Watergate Essay - 1580 Words

Watergate â€Å"Watergate† is a term used to describe a complex web of political scandals occurring between 1972 and 1974. Although twenty-five years has passed since the notorious President Nixon resigned from office, the infamous legacy left by Richard Nixon and his administration will never be forgotten, leaving the American people with distrust among Politicians and disrespect for the American Presidency. In August 1968, Nixon stated at a Republican convention, â€Å"America is in trouble today not because her people have failed but because her leaders have failed (Porter, 206).† This ironic quote foreshadows the demise and corruption of one of the most controversial presidents, Richard Millhouse Nixon. On January 20, 1969, Richard†¦show more content†¦George Liddy and E. Howard Hunt; Judge John Sirica sentenced the â€Å"Watergate Seven†. Although Nixon was worried about the break-in, he advised the White House press secretary, Ron Ziegler, to dismiss the incident as â€Å"a third-rate burglary† (Anson, 107). In the years ensuing the invasion at the Watergate building, questions and controversy have surfaced consequent to whether or not the White House, under the control of President Nixon, was either directly or discursively involved in the planning or performing of any illegal deeds. As the Watergate scandal unfolded, the Nixon administration was quick to mitigate the responsibility for the occurrences, however, in actuality, numerous facts and particulars ascertain White House involvement and justify the repercussions (Spear, 58). The arrests of the â€Å"Watergate Seven† eventually uncovered a â€Å"White House-sponsored plan of espionage against political opponents and a trail of complicity that led to many of the highest officials in the land† (Emergy, 11†). These high political executives included former United States Attorney General John Mitchell, White House Counsel John Dean, White House Special Assistant on Domestic Affairs John Ehrlichman, White House Chief of Staff H.R. Haldeman, and President Nixon himself. Evidence corroborating White House involvement was ample and immense. On April 30, 1973, close to a year after the burglary and subsequent to a grand jury investigation of the break-in,Show MoreRelatedWatergate Of The Watergate Scandal1135 Words   |  5 PagesWatergate Scandal The Watergate Scandal happened almost 43 years ago; the event will never be forgotten. The Watergate scandal defined, perhaps for the first time, that a president of the United States could be portrayed as untrustworthy. Richard Nixon ran for a second term in 1972, in which he won by a huge margin. The Democratic Party had their headquarters at the high-end Watergate hotel. The break-in happened on June 17th, 1972, in which a security guard noticed the tape on the door lockRead MoreWatergate643 Words   |  3 PagesWatergate Student’s Name Professor Course Institution Date The Watergate Scandal was considered one of the most of disturbing political scandals in the history of America. This Scandal brought down a President and his administration, also made the American public distrust the government which still goes on today. In 1972 there were two break-ins at the headquarters of the Democratic National Committee, located in the Watergate office and apartment complex located in WashingtonRead MoreWatergate670 Words   |  3 PagesVery few American’s over the age of 20 do not know about Watergate. They have seen the plots in movies, history books, TV shows, and Made for TV movies. Some of the media plots are real and some not so much. Contrary to popular belief â€Å"Forest Gump† was not the person to crack open Watergate [ (Groom, 1994) ]. That honor goes to a simple security guard at the Watergate Complex, Frank Wills [ (AHC, 2012) ]. Mr. Willis was making his rounds when he became aware of tape covering the locks on theRead MoreWatergate740 Words   |  3 PagesWatergate Lucia San Nicolas HIS/145 October 19, 2011 Marciano Flores Watergate The Watergate scandal shocked millions of Americans when it was revealed in 1972. The president at that time was Richard M. Nixon, who himself was involved within the scandal. The Watergate scandal took place in 1972 when a group of five men broke into the offices of the Democratic National Committee in the Watergate office complex in Washington. The five men involved in this burglary were eventuallyRead MoreWatergate637 Words   |  3 PagesWatergate Scandal Ever since the beginning of time, scandals have occurred. But one of the biggest and infamous scandals is the Watergate. Approximately forty years ago from date, a Watergate protector found a small portion of tape attached on the lock of on the National Democratic Headquarters door. Then it all began. The Watergate’s attempted break in was a part of a bigger operation by President Nixon. The rumor was Nixon’s supporters and people involved in the scandal wanted to tarnish theRead MoreWatergate722 Words   |  3 Pagesstory of Watergate is both historically and politically interesting. It began to occur from the Pentagon Papers, in which Daniel Ellsberg handed over to the press. The Pentagon Papers contained secret documents outlining the history of U.S. involvement in Vietnam (p.848).These secret documents would bring to light the deception of the the morning of June 17, 1972, at 2:30 a.m. 5 burglars were arrested inside the office of the Democratic National Committee, located inside of the Watergate buildingRead MoreWatergate3095 Words   |  13 PagesRunning head: WATERGATE 1 WATERGATE DEVRY UNIVERSITY ONLINE. OCTOBER 20, 2014 WATERGATE 2 INTRODUCTION Watergate is a word that will forever be connected to the 37th President, Richard Nixon. What started out as a botched robbery at the Democratic Reelection headquarters would later become know for bringing down the Presidency. The American public would be able to see and hear firsthand what actually occurred in the Whitehouse behind closed doors, becauseRead MoreThe Watergate Scandal1543 Words   |  7 Pagestrustworthy – or so they thought. Unfortunately, shortly after Nixon was elected to his second term of presidency in 1972, the Watergate Scandal changed America forever by creating a sense of mistrust toward the government for the American people because of The Nixon Administration’s actions. It all began on Sunday, June 18, 1972 when Frank Wills, security guard at the Watergate office complex in Washington, D.C., found a piece of tape that was preventing a door from locking. After removing the pieceRead MoreWatergate Complex After The Watergate1781 Words   |  8 Pagesin the Watergate complex after signs of breaking in were found on the doors. No one at that time knew this subtle crime would lead to the greatest scandal in the US history and the resignation of the current President, Richard Nixon. Evidences later showed that the Watergate Incident was only a mere part of the ugly crimes the Nixon Administration had committed to achieve their ultimate goal of reelection, and Nixon had intentionally attempted a cover up to save his reputation. The Watergate incidentRead MoreThe Watergate Scandal2082 Words   |  9 PagesThe Watergate Scandal Richard Milhous Nixon was the thirty-seventh President of the United States of America from 1969 until 1974. Nixon completed his first term as President in 1973 and was re-elected for the position for the next four years. However, Nixon would have his time in the White House cut short by the series of events that occurred in the twenty-six months that followed the Watergate burglary. On June 17, 1972 five men, one White House employee and four Cubans, broke into the Watergate

Multinational Financial Management by Alan Shapiro...

CHAPTER 6 Country Risk Analysis EASY (definitional) 6.1 The degree of political risk faced by a firm operating in a foreign country a) can be determined by using a political risk index b) depends on the benefits provided by the firm c) both a and b d) depends on how the firm has structured its operations Ans: d Section: Measuring political risk Level: Easy 6.2 One good indicator of political risk is a) the seriousness of capital flight b) the level of local interest rates c) the level of local tax rates d) a large middle class population Ans: a Section: Capital flight Level: Easy 6.3 Capital flight occurs for several reasons, most of which have to do with a) government regulations on interest rates b) high taxes on†¦show more content†¦a) currency controls b) privatization of public utilities c) changes in tax or labor laws d) regulatory restrictions Ans: b Section: Measuring political risk Level: Difficult 6.17 Which one of the following is NOT a measure of political instability? a) the number of political parties in one nation b) frequency of changes of government c) the level of violence d) conflicts with neighboring states Ans: a Section: Measuring political risk Level: Difficult 6.18 Which of the following foreign investments would be least subject to expropriation? a) an oil well in an LDC that is providing needed foreign exchange b) a coffee plantation that is producing beans for export c) an assembly plant for automobiles located in an LDC d) a tire making plant in an LDC that is substituting for tire imports Ans: c Section: Key indicators of country risk Level: Difficult 6.19 A U.S. company whose foreign property hasShow MoreRelatedInternational Parity Conditions4098 Words   |  17 PagesInterest Rates, and Exchange Rates in Equilibrium (International Parity Conditions) Table of Content Executive SummaryÂ…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…3 1. IntroductionÂ…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â….4 2. Literature ReviewÂ…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…6 3. Findings and Analysis: Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…10 a. PPPÂ…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…..Â…Â…Â…Â…10 b. FEÂ…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…..Â…Â…Â…Â…Â…..12 c. IFEÂ…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…..Â…Â…Â…Â…Â…Â….14 4. Conclusion Recommendations Â…Â…Â…Â…Â….Â…Â…..Â…Â…Â…Â…Â…Â…16 BibliographyÂ…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â….17 Appendix A. Historical DataÂ…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…Â…18 Read MoreEssay about Pestel Analysis Russian Federation3424 Words   |  14 Pages4.1.1 PESTEL Analysis This part of the dissertation will analyze main political, economic, social, technological, environmental and legal issues within the Russian Federation. All of the Interviewees outlined the political aspect as the most important when investing into Russia, however the Author would like to acknowledge that the economical and legal factors have a critical weight in the issues of FDI, therefore their analysis will play a comprehensive role in the thesis, assuming that the initialRead MoreResearch on Foreign Exchange Risk Management13065 Words   |  53 PagesResearch Paper On Foreign Exchange Risk Management Submitted In Partial Fulfillment Of the Requirement Of Masters of Business Administration Table of Contents EXECUTIVE SUMMARY 1 CHAPTER 1: PLANRead More International Parity Conditions Essay3163 Words   |  13 Pages Table of Content Executive Summary†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦3 1.nbsp;nbsp;nbsp;nbsp;nbsp;Introduction†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.4 2.nbsp;nbsp;nbsp;nbsp;nbsp;Literature Review†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦6 3.nbsp;nbsp;nbsp;nbsp;nbsp;Findings and Analysis: †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦10 a.nbsp;nbsp;nbsp;nbsp;nbsp;PPP†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦..†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦10 b.nbsp;nbsp;nbsp;nbsp;nbsp;FE†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦..†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦..12 c.nbsp;nbsp;nbsp;nbsp;nbsp;IFE†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦..†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.14 4.nbsp;nbsp;nbsp;nbsp;nbsp;ConclusionRead MoreMarketing Literature Review11908 Words   |  48 PagesRoutinized response, Brand loyal, Switchers, Pure variety seeking, Statistical analysis, Implications.] 4 The Impact of Affect on Memory of Advertising. 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Deteriorating Patient Suffering from Sepsis Sample for Students

Question: Develope a Profile of a Patient Presenting to a Health Care facility with Sepsis. Answer: Introduction: Mr. A, a 70 year old male was admitted to emergency department by his son. His son told nurse that 15 days back he was cutting vegetables in their garden and accidently he cut his fingure. He carelessly washed the bleeding fingure, covered it with small piece of cloth and continued working. Next day, he removed piece of cloth from fingure and observed that wound was open and it was moist. After two days, fingure was swollen and red. He visited nearby physician. Physician prescribed him with broad spectrum antibiotic, however he discontinued it after two days. On the arrival in the emergency department, his son explained that Mr. A is having high fever and he is behaving like confused person since last two days. His history indicates that he is suffering through cancer since last two years and type 2 diabetes mellitus since last ten years. Currently, he is on the medications like metformin for type 2 diabetes mellitus and cisplatin for cancer. In the initial assessment, it was observe d that his vital signs are deviating from normal values. His temperature was 40.2 ?C, his respiratory rate was 25, his blood pressure was 86/62 mmHg and pulse rate was 114. Blood culture identified E. coli infection. All these information indicate he has developed septic shock. For initial management, he was given appropriate antibiotic and kept on ventilation. Definition and two diagnostic criteria: Sepsis is defined as devastating response of body to the infections which may lead to the tissue damage, organ failure and consequently death of the person (Singer et al., 2016). In the initial assessment, it was observed that Mr. A has increased pulse rate (114) and increased breathing rate (25). These are the prominent symptoms of sepsis. In sepsis due to coronary dysfunction there is insufficient blood flow. This insufficient blood flow leads to the increased pulse rate and respiratory rate. Due to less blood flow there is reduced blood pressure in the patient with septic shock. Due to less circulating volume of blood, there is less venous return. When blood gets ejected from the heart, elastic fibers present in the arteries are helpful in maintaining high pressure gradient. This high pressure gradient is due to the expansion of arteries for accommodation of blood and again they recoil. This sequence of expansion and recoiling is measured as pulse rate. If cardiac output is more a nd systolic pressure is high, then pulse is strong. In case of septic shock there is less cardiac output and low systolic pressure. It indicates weak pulse. This weak pulse increases its frequency to maintain normal pressure in the blood vessels. Thus, in septic shock patients pulse rate is rapid due to less circulating blood and hypotension (DellaVolpe et al., 2015). This less circulating blood also leads to the pulmonary complication. Due to less circulating blood, there is less oxygen supply to the tissues. Due to less oxygen supply to the tissues oxygen desaturation occurs. Due to oxygen desaturation, there is decreased amount of oxygen and increased amount of carbon dioxide in the blood. For proper functioning of tissues and organs, optimum level of oxygen is required in the blood. Lung tries to maintain this normal level of oxygen through respiration. Lung put extra efforts to inhale oxygen and exhale carbon dioxide. As a result there is increased respiratory rate in patients with septic shock. In this case arterial blood gas (ABG) test should be performed in patients with hypoxia. This test measure pH, oxygen and carbon dioxide level in the blood. ABG test evaluate capability of lung to transfer oxygen to the blood. Less supply of blood to the tissues is termed as hypo-perfusion and it is due to hypovolemic shock. Common symptoms of hypovolemic shock are hypotension, rapid heart rate (tachicardia) and dizziness. Due to less supply of oxygen to the cells and tissues, there is lactic acid fermentation in the cells. It leads to the accumulation of lactate in the cells which is termed as lactic acidosis (Kim and Hong, 2016; Gajic et al., 2011). Assessment in emergency department: Complete blood cell (CBC) count and differential count was performed in Mr. A. This test gave estimation of red blood cell, white blood cell, hemoglobin and platelets. This test gave idea about infection in Mr. A. Test for serum electrolyte levels was carried out. Renal and hepatic function tests were carried out to understand functioning of kidney and liver. Kidney function test was carried out by blood tests for urea and creatinine levels. Hepatic function test was carried out by blood test for alanine aminotraseferase (ALT) and aspartate aminotraseferase (AST). Coagulation status in Mr. A was evaluated by calculating prothrombin time and activated thromboplastin time. Amount of oxygen, carbon dioxide and acidity were measured by applying arterial blood gas analysis. This test was performed because respiratory rate in Mr. A was increased due to hypoxia. Serum lactate test was performed to assess hypoperfusion in Mr. A. Due to less cardiac output, there is possibility of hypoperfusi on of tissues in Mr. A. Urine analysis and culturing of urine sample were performed to detect urinary tract infection. Blood culture was performed to detect presence of microbial infection in Mr. A. This test was useful for the initiation of the antibiotic therapy based on the type of detected bacteria (Reinhart et al., 2012; Khardori, 2014). Initial interventions: Antibiotic therapy was initiated in Mr. A immediately within 1 hr of diagnosis of septic shock. Initial therapy was started with broad spectrum antibiotic without waiting for detection of specific microorganism. Levofloxacin was administered because of its usefulness in gram positive and gram negative bacteria. It is also useful in cases of pneumonia. Later, it was observed that Mr. A was detected with E.coli infection. After detection of E.coli infection, Mr. A was administered with third generation cephalosporin like ceftriaxone (Yealy et al., 2014). Mr. A developed respiratory distress due to septic shock. This respiratory distress is due to the diffuse alveolar damage, acute lung injury and mild acute respiratory distress syndrome. Mr. A had rapid breathing rate due to hypoxemia. Hence, Mr. A requires intubation and mechanical ventilation for optimum respiratory support. This ventilation was considered in the initial phase after diagnosis of septic shock. Supplemental oxygen was given to Mr. A though oxygen mask with flow rate of 2 l/min. Ventilation was provided with suitable sedation because it reduced work of breathing in Mr. A. As a result, it reduces metabolic demand for breathing in case of Mr. A. Low tidal volume was kept at the time of artificial ventilation because it reduces, alveolar overdistention and repetitive opening and closing of alveoli at the time of artificial ventilation. This collapse of alveoli was prevented by applying positive end-expiratory pressure (PEEP) (Ranieri et al., 2012; Yealy et al., 2014). Pathophysiology and assessment: Pathophyiology of septic shock is very complex and it is not completely understood. Inflammation and coagulation plays prominent role in the pathophysiology of septic shock in response to the infection. Gram-positive bacteria are the major cause of septic shock followed by gram-negative bacteria and fungal infections. Circulating proteins in the body interacts with infected microbial proteins. It leads to the chain of events which results in the release of both proinflammatory and anti-inflammatory mediators. In the event of inflammatory phase complement system also get activated. Mediators of the complement system produces endothelial damage and hypotension. Due to infection and flowed by inflammation there is increase release of acute phase inflammatory mediators like C-reactive protein, proinflammatory cytokines like tumor necrosis factor- (TNF-), interleukin-1 (IL-1), interleukin-6 (IL-6), markers for nitric oxide production like plasma methemoglobin and nitrite/nitrate concentra tions (Cinel and Opal, 2009). Cardiopulmonary changes are the prominent changes occur is septic shock. Initial phase is the vasodilatation phase which is termed as warm shock. In this phase there are warm extremities, little systemic resistance, elevated or optimal cardiac output, optimal or lesser blood pressure and elevated pulse pressure. Reduced venous return in the early phase of sepsis lead to increased level of catecholamines. This lead to the increased adrenergic response and consequently cardiac contractibility and heart rate. In progressive sepsis, mitochondrial dysfunction and tissue hypoxia occurs which lead to the decreased levels of adenosine triphosphate formation. This inequality between demand and supply of oxygen lead to cardiac myocytes death. This results in the cardiac dysfunction and there is increased levels of troponin, reduced contractibility, weakned ventricular response to fluid, ventricular dilation and hypotension. In this phase, there is increased capillary permeability which results in the loss of intravascular fluid to the interstitial space. As a result, there is loss of intravascular fluid. Later phase is the vasoconstricted phase in the septic shock. This phase is marked with cold extremities, hypotension, little pulse pressure and reduced cardiac output. In this phase there is reduced myocardial contractibility, loss of intravascular fluid and peripheral vasoconstriction (Schuetz et al., 2011). TNF- produced due to infection and inflammation is responsible for the decrease in myocardial function. TNF- also produces vasodilatation and decrease in the cardiac contractibility. This action occurs due to the increase in the cGMP level due to the increased nitric oxide production (Kothari et al., 2012). Peripheral oxygen supply is reduced in the patients with septic shock due to less circulating blood. Lung would not be able to exchange enough oxygen at the capillaryalveoli interface. This results in the hypoperfusion at the tissue level. Due to less oxygen at the tissue level, lung initiates compensatory mechanism. Bu virtue of this compensatory mechanism, lung starts breathing at the faster rate to supply more amount of oxygen to the lungs. Hence, in septic shock patients there is increased breathing rate. Assessment findings indicating patient is safe: For the transfer of the patient to the ward two clinical conditions were identified as indicators of safety of Mr. A. These conditions were blood pressure and respiratory rate. After initial treatment to Mr. A, it was observed that his blood pressure and respiratory were improved. His measured blood pressure was 116/78 and respiratory rate was 18 breaths per minute. There was improvement in the breathing rate in Mr. A because he kept on the ventilation with oxygen supplementation. Due to this, his oxygen saturation level improved. His Po2 level observed was 93 %. As result, his lung needS not to breathe faster to deliver more amount of oxygen to the blood and tissues. His pulmonary function test also was performed. This pulmonary function test includes spirometric measurement of expiratory reserve volume (ERV), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), forced expiratory flow 25% to 75% (FEF25-75), functional residual capacity (FRC), residual volume (RV ), peak expiratory flow (PEF) and total lung capacity (TLC) (Gold and Koth, 2016; Scanlon, 2016). Measurements in these tests were normal. Blood pressure measurement for Mr. A was performed using sphygmomanometer. There was recovery in the hypotension because infection in Mr. A was recovered. As a result, there was less secretion of inflammatory mediators and nitric oxide. Less release of nitric oxide increased blood pressure from hypotension to normal level (Kothari et al., 2012). Findings indicating patient is detoriating: Deteriorating conditions observed in Mr. A were disturbed mental status, impaired renal function and impaired hepatic function test. Renal output was measured in Mr. A in previous 18 hours. It was observed that no urine was passed in previous 18 hours and it was measured less than 0.5 ml/kg/hour with the help of catheter. Glomerular filtration rate was very less in Mr. A. According to literature urine output is variable in patients with less glomerular filtration rate. It can vary for oliguria to high urine output. It reflects urine output is not solely dependent on glomerular filtration rate, however it depends on difference between glomerular filtration rate and rate of tubular reabsorption. Decreased urine output mainly occurs due to dehydration, kidney failure, hypovolemic shock, multiple organ dysfunction syndrome and urinary tract infection (Dennen et al., 2010). Out of these kidney failure, hypovolemic shock and urinary tract infection were observed in Mr. A. Hepatic function test can also get affected in patients with septic shock. Hepatic function was assessed by performing blood tests for ALT and AST. Hepatotoxicty reflects reduced metabolic capability of Mr. A. This reduced metabolic activity leads to the improper digestion of the consumed food and impaired elimination of waste products. This impaired elimination lead to the accumulation of toxic waste in body. This toxic waste material adversely affects proper functioning of the body. Adult patients with septic shock generally develop depression, stress and anxiety. Mr. A also exhibited symptoms related to mental disorder. This may be due to improper functioning of the organs and difficulty in normal living. Mr. A is confused about his thoughts and he developed memory loss. He was also facing problem in sleeping because of stress (Mayr et al., 2010; Iwashyna, 2010). Inotropic therapy (Management) : In septic shock, systemic infection leads to the hypotension. This hypotension is unresponsive to the fluid resuscitation. Along with infection control, initial management goal of the septic shock patient is to maintain normal blood pressure and cardiac output. In unusefulness of fluid resuscitation, vasopressor or inotropic therapy can be effectively used to maintain optimum hemodynamic condition (Dellinger et al., 2012). Several studies were carried out for the effectiveness of vasopressors like norepinephrine, dopamine, epinephrine, vasopressin, phenylephrine and inotropes like dobutamine, milrinone. Role of vasopressor agents in the septic shock is to improve blood pressure. Norepinephrine stimulate -adrenergic and -adrenergic receptors thereby increasing vasoconstriction, cardiac contractibility and heart rate. Dopamine stimulate dopaminergic receptors and increase renal perfusion. Norepinephrine and dopamine are considered as the first line therapy for septic shock, however use of norepinephrine is more because of its fewer side effects. Moreover, effect of norepinephrine is stronger and consistent as compared dopamine. Epinephrine is used as alternative to the norepinephrine and acts by same mechanism. Epinephrine increases arterial blood pressure, cardiac output and vascular tone. One study indicates that epinephrine has more side effects as compared to the norepinephrine. Patients treated with epinephrine exhibited more lactic acidosis and tachycardia. Vasopressin produces actions like vasoconstriction, adrenocorticotropin hormone release and water retnetion. Vasopressin also activated oxytocin receptors which induces vasodilatation. Some studies indicated that vasopressin is useful in reducing dose of norepinephrine (Vasu et al., 2011; De Backer et al., 2012). Vasopressin also increase creatinine clearance and urine output. Most of the research indicated that vasopressin is a rational second line therapy for septic shock in patients where nonepinephri ne is ineffective. Inotropic agents can be used alone or along with existing vasopressors. Dobutamine is useful in to relieve signs of hypoperfusion. Invasive monitoring: Pulmonary artery catheterization was used for obtaining hemodynamic information of Mr. A. It is a flow directed and balloon shaped catheter. This catheter is mainly useful for investigating complications due to acute myocardial infarction. Cardiac output can be measured using pulmonary artery catheterization by application of thermodilution technique. Gold standard for measuring cardiac output is electromagnetometry of aortic blood flow. In studies, it has been found that pulmonary artery catheterization exhibited good correlation with electromagnetometry. In septic shock patients continuous monitoring of cardiac output is very necessary. Hence, pulmonary artery catheterization can be effectively used in septic shock patients because it is a simple measurement technique, it provides calibrated continuous cardiac output, pulmonary artery pressure, pulmonary artery occlusion pressure and mixed-venous oxygen saturation (Velissaris et al., 2016). Conclusion: Mr. A, a 70 year male was admitted to emergency department with the complain of fever and confused state. Description by his son revealed that he might develop infection due to cut in his fingure. However, he discontinued it after consumption for short span. Preliminary evaluation revealed that he had E.coli infection. Also, his vital signs like temperature, respiratory rate, blood pressure and pulse rate indicated that he had septic shock. In the emergency department, preliminary treatment was initiated for him. This treatment comprises of antibiotic treatment and supplementation of oxygen through ventilation. After preliminary treatment, it was observed that his condition was improving and he was more stabilized as compared to the earlier condition. Normal values obtained for blood pressure and respiratory rate were considered as safe parameters for transfer to ward from emergency department. In septic shock, there are more chances of multiple organ dysfunctions. In Mr. A also psyc hological, renal and hepatic dysfunction was observed. It indicates his condition was detoriating. Inotropes and vasopressors can be effectively used in the management of septic shock patient. In summary, condition of septic shock patient detoriates very rapidly and careful monitoring and management required in these patients. ISBAR Handover: Introduction Myself Ms. B, Residential Nurse in Emergency Department to head of Ward. Patient is Mr. A, Age - 70yrs., male admitted to Dr. Z in emergency department. Situation Mr. A was admitted to emergency department with fever and confused state of mind. 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