ENEMA in Relieving Constipation Essay Example | Topics and Well Written Essays - 1000 words

ENEMA in Relieving Constipation - Essay Example An enema is the introduction of a solution into the rectum and sigmoid column. And is a common clinical practice by nursing to promote the evacuation of feces in patients complaining of constipation (Funnell, Koutoukidis & Lawrence, 2009). Bowers, 2008, in the evaluation of evidence on the use of phosphate enema as an intervention for constipation, points out that though phosphate enemas are routinely used in clinical practice for relieving constipation, there is no clear evidence to support the continued use of phosphate enemas. This finding stems from the limited evidence available in support of enemas, as a more effective intervention in constipation, over the other medication and treatment strategies available in the management of chronic constipation, though phosphate enemas have useful for some diagnostic bowel investigations. This lack of evidence of efficacy on enemas is further compounded by two factors, reducing the potential use of enemas as an intervention in constipation . The first factor lies in the detrimental complications in the patient that could arise from the use of enemas in the management of constipation. The second factor pertains to the need to avoid the use of phosphate enemas in patients with certain underlying conditions (Bowers, 2008). The findings of Bowers 2008, in the evaluation of phosphate enema is strongly supported by the body of knowledge on constipation and its treatment, which can be extended to the use of enemas in the interventions to alleviate constipation. Based on the history of the patient and the duration of symptoms, it is possible to differentiate constipation into occasional constipation (Johnson, 2006). Using enemas is known to interfere with normal bowel movement and enemas are not recommended in simple constipation. Enemas should not be considered as a means to alleviate constipation when there is obstruction of the bowel and the cause of the obstruction is still to be diagnosed. Additionally, enemas are not an option when the constipation is accompanied by abdominal pain, rectal fissures, and ulcerated hemorrhoids. This is because evidence shows that in all these cases enemas can lead to mechanical damage and perforation of the bowel (Lemone & Burke, 2008). Evidence points to use of enemas only in the case of significant or chronic constipation, particularly, when the constipation arises from fecal impaction. The general rule in the use of enemas is that it be employed in acute situations and that too only on short term basis. Phosphate enemas are efficient is such situations through its ability to draw fluid into the bowel and irritate the mucosa, causing evacuation of the bowel. However, repeated use of enemas is known to cause impaired bowel function and fluid and electrolyte imbalances. This is particularly true in the case of phosphate enemas and tap water enemas (Lemone & Burke, 2008). Meier & Monias, 2005, point out a further restriction in the use of phosphate en

Financial reporting Research Paper Example | Topics and Well Written Essays - 3750 words

Financial reporting - Research Paper Example Both CarMax and AutoNation engage in the sale of used vehicles; however, they also trade new vehicles. This report sheds light on the US automotive industry which experienced sale of 15,600 vehicles in 2013. The report further assesses the past financial performance of CarMax and AutoNation. Among the financial aspects that would be analysed include, the revenue and working capital. Additionally, the report analyses the strategies that are used by both AutoNation and CarMax to maintain a competitive edge at the market. AutoNation is rated as the largest automotive firm that retail vehicles in the US (Morningstar 1). It is also considered the top company that offers both used and new vehicles to the market. With its foundation dating back to 1996, the company runs more than 260 dealerships in the United States (AutoNation 1). The company’s headquarters is based in Florida. According to AutoNation, the management of the company consists of the Chief Executive Officer, Mike Jackson and the COO (Chief Operation Officer), Maroone Mike. AutoNation experienced revenue of $17.517 billion as of 2013 (1). However, the total equity stood at $2.061 billion in the same year (AutoNation 1). On the other hand, Morningstar shows that CarMax is the largest company that engages in the selling of used cars (1). The company was founded in 1993 (CarMax 1). Currently, the company boasts of one-hundred and twenty-eight stores where the pre-owned vehicles are sold (CarMax 1). The headquarters of the company is located in Virginia, US. Under the leadership of the Chairperson, Mr. Tiefel William, the Chief Executive Officer, Folliard Thomas and the Chief Finance Officer, Mr. Reedy Tom, CarMax managed to record revenue of $12.547 billion as of February 2014 (CarMax 1). This report is set analyse the economic features of the US automotive industry. Additionally, the report would assess the strategies that are used by AutoNation and CarMax. The report would finally analyse the