), English phonetics, the commonly used word in SPANISH, words English phonetics, and its associated English word for easy understanding and reference with pictures.

The Book Contains:

Picture book details All 27 SPANISH ALPHABET accompanied with a picture that describes the first words/sight words for respective alphabet

 A Perfect Bilingual Early Learning & Easy Teaching SPANISH Books for Kids

The book features English phonetics, the commonly used word in SPANISH, words English phonetics and its associated English word

Premium color cover design

Printed on high quality perfectly sized pages at 8.5x8.5 inches 

COLOR pages

ALPHABET with commonly used word (SPANISH and English with phonetics) and pictures

This should be a perfect Workbook For Children To Learn SPANISH ALPHABET

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Sincerely hoping to better serve and appreciate your feedback and support.

NLCEX- RN: Grief and Loss - Notes

Loss - is an Absence of an object, person, body part, emotion, idea or function that was valued Actual loss is identified and verified by others Perceived Loss cannot be verified by others Maturational Loss occurs in normal development Situational Loss occurs without expectations Ultimate Loss (Death) results in a lost for a dying person as well as for those left behind, can be viewed as a time of growth for all who experienced it 3 Phases of Grief(Theory of Grief, Dying and Mourning)

• Protest- lack of acceptance, concerning the loss, characterized by anger, ambivalence and crying
• Despair- denial and acceptance occurs simultaneously causing disorganized behavior, characterized by crying and sadness
• Detachment- loss is realized; characterized by hopelessness, accurately defining the relationship with the lost individual and energy to move forward in life.
Kubler-5 Stages of Grieving
• Denial – characterized by shock and disbelief, serves as a buffer to mobilize defense mechanism
• Anger– resistance of the loss occurs, anger is typically directed toward others
• Bargaining – deals are sought with God or other higher power in an effort to postpone the loss
• Depression– loss is realized; may talk openly or withdraw.
• Acceptance– recognition of the loss occurs disinterest may occur; future thinking may occur.
Worden’s 4 Tasks of Mourning
• Accept the reality of the loss, the loss is accepted
• Experience the pain of grief, healthy behaviors are accomplished to assist in the grieving process.
• Adjust to the environment without the deceased, task are accomplished to reorient the environment, i.e. removing the clothes of the deceased from the closet.
• Emotionally relocate the deceased and move forward with life, correctly align the past, the present & look towardsthe future
Anticipatory Grief - Expression of the symptoms of grief prior to the actual loss, grief period following the lost may be shortened and the intensity lessened because of the previous of grief; for example, a child told that a family move is expected may grieve about losing friends prior to actually living Complications of Bereavement
• Chronic Grief – symptoms of grief occur beyond the expected time frame and the severity of symptoms is greater; depression may result.
• Delayed Grief – when symptoms of grief are not expressed and are suppressed, a delayed reaction of grief occurs, the nurse should discuss the normal process of grieving with the client and give permission to express these symptoms
Symptoms of Normal Grief
• Feelings include sadness, exhaustion, numbness, helplessness, loneliness, and disorganization, preoccupation with the lost object or person, anxiety, depression.
• Thought patterns include fear, guilt, denial, ambivalence, anger
• Physical sensations include nausea, vomiting, anorexia, weight loss or gain, constipation or diarrhea, Diminished hearing or sight, chest pain, shortness of breath, tachycardia
• Behaviors include crying, difficulty carrying out activities of daily living and insomnia
Nursing Health Promotion to facilitate mourning are:
• Help client accept that the loss is real by providing sensitive, factual information concerning the loss
• Encourage the expression of feelings to support people; this build relationships and enhances the grief process
• Support efforts to live without the diseased person or in the face of disability; this promotes a client’s sense of control as well as a healthy vision of the future
• Encourage establishment with new relationships to facilitate healing.
• Allow time to grief, the work of grief may take longer for some; observe for a healthy progression of symptoms.
• Interpret “normal” behavior by teaching thoughts, feelings, and behaviors that can be expected in the grief process
• Provide continuing support in the form of the presence for therapeutic communication and resource information.
• Be alert for signs of ineffective coping such as inability to carry out activities of daily living, signs of depression, or lack of expression of grief.

"Kubler-5 Stages of Grieving

"Kubler-5 Stages of Grieving

• Denial – characterized by shock and disbelief, serves as a buffer to mobilize defense mechanism
• Anger– resistance of the loss occurs, anger is typically directed toward others
• Bargaining – deals are sought with God or other higher power in an effort to postpone the loss
• Depression– loss is realized; may talk openly or withdraw.
• Acceptance– recognition of the loss occurs disinterest may occur; future thinking may occur.
"

NCLEX- RN: Assignment, Delegation and Supervision

The RN takes responsibility and accountability for the provision of nursing practice. The RN directs care and determines the appropriate utilization of any assistant involved in providing direct patient care. The RN may delegate components of care but does not delegate the nursing process itself. The practice pervasive functions of assessment, planning, evaluation and nursing judgment cannot be delegated. The decision of whether or not to delegate or assign is based upon the RN’s judgment concerning the condition of the patient, the competence of all members of the nursing team and the degree of supervision that will be required of the RN if a task is delegated. The RN delegates only those tasks for which she or he believes the other health care worker has the knowledge and skill to perform, taking into consideration training, cultural competence, experience and facility/agency policies and procedures. The RN individualizes communication regarding the delegation to the nursing assistive personnel and client situation and the communication should be clear, concise, correct and complete. The RN verifies comprehension with the nursing assistive personnel and that the assistant accepts the delegation and the responsibility that accompanies it. Communication must be a two-way process. Nursing assistive personnel should have the opportunity to ask questions and/or for clarification of expectations. "The RN uses critical thinking and professional judgment when following the Five Rights of Delegation, to be sure that the delegation or assignment is:

1. The right task
2. Under the right circumstances
3. To the right person
4. With the right directions and communication; and
5. Under the right supervision and evaluation.

" Chief Nursing Officers are accountable for establishing systems to assess, monitor, verify and communicate ongoing competence requirements in areas related to delegation. "Organization-related Principles

1. The organization is accountable for delegation through the allocation of resources to ensure sufficient staffing so that the RN can delegate appropriately.
2. The organization is accountable for documenting competencies for all staff providing direct patient care and for ensuring that the RN has access to competency information for staff to whom the RN is delegating patient care.
3. Organizational policies on delegation are developed with the active participation of all nurses (staff, managers and administrators).
4. The organization ensures that the education needs of nursing assistive personnel are met through the implementation of a system that allows for nurse input.
5. Organizations have policies in place that allow input from nurses indicating that delegation is a professional right and responsibility.

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