Overview Of The Presenting Condition Nursing Essay

Overview Of The Presenting Condition Nursing Essay This case study is intended to explain pulmonary oedema through Mr. Toscanas case. It will discuss the pathophysiology of pulmonary oedema and how Mr. Toscanas chronic renal impairment is related to this specific condition. Also, Mr. Toscanas ECG, aerial blood gas results and blood tests result will be analysed and explained. Moreover, a nursing plan based on Mr. Toscanas condition will be made. Overview of the Presenting Condition Pulmonary oedema is a serious condition of the pulmonary system. In simple terms, it is actually excess fluid in the lungs (skinner Mckinner 2011). To be more specific, it is fluid that moves out from capillaries into the extravascular spaces and causes additional pressure to the lungs (Craft, J 2011). Pulmonary oedema is affecting about 1% of people over the age of 65 (Johnson 2009). It is a worldwide condition and the mortality rate is about 40% within a year of diagnosis (Parissis et al. 2010). The accumulation of the fluid can be in a slow process for patients with chronic renal failure. It can also occur fast for patients who suffer from myocardial infarction (McPhee Hammer 2010). There are two types of pulmonary oedema, one is cardiogenic pulmonary, and the other in non-cardiogenic pulmonary oedema (Craft, J 2011). Pulmonary oedema is defined as alveolar or interstitial oedema, and such a condition can be identified by chest X-ray (Johnson 2009). And often patients oxygen satur ation is less than 90% on room air (Johnson 2009). Also severe respiratory distress, with crackles over the lungs and orthopnoea, is often associated with acute pulmonary oedema (Parissis et al. 2010). The most common cause of pulmonary oedema is untreated heart failure (Johnson 2009). The acute respiratory distress syndrome and capillary vessel injury are other common causes of pulmonary oedema (Craft, J et al. 2011). Its signs and symptoms often include dyspnoea, hypoxaemia and increased work of breathing (Skinner Mckinney 2011). In severe cases of pulmonary oedema, patients often bring up pink frothy sputum when coughing and their carbon dioxide level increases while oxygen level decreases (Craft, J et al. 2011). Pathophysiology that Underpins the Presenting Condition As mentioned before, pulmonary oedema is excess fluid in the extravascular space and according to McPhee Hammer (2010) the extravascular space is constituted by the interstitial space and the airspace (alveoli and airways). The excess fluid can be found in one or both spaces in patients with pulmonary oedema (McPhee Hammer 2010). Moreover, both spaces have different barriers to stop fluid from entering into them (McPhee Hammer 2010). The intersitital space is protected by the pulmonary capillary endothelium, i.e. inside layer of capillary and airspaces are protected by alveolar epithelium, namely surface of alveoli (McPhee Hammer 2010). It is normal for blood vessel to leak and about 0.01% of pulmonary blood flow will leak into interstitial space every hour (McPhee Hammer 2010). There are several factors that may influence the amount of fluid leaking into interstitial space and the most important one is net pressure (transmural pressure) (McPhee Hammer 2010). The transmural pressure maintains the balance between the net hydrostatic pressure that moves fluid out of the capillaries, and the colloid osmotic pressure that keeps fluid inside the capillaries (McPhee Hammer 2010). Any imbalance of these pressures can lead to pulmonary oedema. Pulmonary oedema can be divided into two types: the cardiogenic and the noncardiogenic. The former is caused by increased transural pressure (hydrostatic or osmotic) while the latter is caused by increased permeability (damaged alveoli and/ or airways) (Copstead Banasik 2010). Increased pulmonary venous pressure, increased alveolar surface tension, or decreased capillary colloid osmotic pressure can all lead to cardiogenic pulmonary oedema (Copstead Banasik 2010). Non-cardiogenic pulmonary oedema is normally caused by an acute respiratory distress syndrome, which often results from injury, infection or inhaled toxins (Copstead Banasik). In this case study, there is no evidence of injury of the lungs nor inhaled toxins, nor infection of any kind. Thus, Mr. Mario Toscanas condition is more likely to be cardiogenic pulmonary oedema. Although the case study does not address any cardiac problem based on his age and/ or history of chronic renal impairment, Mr. Toscana is prone to cardiac d iseases. In patients with chronic renal diseases, there are damaged nephrons that cannot be regenerated (Craft, J et al. 2011). Due to slow losses of nephrons, the remaining nephrons have to take the burden and try to maintain the normal function of the kidneys (Craft, J et al. 2011). However, over time this compensation will increase the loss of nephrons and the kidney will lose its normal function (Craft, J et al. 2011). This loss of normal function can result in electrolyte imbalance, which leads to various conditions (Craft, J et al. 2011). Fluid over load, hyperkalemia, metabolic acidosis, congestive heart failure and pulmonary oedema are all the common conditions of chronic renal diseases (Craft, J et al. 2011). Cardiovascular diseases often presents in patients with chronic renal diseases and they have a very high morbidity and mortality rate (McPhee Hammer 2010). Hypertension can be caused by excess sodium and fluid, and vascular calcification by decreased glomerular filtration rate (Craft, J et al. 2011). Moreover, vascular diseases can lead or contribute to coronary heart disease, left ventricular hypertrophy, heart failure and stroke. Heart failure is defined as a complex syndrome, which comprises of several cardiac dysfunctions and causes inadequate cardiac output (McPhee Hammer 2010). The common type of heart failure is the left heart failure, also known as congestive heart failure (Craft, J et al. 2011). Additionally, congestive heart failure can result in both systolic and diastolic heart failures, and any of the two can cause pulmonary oedema (Craft, J et al. 2011). In systolic heart failure, the contractility of the heart decreases because of the disease and it can result in the i ncrease of preload (Craft, J et al. 2011). Eventually, the combination will lead to decreased cardiac output and result in increased afterload (Craft, J et al. 2011). Due to the reduced cardiac output, renal perfusion diminishes and plasma volume increases (Craft, J et al. 2011). Patients with systolic heart failure often present with decreased urine output, oedema and pulmonary oedema (Craft, J et al. 2011). And patients with diastolic heart failure can maintain a normal stroke volume and cardiac output (Craft, J et al. 2011). However, left ventricular end-diastolic pressure is still increased by the decreased compliance of the left ventricular, and the abnormal diastolic relaxation (Craft, J et al. 2011). The pressure pushes fluid to go back to the lungs and causes pulmonary oedema (Craft, J et al. 2011). ECG Examination An ECG can provide information on the electrical movement in the heart and ECG graphs give information such as heart rate, rhythm and any abnormality that may involve the heart (Jevon 2010). With the method proved by Jevon (2009), Mr Toscanas heart rate can be calculated, which is 120 beats per minute. According to Jevon (2009) heart rate over 90 beats per minute is defined as tachycardia. Based on his other presenting conditions, Mr. Toscanas tachycardia is most likely caused by hypoxia. Hypoxia is resulted from hypoxemia, which is the decreased level of oxygen in the blood (Craft, J et al. 2011). In order to meet the oxygen demand, the heart is trying to pump harder and faster to bring up cardiac output (Craft, J et al. 2011). On the one hand, hypoxemia can cause dilation of arterioles, capillaries and venules, in order to increase the blood flow through them (Copstead Banasik 2010). Therefore, peripheral blood flow is increased as well as venous return (Copstead Banasik 2010). Ven ous return is a major factor that influences preload and the increased venous return means increased preload (Copstead Banasik 2010). Preload is one of the factors that determines stroke volume, and when preload increases, stroke volume increases as well (Copstead Banasik 2010). On the other hand, the cardiovascular system is controlled by medulla oblongata of the brainstem and the neurons communicate with the heart via autonomic nervous system (Craft, J et al. 2011). The Bainbridge reflex causes increased heart rate with increased venous return at the same time (Craft, J et al. 2011). Mr. Toscanas ECG shows elevated ST segment and tale T wave as well. They are both signs of hyperkalaemia (Humphreys 2007). This condition can also be confirmed by his potassium level. The normal range of potassium is 3.5-5mEq/L, and his potassium is 5.8mEq/L (Humphreys 2007). Interpretation of Pathology Tests Mr. Toscanas Arterial Blood Gas Result shows that pH is 7.34 and the normal range is 7.35-7.45, which means his pH is lower than normal range. Hasan (2009) states that pH lower than normal range represents acidosis. According to Cowley, Owen Bion (2013) that high level of blood carbon dioxide means respiratory acidosis, and low level of bicarbonate means metabolic acidosis. The Arterial Blood Gas Result of Mr. Toscana shows blood carbon dioxide and bicarbonate is 51mmHg and 18mmol/L respectively. The normal range of blood carbon dioxide is 35-45mmHg and that for bicarbonate is 22-28mmol/L. Thus, his blood carbon dioxide level is higher and bicarbonate level is lower, which explains that Mr. Toscana is suffering both respiratory and metabolic acidosis (Hasan 2009). Besides, Mr. Toscanas blood oxygen level is 70mmHg and the acceptability range is 75-100mmHg. According to Hasan (2009) low blood oxygen level indicates hypoxia. SaO2 (saturation of haemoglobin by oxygen) is the most common way to monitor oxygen level in the body. For a healthy person, SaO2 below 95% shows lack of oxygen in the body and can lead to hypoxia (Humphreys 2007). There are many causes of metabolic acidosis, such as hyperlactataemia, ketoacidosis and renal tubular acidosis (Halperin, Kamel Goldstein 2010). In this case, based on his history of chronic renal impairment, the cause of his metabolic acidosis is more likely the renal tubular one (Halperin, Kamel Goldstein 2010). One of the functions of the kidneys is to clear the bodys acid load (Halperin, Kamel Goldstein 2010). However, for patients with chronic renal impairment, their kidneys are already damaged and they are losing normal renal function (Craft, J et al. 2011). Therefore, kidneys cannot remove acid out of body in an adequate rate. When the acid builds up in the body, it will neutralise with bicarbonate and generate carbon dioxide (Halperin, Kamel Goldstein 2010). Normally carbon dioxide will be exhaled. However, in this case, because Mr. Toscana suffers from an acute pulmonary oedema, he cannot exhale carbon dioxide effectively (Craft, J et al. 2011). One of the symptoms of pulmonary oedema is hypoxemia, which is low level of blood oxygen in the body (Craft, J et al. 2011). This occurs as the excess fluid builds up in the extravascular spaces, and impairs normal gas exchange in the lungs (McPhee Hammer 2010). Moreover, pulmonary oedema can cause dyspnoea, which is a difficulty of breathing and eventually it can damage alveoli (Craft, J et al. 2011). Both dyspnoea and the damaged alveoli can worsen the inadequate gas exchange (Craft, J et al. 2011). Based on Craft, J et al. (2011) when inadequate gas exchange occurs, oxygen in the alveoli cannot get into vessels and the carbon dioxide cannot go in to alveoli to be exhaled. While carbon dioxide accumulates in the body, pH decreases and respiratory acidosis occurs (Halperin, Kamel Goldstein 2010). In this case, besides the inadequate gas exchange, the chronic renal impairment also contributes to the increase of carbon dioxide in the body. The blood test results show both high level of serum creatinine and blood urea nitrogen. Based on Thomas Thomas (2009) creatinine results from muscular metabolism and will be cleaned out of the body by the kidneys. Urea nitrogen is resulted from protein metabolism and it will also be cleaned out of body by the kidneys (Thomas Thomas 2009). The reason for the increase in both creatinine and urea nitrogen levels is because of the decreased glomerular filtration rate, which is an indication of chronic renal disease (Craft, J et al. 2011). Holistic Plan of Nursing Care The first nursing care for Mr. Toscana is in fact to provide a reassurance to him as he is distressed by the tightness of CPAP mask and his difficulty in breathing. There is a very high chance that he will remove the CPAP mask. If CPAP is removed, it will make it even harder for him to breathe (Ducros et al. 2010). Nurses can educate Mr. Toscana on the use of CPAP and explain to him that by using CPAP, he can breathe more easily (Nehyba 2006). Nurses can also get his family involved to give reassurance to Mr. Toscana. Then, because Mr. Toscanas oxygen saturation is lower and he is presenting respiratory acidosis, nurses need to keep his oxygen saturation up (Lemone Burke 2011). Due to his acute pulmonary oedema, CPAP is a more effective way to deliver oxygen and open up more air ways, which in return improves his gas exchange in the lungs and reduces work of breathing (Ducros, L et al. 2010). Nurses need to remind themselves of a few things while looking after patients breathe with CPAP. First, CPAP mask needs to be sealed properly and tightened to provide a positive pressure air (Ducros, L et al. 2010). Second, nurses need to monitor the patients closely for any change in oxygen saturation and respiratory rate (Ducros, L et al. 2010). Third, they should allow breaks in between sections of the treatment so that patients can cough, drink or eat (Nehyba 2006). Also, breaks can release the pressure caused by CPAP mask and decrease the risk of pressure ulcer. Finally, like any other medical procedure, CPAP also has its adverse effects. When a full mask is used, CPAP therapy can lead to gastric distension (Nehyba 2006). In addition, some air can go into stomach and cause discomfort, splinting of the diaphragm and reduce lung expansion. Therefore, nasogastric tube may be required at some stage (Nehyba 2006) Monitoring Mr. Toscanas fluid intake and urine output is also important, as he has a history of chronic renal impairment and presenting pulmonary oedema (Lemone Burke 2011). A fluid balance chart can be used. If there is a negative balance, doctors need to be notified accordingly (Lemone Burke 2011). Nurses need to educate Mr. Toscana on adequate fluid intake. His vital signs also need to be monitored, especially his oxygen saturation and respiratory rate (Lemone Burke 2011). He is presenting signs of hypoxemia and respiratory acidosis, which can lead to respiratory failure (Craft, J et al. 2011). Therefore, closely monitoring his oxygen saturation and respiratory rate can identify any trend towards respiratory failure so as to intervene earlier to prevent it from happening. Cardiac monitoring is also required for Mr. Toscana because of the following reasons. First, his ECG shows heart rate of 120 which means tachycardia. Second, the most likely cause of his acute pulmonary oedema is heart failure. Third, abnormal potassium level can cause cardiac arrest (Humphreys 2007). Moreover, nurses need to check for any new arterial blood gas results and blood test results to be aware of any changing situation of the patient. Finally, as Mr. Toscana has a history of chronic renal impairment and both his arterial blood gas results and blood tests result show trend of renal failure, acute dialysis may be needed for him (Daugirdas, Blake, Ing 2012). For patients with chronic renal disease, their renal functions are impaired and some toxic wastes cannot be removed from their bodies (Craft, J et al. 2011). Dialysis is the only effective way to help them to remove these toxic wastes (Daugirdas, Blake, Ing 2012). Nurses cannot order dialysis. However, they can discuss patients conditions and tests result with doctors to arrange dialysis if necessary. Summary Pulmonary oedema is a crucial condition that can lead to respiratory failure. This condition can be caused by heart failure and worsen by chronic renal diseases. Procedures such as ECG, arterial blood gas test and blood tests can help nurses to understand patients conditions can identify any trend of deterioration. A detailed, holistic nursing care plan can help nurses to provide better care for patients.

Dnp Practice Model

Week 6 The DNP Project Describe a needs or change related to a practice environment, include your rationale for why this situation warrants attention Explain how your participation in a specific professional organization could be beneficial as you attempt to affect positive change in your identified practice environment through your DNP project I believe a significant practice problem is that many nurses do not see the need to advance their education after obtaining an R. N.By continuing to have the triple level entry into practice we do not have the control of the practice development that other professional practices may have. The other professional practices have entry degree requirements that are reflective of the expectation that each requires. It is difficult to persuade a nurse to incur debt and expense to obtain a DNP when they believe as an RN, the benefits do not outweigh the work required. They don’t see how the investment of further education can change the future of nurses.Nurses may not want to give up the opportunity to work at the bedside and do not want the politics of management. The DNP offers the opportunity to maintain the clinical expertise and further education. The AACN recommendations that the entry as a NP by the DNP will assist with this, as many nurses do want to obtain the NP licensure and level of practice. Another attractive measure of the DNP is the ability of the clinical nurse to stay at the bedside of the patient.Many nurses are not attracted to administration or education and have resisted advanced practice unless its clinical in nature. I am particularly interested in nursing education and have experience as a clinical education instructor at the undergraduate level. The national organization that I would join must have a strong educational component and outreach to encourage nurses to obtain advanced education. McEwin, M. , & Wills, E. M. (2011). Theoretical basis for nursing. Philadelphia, PA: Lippincott Williams & Wilkins

Audience Analysis Essay

Communication is one of the most important skills that an individual can possess when presenting to a group of people. The audience should always be focal point of the presenter as communication is an important foundation and can often determine the success or failure of a message being received. When communication is done properly it can build respect and trust between groups and help identity the issues at hand. The presenter must have a good understanding of the audience’s culture in order to effectively communicate with the group. In this assignment I have been asked to present quarterly sales information in an in-person meeting to a group of stakeholders that includes managers, salespeople, and customers. I have been asked to answer a number of different questions before I present my information to the audience. The following questions will be answered in this paper. 1.What are audience characteristics you need to consider?2.What communication channels would be appropriate and why?3.What are some considerations that you must keep in mind given the diversity of the audience?4.What would you do to ensure that your message is effective?Before you can prepare a presentation you must consider the characteristics of your audience. I know that my audience consists of managers, salespeople, and customers of this particular organization. Because I have identified my audience I now have a better understanding of the audience’s knowledge of the subject. I also understand their interest in the subject; I understand that the different groups of individuals may only be interested in certain results of the quarterly sales information that is being presented. Managers and salespeople may have different subject knowledge than the customers. I will needs to address the different needs of all parties in attendance. I will have to customize certain parts of my presentation in order to address the specific needs of each group within the audience. I will also need to understand what the audience is expecting to learn from my presentation. I should be able to meet and exceed their expectations and the audience should walk away with their questions answered and explained as well as have a better understanding of the quarterly sales information that was presented to them. Because this is an in-person meeting certain communication channels are more appropriate than others. Power-point presentations would be an appropriate method of communication between the presenter and the audience. This is an effective method because it not only allows the presenter to discuss the statistics; but will also allow the present to show the audience the statistics in detail and all together as a group. Printed handouts or documents are another method of communication that would be considered appropriate in an in-person meeting. This method allows the audience to take part in reading the information provided and also gives them something to take with them from the meeting for future reference. Because the majority of the information is being presented orally, the presenter must consider their own body language and speech effectiveness to the audience. Body language and speech are both very important as the audience will be feeding off of the enthusiasm of the presenter. If the presenter gets the attention of their audience it is important to keep it in order to effectively communicate the information. Because there is diversity in the audience certain considerations must be kept in mind when presenting quarterly sales information. Each group will have different levels of interest in the information being presented. The customers will probably not have the same level of interest in certain aspects of the presentation as the managers and salespeople. Another consideration that the presenter must keep in mind is the information that is being communicated to the group. There is a certain amount of statistical data that the organization might not want all the members of the audience to know about. This information might be better presented in a manager’s only meeting. Other considerations that a presenter may want to keep in mind given the diversity of the audience is the average age, gender, culture background, education, economic status, and group memberships of the attending audience. These considerations individually may not have a big impact on the methods of communication chosen by the presenter, but together will allow the presenter to understand the diversity of the audience to which the information is being communicated. To ensure that the presentation is a success and the information is received effectively I would make sure that I have a concrete agenda and use it. I would also make sure that I interact with the audience, for example when presenting the sales data I might ask the audience if anyone has any suggestions to help increase the sales in a particular area. I would ask some open-ended questions to help encourage audience participation. I would also ask the audience to participate in constructive group discussions and would frequently check for group consensus on particular issues and decisions. At the end of the meeting I would survey the group through E-mail, fax, letter to ensure that the information that was presented was received and understood. I would also make myself available to answer any questions that may need clarification on an individual level. References Locker, K., & Kienzer, D. (2008). Business and Administrative Communication (8th edition). McGraw-Hill, 2008 New York, NY. Retrieved from the University of Phoenix web-site. Payne, B. (2008). Effective group Communication. Retrieved on April 24, 2009 from the world wide web at: http://www.dpi.vic.gov.au/DPI/nreninf.nsf/childdocs/-C835B1CE4BC7F1D04A2568B30004FC37-4FEBC5DEBF535AC1CA256BC8000410EB-5D3323C8EDE7C7EB4A256DEA00294D0A-B59DCFB30DB614C3CA256BCF000AD4E0?openPearson, Allyn & Bacon (1995-2009). Demographic Characteristics of Your Audience. Retrieved on April 24, 2009 from the world wide web at: http://wps.ablongman.com/ab_public_speaking_2/24/6223/1593259.cw/index.html . Copyright  © 1995 – 2009, Pearson Education, Inc., publishing as Pearson Allyn & Bacon. McGee, J. Important Characteristics of your Audience. Writing and Designing Print Materials for Beneficiaries: A Guide for State Medicaid Agencies. Health Care Financing Administration, Baltimore, MD. HCFA Publication Number 10145. October 1999, page 66, and the Plain English Network Web site at http://www.plainlanguage.gov. Retrieved from the world wide web on April 26, 2009 at: http://www.talkingquality.gov/docs/section3/popups/characteristics_pop.htm

Timeline from 1870 to 1880

1870 1870: Thomas Nast, the star political cartoonist of Harpers Weekly, began a campaign of lampoon the corrupt ring that secretly ran New York City. Nasts biting depictions of the Tweed Ring  helped bring down Boss Tweed.February 3, 1870: The 15th Amendment to the U.S. Constitution, which gave the right to vote to black males, became law when the required number of states ratified it.June 9, 1870: Charles Dickens, British novelist, died at the age of 58.July 15, 1870: Georgia became the last of the Confederate states to return to  the Union.July 19, 1870: The Franco-Prussian War began. The war was provoked by Otto von Bismarck, the Prussian leader, as part of his plan to unite Germany.October 12, 1870: Robert E. Lee, Confederate general in the Civil War, died at the age of 63 at Lexington, Virginia. 1871 January 1871: Italian troops led by Giuseppe Garibaldi briefly fought against Prussians in France during the Franco-Prussian War.March 26, 1871: The Paris Commune, a temporary government, formed after an uprising during the Franco-Prussian War, was proclaimed in Paris.May 28, 1871: The Paris Commune was suppressed as the French Army took over the city during what becomes known as The Bloody Week.Summer 1871: Photographer William Henry Jackson takes a number of photographs on the Yellowstone Expedition. The scenery he captured was so remarkable that it led to the creation of the National Parks.July 15, 1871: Thomas Tad Lincoln, the son of Abraham Lincoln, died in Chicago at the age of 18. He was buried beside his father in Springfield, Illinois.October 8, 1871: The Great Chicago Fire broke out. It destroyed much of the city of Chicago, and a persistent rumor was that it was caused by Mrs. OLearys cow.October 27, 1871: William M.  Boss Tweed, the leader of the legendary New York poli tical machine Tammany Hall, was arrested on multiple charges of corruption.November 10, 1871: The journalist and adventurer Henry Morton Stanley located David Livingstone in Africa, and said the famous greeting: Dr. Livingstone, I presume. 1872 January 6, 1872: Notorious Wall Street character Jim Fisk was fatally shot in a Manhattan hotel lobby. As he died, his partner Jay Gould and Boss Tweed stood vigil at his bedside. Legendary detective Thomas Byrnes apprehended Fisks assassin.March 1, 1872: Yellowstone National Park was established as the first National Park in the United States.April 2, 1872: Samuel F.B. Morse, American artist, and inventor of the telegraph and Morse Code, died at the age of 80 in New York City.Spring 1872: After supervising work on the Brooklyn Bridge in the caisson under the East River, Washington Roebling came to the surface too quickly and was stricken with the bends. He would be in poor health for years afterward.June 1, 1872: James Gordon Bennett, who in many ways invented the modern newspaper by founding the New York Herald, died in New York City.November 5, 1872: President Ulysses S. Grant wins a second term in the election of 1872, defeating legendary newspaper editor turned candidate Horace Greeley.November 29, 1872: Horace Greeley, who weeks earlier lost the presidential election, died in New York City. 1873 March 4, 1873: Ulysses S. Grant took the oath of office for the second time as he began his second term as President of the United States.April 1, 1873: The steamship Atlantic struck rocks on the coast of Canada, and at least 500 passengers and crew perished in one of the worst maritime disasters of the 19th century.May 4, 1873: David Livingstone, Scottish explorer of Africa, died in Africa of malaria at the age of 60.September 1873: A stock market crashed sets off the Panic of 1873, one of the great financial panics of the 19th century. 1874 January 17, 1874: Chang and Eng Bunker, conjoined twins who became famous as the Siamese Twins, died at the age of 62.March 11, 1874: Charles Sumner, Massachusetts senator who in 1856 had been beaten in the U.S. Capitol in an event leading up to the Civil War, died at the age of 63.March 8, 1874: Millard Fillmore, former president of the United States, died at the age of 74.November 1874: The Greenback Party was established in the United States. Its constituencies were the farmers and workers adversely affected by the Panic of 1873. 1875 April 21, 1875: Charles Stewart Parnell, Irish political leader, was elected to the British House of Commons.May 19, 1875: Mary Todd Lincoln, the widow of Abraham Lincoln, was judged to be insane in a trial instigated by her son, Robert Todd Lincoln.July 31, 1875: Andrew Johnson, who became president following the assassination of Abraham Lincoln, died at the age of 66. 1876 March 10, 1876: Alexander Graham Bell made the first successful telephone call, saying, Watson, come here, I need you.April 10, 1876: Alexander Turney Stewart, renowned New York City merchant, died.June 25, 1876: General George Armstrong Custer, commander of the 7th Cavalry, is killed, along with more than 200 of his men, at the Battle of the Little Bighorn.July 4, 1876: The United States celebrated its centennial with celebrations in cities and towns across the country.August 2, 1876: Wild Bill Hickok, gunfighter and lawman, was shot and killed while playing cards in Deadwood, Dakota Territory.August 25, 1876: The first crossing of the unfinished Brooklyn Bridge was accomplished by its master mechanic, E.F. Farrington, riding on a wire strung between its towers.November 7, 1876: The United States presidential election of 1876 was disputed and became the most controversial American election until the election of 2000. 1877 January 4, 1877: Cornelius Vanderbilt, known as The Commodore, died in New York City. He was by far the wealthiest person in the United States.Early 1877: An electoral commission was formed to settle the disputed presidential election of 1876 results in the Compromise of 1877. Rutherford B. Hayes was declared the winner of the election, and Reconstruction was effectively brought to an end.March 4, 1877: Rutherford B. Hayes was  inaugurated as president, and comes into office under a cloud of suspicion, being called His Fraudulency.May 1877: Sitting Bull led followers into Canada to escape the U.S. Army, and Crazy Horse surrendered to U.S. troops.June 21, 1877: Leaders of the Molly Maguires, a secret society of coal miners in Pennsylvania, were executed.July 16, 1877: A strike in West Virginia set off the Great Railroad Strike of 1877, which spread nationwide and spurred violent clashes in American cities.September 5, 1877: Crazy Horse was killed at an army base in Kansas. 1878 February 19, 1878: Thomas A. Edison patented the phonograph, which would rank as one of his most important inventions.April 12, 1878: William M.  Boss Tweed, the legendary head of Tammany Hall, died in jail in New York City at the age of 55.Summer 1878: The head of the Statue of Liberty was displayed in a park in Paris during an international exhibition.November 1878: The Second Anglo-Afghan War began when British troops began invading Afghanistan. 1879 April 30, 1879: Sarah J. Hale, a magazine editor who urged President Lincoln to make Thanksgiving an official holiday, died at the age of 90.August 21, 1879: Villagers at Knock, in rural Ireland, saw visions of the Virgin Mary, St. Joseph, and St. John the Evangelist. The village became a place of Catholic pilgrimage afterward.October 1879: In Ireland, following mass meetings held earlier in the year, the Land League  was  formed to organize tenant farmers.