Culture-is defined as the beliefs, values, behavior, and material objects that constitute

a people's way of life. Sociologists differentiate between nonmaterial culture, or the

intangible creations of human society, and material culture, or the tangible products of
human society. Society refers to people interacting within a limited territory guided by

THE COMPONENTS OF CULTURE

Even though considerable variation exists, all cultures share five components:
symbols, language, values, norms, and material culture.

Symbols- This component underlies the other four. A symbol is anything that carries a
particular meaning recognized by people who share culture. Symbols serve as the basis
for everyday reality. Symbols vary within cultures, cross-culturally, and change over
time. We take much of our culture's symbols for granted. Culture shock, a two way
process (both experienced and inflicted), is really the inability to "read" meaning in
new surroundings.

Language- The significance of language for human communication is vividly

illustrated by the story of Helen Keller recounting the moment she acquired language
and symbolic understanding of the world, through the help of her teacher Ann
Sullivan. Language is a system of symbols that allows members of a society to
communicate with one another. All cultures have a spoken language, though not all
have a written language.

Values and Beliefs Values- are defined as culturally defined standards of desirability,
goodness, and beauty, which serve as broad guidelines for social living. They support
beliefs, or specific statements that people hold to be true.

Values- Inconsistency and Conflict The values people hold vary to some degree by age,
sex, race, ethnicity, religion, and social class. Individuals are likely to experience some
inconsistency and conflict with their personal values. Further, the dominant values
identified above contain certain basic contradictions. Finally, values change over time.

Norms -are rules and expectations by which a society guides the behavior of its
members. Norms can change over time, as illustrated by norms regarding sexual
behavior.

Material culture-also reflects a culture's technology, which is knowledge that a society

applies to the task of living in a physical environment.
 BLOOD TRANSFUSION

Blood transfusion is the process of transferring blood or blood-based

products from one person into the circulatory system of another. Blood
transfusions can be life-saving in some situations, such as massive blood loss
due to trauma, or can be used to replace blood lost during surgery. Blood
transfusions may also be used to treat a severe anaemia or thrombocytopenia
caused by a blood disease. People suffering from hemophilia or sickle-cell
disease may require frequent blood transfusions. Early transfusions used Whole
Blood, but modern medical practice is to use only components of the blood.

Transfer of blood from one person to another, or from one animal to another
of the same species. Transfusions are performed to replace a substantial loss of
blood and as supportive treatment in certain diseases and blood disorders.
When whole blood is not needed, or when it is not available, plasma, the fluid of
the blood without the blood cells, can be given. Alternately, such components of
the blood as red cells, white cells, or platelets may be given for particular
deficiencies. Blood substitutes, which are under development, are expected
ultimately to ease the chronic short supply of blood and to alleviate certain
storage and compatibility problems.

Blood transfusions can be grouped into two main types depending on their
source:

• Homologous transfusions or transfusions using the stored blood of others.

These are often called Allogeneic instead of homologous.
• Autologous transfusions, or transfusions using the patient's own stored
blood.
• Donor units of blood must be kept refrigerated to prevent bacterial growth
and to slow cellular metabolism. The transfusion must begin within 30
minutes after the unit has been taken out of controlled storage.

Blood can only be administered intravenously. It therefore requires the insertion

of a cannula of suitable caliber.

Before the blood is administered, the personal details of the patient are matched
with the blood to be transfused, to minimize risk of transfusion reactions. Clerical
error is a significant source of transfusion reactions and attempts have been
made to build redundancy into the matching process that takes place at the
bedside.

A unit (up to 500 ml) is typically administered over 4 hours. In patients at risk of
congestive heart failure, many doctors administer a diuretic to prevent fluid
overload, a condition called Transfusion Associated Circulatory Overload or
TACO. Acetaminophen and/or an antihistamine such as diphenhydramine are
sometimes given before the transfusion to prevent other types of transfusion
reactions

EQUI PMEN T NEED ED :

• Blood administration set & filter

• Intravenous solution of 0.9% sodium chloride(normal saline)

• Disposable gloves

• Infusion pump if compatible with the specific blood product

• Tape

• Leukocyte-depleting filter, if ordered

• Pressure bag, if needed

• Blood warmer, if needed

PROCEDURE:
• Verify the health care provider’s order for the transfusion

• Explain the procedure to the client

• Review side effects (dyspnia, chills, headache, chest pain, itching)

with client & ask him/her to report these to the nurse.

(Reporting of side effect will lead to earlier discontinuation of

transfusion & minimize the reaction)

• Have the client sign consent form

• Obtain baseline v/s

(Allows detection of reaction by any change in v/s during the

transfusion)

• Obtain the blood product the blood bank within 30mins of initiation

(Prevents bacterial growth & destruction of red blood cells)

• Verify & record the blood product & identify the client with another
nurse

(Verification prevents administering blood to the wrong patient)

• Instruct the patient to empty the bladder

(Urine specimen after initiation of transfusion will be needed if

transfusion reaction occurs

• Wash hands & wear gloves

(Reduce transmission of microorganism)

• Open blood administration kit & move roller clamps to “off” position

(Closed roller clamps prevents accidental spilling of blood)

• For Y tubing set:

*Spike the normal saline bag & open the roller clamp on the Y
tubing connected to the bag & the roller clamp on the inlet tube
until tubing from the normal saline bag is filled. Close clamp on
unused tubing.

*Squeeze sides of drip chamber & allow filter to partially fill

*Open lower roller clamp & allow tubing to fill with normal saline to
the hub

(Removes all air from tubing system)

*close lower clamp

(Prevents waste of IV fluid)

*invert blood bag once or twice. Spike blood bag & open clamps
on inlet tube to cover the filter completely

*close lower clamp

(Prevents blood from flowing until tubing is attached to venous

catheter)

• For SINGLE-TUBING set:

*spike blood unit

*squeeze drip chamber & allow the filter to fill with blood

(A correctly filled drip chamber enables an accurate drip count)

 *open roller clamp & allow tubing to fill with blood to the nub

(Prevents air from being forced into the vein)

*prime another IV tubing normal saline & piggyback it to the blood

administration set with a needle & secure all connections with tape

• Attached tubing to venous catheter using sterile precautions &

open lower clamp

(Allows the blood product to be infused into the client’s vein)

• Infuse the blood at a rate of 2-5 ml/min according to the health

care providers order

(Packed red blood cells usually run over 1 -2 hours; whole blood
runs over 2-3 hours)

• Remain with the client for first 15-30 minutes, monitoring v/s every
5 minutes for 15mins, then every 15mins for 1 hour, then hourly
until 1 hour after the infusion is completed, or per institution policy

(If reaction occurs, it generally happens during the first 15-30mins.

Change in vital signs can warn of a transfusion reaction)

• After blood has infused, allow the tubing to clear with normal saline

(The client will receive all the blood that is left in the tubing)

• Appropriately dispose of bag, tubing & gloves. Wash hands

• Document the procedure

(Ensures accurate records)

Febril e r ea ctio ns :
Fever and chills, headache and body malise

Aller gic r eacti on s :

Flushing, uticaria, wheezing, rashes

Hemolytic reactions:
Facial flushing, chills, low back pain, hypotension, hematuria leading to
anaphylactic shock
The Five Themes of Geography

Location, Place, Human-Environment Interaction, Movement, and Region

1. Location

Most geographic study begins with learning the location of places. Location can be
absolute or relative.

Absolute location provides a definite reference to locate a place. The reference can be
latitude and longitude, a street address, or even the Township and Range system.

Relative location describes a place with respect to its environment and its connection to
other places.

2. Place

Place describes the human and physical characteristics of a location.

Physical characteristics include a description such things as the mountains, rivers,

beaches, topography, and animal and plant life of a place.

Human characteristics include the human-designed cultural features of a place, from land
use and architecture to forms of livelihood and religion to food and folk ways to
transportation and communication networks.

3. Human-Environment Interaction

This theme considers how humans adapt to and modify the environment. Humans shape
the landscape through their interaction with the land; this has both positive and negative
effects on the environment.

4. Movement

Humans move, a lot! In addition, ideas, fads, goods, resources, and communication all
travel distances. This theme studies movement and migration across the planet.

5. Region

Region divides the world into manageable units for geographic study. Regions have some
sort of characteristic that unifies the area. Regions can be formal, functional, or
vernacular.
SOCIOLOGY
The study of human social behavior, especially the study of the origins, organization,
institutions, and development of human society.

GLOBAL PERPECTIVE - learning which enhances the individual’s ability to understand his
or her condition in the community and the world and improves the ability to make effective
judgments.

IDENTIFYING GENERAL PATTERNS OF BEHAVIORS

Maintenance behavior
Social behavior

CULTURAL ANTHROPOLOGY – It is the branch of anthropology that has developed and

promoted "culture" as a meaningful scientific concept, studied cultural variation among humans,
and examined the impact of global economic and political processes on local cultural realities.

GEOGRAPHIC PERPECTIVE - the perspective used by geographers when they use all
available data and tools to first assess spatial distributions, then investigate the underlying
spatial processes responsible for the observable spatial distributions, and finally make spatial
predictions and decisions about how best to preserve or change the distributions

SEEING THE EVENTS IN THE CONTEXT OF SPACE AND PLACE

Both themes address place (inhabited space) as well as structural aspects of space
(spatiality). In considering how these structural aspects relate to the users body, geometrical
space turns from a mere collection of coordinates into meaningful, lived-in space.