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Title of Assignment: Comprehensive Health History
Purpose of Assignment: The first part of a health assessment is
the history. It is contains critical information about the client. It
is important for the nurse to feel comfortable asking all types of
questions and to be able to identify the pertinent information for
that client. This assignment is a comprehensive health history
which would normally be done for a new client to a practice or
admission.
Course Competency(s): Identify the foundations of health
assessment.
Instructions: Using the provided form to guide the interview,
collect as much information as the client is willing to divulge.
In a combination of bulleted and narrative formatting, document
the information gathered. Try not to be too wordy but, at the
same time, be comprehensive in your documentation.
Remember this is subjective information and should only be
what the client tells you. Avoid making judgments until you
determine what the strengths and weaknesses are. Submit this as
a word document
Grading Rubric:
See history form.
FIN 336 Final Project Guidelines and Rubric
Overview
The final project for this course is the creation of a
multinational performance report. The report will investigate
the motivation behind expanding business
internationally, whether revenue-related, cost-related, or a
combination of both. You will gain a better understanding of
international business and the factors
that make multinational business complex (e.g., risk
management, ethical and legal compliance). As you work
though this project, you will explore how the
2007–2008 financial crisis affected multinational corporations
(MNCs), with both additional opportunities and potential risks.
The project is divided into two milestones, which will be
submitted at various points throughout the course to scaffold
learning and ensure quality final
submissions. These milestones will be submitted in Modules
Two and Five. The final product will be submitted in Module
Seven.
In order to successfully complete this project, you will choose a
multinational company from the Final Project Company List
document and access the following
financial reports:
ement of cash flows
–2008 annual report
In order to access this information, follow the steps in the
Mergent Online Instructions document to access the Mergent
Online database. P lease ensure that you
select forms based on the company’s most recent tax
submission. The annual report is also available on the U.S.
Securities and Exchange Commission website.
In this assignment, you will demonstrate your mastery of the
following course outcomes:
-336-01: Analyze the impact of legal and ethical
challenges on stakeholders for supporting an organization’s
conduct and decision making in global
markets
-336-02: Analyze risks and financial factors associated
with multinational corporate expansion for informing strategic
financial decisions and
mitigating risk
-336-03: Assess multinational expansion factors for
ensuring alignment with corporate strategies based on economic
environments and market
conditions
1
https://learn.snhu.edu/d2l/lor/viewer/view.d2l?ou=6606&loIdent
Id=21599
https://learn.snhu.edu/d2l/lor/viewer/view.d2l?ou=6606&loIdent
Id=21598
http://www.sec.gov/
Prompt
Develop a report that analyzes one company’s approach to
multinational expansion and includes financial factors such as
economic environments and market
conditions, risk mitigation strategies, and ethical and legal
practices.
Specifically, the following critical elements must be addressed:
I. Company Overview: Use the company’s website and 10-K
report to support responses for this section.
A. Describe the company’s background, including its industry
and extent of its multinational reach for identifying expansion
factors and corporate
strategies. [FIN-336-03]
II. Economic Environments and Market Conditions: Use the
2007-2008 annual report and the most current annual report to
support responses for this
section.
A. Identify international financial markets in which the
company operates, such as stock markets, bond markets, and
money markets, for
explaining how the company raises capital within these markets.
[FIN-336-03]
B. Discuss effects of the global credit crisis on the company’s
ability to raise capital required to support its expansion and
operations, and provide
examples to support your claims. [FIN-336-03]
C. Explain the role of international financial markets and
institutions in global environments in evaluating their impact on
the company’s risk
management strategies. [FIN-336-03]
D. Analyze impacts of exchange rate on the company’s
performance for determining if a loss occurred because of
fluctuations or devaluations of
foreign currencies, providing examples from the past year to
support your claims. [FIN-336-03]
E. Assess the impact of the global financial crisis as it relates
to transaction, economy, and translation exposures with
consideration of liabilities
and assets in foreign currencies, and support your assessment
with financial information. [FIN-336-03]
III. Risk Mitigation: Examine sources of risk and risk reduction
methods available to multinational corporations. Use the 2007–
2008 annual report and the
most current annual report to support responses in this section.
A. Discuss techniques the company used to hedge foreign
exchange exposure such as the use of forwards, futures, options,
money markets, or
swap agreements, and support with financial information from
the past year. [FIN-336-02]
B. Discuss risks and financial factors associated with exchange
rates and interest rates for assessing how they inform the
company’s financial
management approaches. [FIN-336-02]
C. Discuss diversification in the company’s expansion model
for examining advantages or disadvantages, and provide
examples and financial
information from the past year to support your claims. [FIN-
336-02]
D. Discuss company strategies before and after the 2007–2008
crisis for determining possible reasons for the company’s
current financial
performance, and provide examples to support your claims.
[FIN-336-02]
2
IV. Ethical and Legal Considerations: Explain how the
company is maximizing shareholders’ value while maintaining
ethical and legal practices.
A. Discuss the company’s ethical and legal management
during the 2007–2008 crisis for evaluating its impacts on
international investing. [FIN-336-
01]
B. Analyze the impact of ethical and legal decisions on internal
stakeholders, including shareholders, for identifying strengths
and areas of
improvement in international expansion strategies. Provide
examples to support your claims. [FIN-336-01]
C. Discuss the impact of the company’s ethical and legal
decisions on external stakeholders, including the government,
culture, and environment
into which the company expanded, for identifying strengths and
areas of improvement in expansion strategies. Provide examples
to support
your claims. [FIN-336-01]
V. Future Risks and Challenges: Based on the company’s
financial information and your research, make informed
predictions about the company’s future
risks and challenges.
A. Discuss financial decisions for informing future approaches
to increase the company’s value based on trends in corporate
strategies and
financial information. [FIN-336-03]
B. Discuss ethical and legal considerations and approaches the
company may consider for supporting its value in global
markets. [FIN-336-01]
C. Discuss risk mitigation strategies the company may use
for avoiding potential financial crisis and informing
strategic financial decisions. [FIN-
336-02]
Milestones
Milestone One: Multinational Company Selection
In Module Two, you will submit a company overview based on
your selected company as well as specific critical elements from
Section II: Economic
Environments and Market Conditions and Section IV: Ethical
and Legal Considerations. This milestone will be graded with
the Milestone One Rubric.
Milestone Two: Economic Environments and Risk Mitigation
In Module Five, you will submit specific elements of Section II:
Economic Environments and Market conditions and Section III:
Risk Mitigation. This milestone
will be graded with the Milestone Two Rubric.
Final Submission: Multinational Performance Report
In Module Seven, you will submit your final project. It should
be a complete, polished artifact containing all of the critical
elements of the final product. It should
reflect the incorporation of feedback gained throughout the
course. This submission will be graded with the Final Project
Rubric.
Please note that Section II: Economic Environments and Market
Conditions, Section III: Risk Mitigation, and Section IV: Future
Risks and Challenges need to
be submitted in addition to the revised milestones.
3
Final Project Rubric
Guidelines for Submission: Your multinational performance
report must be 5 to 8 pages in length (plus a cover page and
references) and must be written in APA
format. Use double spacing, 12-point Times New Roman font,
and one-inch margins. Cite references in APA format.
Critical Elements Exemplary (100%) Proficient (85%) Needs
Improvement (55%) Not Evident (0%) Value
Company
Overview:
Company
Background
[FIN-336-03]
Meets “Proficient” criteria and
description demonstrates
sophisticated awareness of
expansion factors and company’s
corporate strategies
Describes the company’s
background, including its
industry and extent of its
multinational reach for
identifying expansion factors and
corporate strategies
Describes the company’s
background, including its
industry and extent of its
multinational reach for
identifying expansion factors and
corporate strategies, but
description is cursory or contains
inaccuracies
Does not describe the company’s
background
4.52
Economic
Environments and
Market Conditions:
International
Financial Markets
[FIN-336-03]
Meets “Proficient” criteria and
explanation demonstrates a
nuanced understanding of how
the company raises capital in
identified markets
Identifies international financial
markets in which the company
operates, such as stock markets,
bond markets, and money
markets, for explaining how the
company raises capital within
these markets
Identifies international financial
markets in which the company
operates for explaining how the
company raises capital within
those markets, but explanation is
cursory, illogical, or missing key
elements
Does not identify international
financial markets in which the
company operates
4.52
Economic
Environments and
Market Conditions:
Global Credit Crisis
[FIN-336-03]
Meets “Proficient” criteria and
examples used illustrate a
sophisticated understanding of
the effects of the global credit
crisis on the company’s ability to
raise capital required to support
its expansion and operations
Discusses effects of the global
credit crisis on the company’s
ability to raise capital required to
support its expansion and
operations, and provides
examples to support claims
Discusses effects of the global
credit crisis on the company’s
ability to raise capital required to
support its expansion and
operations, but discussion is
cursory or contains inaccuracies
or examples provided are
illogical
Does not discuss effects of the
global credit crisis on the
company’s ability to raise capital
required to support its expansion
and operations
4.52
Economic
Environments and
Market Conditions:
Financial Markets
and Institutions
[FIN-336-03]
Meets “Proficient” criteria and
explanation demonstrates a
nuanced understanding of the
role of international financial
markets and institutions and
their impact on the company’s
risk management strategies
Explains the role of international
financial markets and institutions
in global environments in
evaluating their impact on the
company’s risk management
strategies
Explains the role of international
financial markets and institutions
in global environments in
evaluating their impact on the
company’s risk management
strategies, but explanation is
cursory, illogical, or missing key
elements
Does not explain the role of
international financial markets
and institutions in global
environments
4.52
4
Critical Elements Exemplary (100%) Proficient (85%) Needs
Improvement (55%) Not Evident (0%) Value
Economic
Environments and
Market Conditions:
Impacts of
Exchange Rate
[FIN-336-03]
Meets “Proficient” criteria and
examples provided illustrate a
nuanced understanding of the
impacts of exchange rate
Analyzes impacts of exchange
rate on the company’s
performance for determining if a
loss occurred because of
fluctuations or devaluations of
foreign currencies, and provides
examples from the past year to
support claims
Analyzes impacts of exchange
rate on the company’s
performance for determining if a
loss occurred because of
fluctuations or devaluations of
foreign currencies, and provides
examples from the past year to
support claims, but analysis or
examples provided are cursory,
illogical, missing key elements or
contain inaccuracies
Does not analyze impacts of
exchange rate on the company’s
performance
4.52
Economic
Environments and
Market Conditions:
Global Financial
Crisis
[FIN-336-03]
Meets “Proficient” criteria and
supporting financial information
demonstrates a sophisticated
awareness of the impact of the
global financial crisis on
transaction, economy, and
translation exposures
Assesses the impact of the global
financial crisis as it relates to
transaction, economy, and
translation exposures with
consideration of liabilities and
assets in foreign currencies, and
supports assessment with
financial information
Assesses the impact of the global
financial crisis as it relates to
transaction, economy, and
translation exposures with
consideration of liabilities and
assets in foreign currencies, and
supports assessment with
financial information, but
assessment or supporting
information is cursory, illogical,
missing key elements or contains
inaccuracies
Does not assess the impact of
the global financial crisis as it
relates to transaction, economy,
and translation exposures
4.52
Risk Mitigation:
Hedge Foreign
Exchange Exposure
[FIN-336-02]
Meets “Proficient” criteria and
supporting financial information
demonstrates a sophisticated
awareness of techniques the
company used to hedge foreign
exchange exposure
Discusses techniques the
company used to hedge foreign
exchange exposure such as the
use of forwards, futures, options,
money markets, or swap
agreements, and supports with
financial information from the
past year
Discusses techniques the
company used to hedge foreign
exchange exposure such as the
use of forwards, futures, options,
money markets, or swap
agreements, and supports with
financial information from the
past year, but discussion or
supporting information is cursory
or illogical or contains
inaccuracies
Does not discuss techniques the
company used to hedge foreign
exchange exposure
6.33
5
Critical Elements Exemplary (100%) Proficient (85%) Needs
Improvement (55%) Not Evident (0%) Value
Risk Mitigation:
Exchange Rates and
Interest Rates
[FIN-336-02]
Meets “Proficient” criteria and
the discussion demonstrates
sophisticated awareness of how
exchange rates and interest rates
inform the company’s financial
management approaches
Discusses risks and financial
factors associated with exchange
rates and interest rates for
assessing how they inform the
company’s financial
management approaches
Discusses risks and financial
factors associated with exchange
rates and interest rates for
assessing how they inform the
company’s financial
management approaches, but
discussion is cursory or illogical
or contains inaccuracies
Does not discuss risks and
financial factors associated with
exchange rates and interest rates
6.33
Risk Mitigation:
Diversification
[FIN-336-02]
Meets “Proficient” criteria and
supporting financial information
demonstrates a nuanced
understanding of diversification
in the company’s expansion
model
Discusses diversification in the
company’s expansion model for
examining advantages or
disadvantages, and provides
examples and financial
information from the past year
to support claims
Discusses diversification in the
company’s expansion model for
examining advantages or
disadvantages, and provides
examples and financial
information from the past year
to support claims, but discussion
or supporting financial
information is cursory or illogical
or contains inaccuracies
Does not discuss diversification
in the company’s expansion
model
6.33
Risk Mitigation:
Company
Strategies
[FIN-336-02]
Meets “Proficient” criteria and
articulation of supporting
examples demonstrates a
complex grasp of how the 2007–
2008 crisis impacted the
company
Discusses company strategies
before and after the 2007–2008
crisis for determining possible
reasons for the company’s
current financial performance,
and provides examples to
support claims
Discusses company strategies
before and after the 2007–2008
crisis for determining possible
reasons for the company’s
current financial performance,
and provides examples to
support claims, but discussion or
supporting examples are cursory
or illogical or contain
inaccuracies
Does not discuss company
strategies before and after the
2007–2008 crisis for determining
possible reasons for the
company’s current financial
performance
6.33
Ethical and Legal
Considerations:
Ethical and Legal
Management
[FIN-336-01]
Meets “Proficient” criteria and
response demonstrates a
sophisticated understanding of
ethical and legal management
during the 2007–2008 crisis and
its impacts on international
investing
Discusses the company’s ethical
and legal management during
the 2007–2008 crisis for
evaluating its impacts on
international investing
Discusses the company’s ethical
and legal management during
the 2007–2008 crisis for
evaluating its impacts on
international investing, but
discussion is cursory, inaccurate,
or missing key elements
Does not discuss the company’s
ethical and legal management
during the 2007–2008 crisis
7.92
6
Critical Elements Exemplary (100%) Proficient (85%) Needs
Improvement (55%) Not Evident (0%) Value
Ethical and Legal
Considerations:
Impact on Internal
Stakeholders
[FIN-336-01]
Meets “Proficient” criteria and
articulation of supporting
examples demonstrates a
sophisticated awareness of the
impact of ethical and legal
decisions on internal
stakeholders
Analyzes the impact of ethical
and legal decisions on internal
stakeholders, including
shareholders, for identifying
strengths and areas of
improvement in international
expansion strategies, and
provides examples to support
claims
Analyzes the impact of ethical
and legal decisions on internal
stakeholders, including
shareholders, for identifying
strengths and areas of
improvement in international
expansion strategies, and
provides examples to support
claims, but analysis or examples
are cursory or illogical
Does not analyze the impact of
ethical and legal decisions on
internal stakeholders
7.92
Ethical and Legal
Considerations:
Impact on External
Stakeholders
[FIN-336-01]
Meets “Proficient” criteria and
articulation of supporting
examples demonstrates a
sophisticated awareness of the
impact of ethical and legal
decisions on external
stakeholders
Discusses the impact of the
company’s ethical and legal
decisions on external
stakeholders, including the
government, culture, and
environment into which the
company expanded, for
identifying strengths and areas
of improvement in expansion
strategies, and provides
examples to support claims
Discusses the impact of the
company’s ethical and legal
decisions on external
stakeholders, including the
government, culture, and
environment into which the
company expanded, for
identifying strengths and areas
of improvement in expansion
strategies, and provides
examples to support claims, but
response or supporting examples
are cursory or illogical
Does not discuss the impact of
the company’s ethical and legal
decisions on external
stakeholders
7.92
Future Risks and
Challenges:
Financial Decisions
[FIN-336-03]
Meets “Proficient” criteria and
response demonstrates a
sophisticated awareness of
financial decisions based on
trends in corporate strategies
and financial information
Discusses financial decisions for
informing future approaches to
increase the company’s value
based on trends in corporate
strategies and financial
information
Discusses financial decisions for
informing future approaches to
increase the company’s value
based on trends in corporate
strategies and financial
information, but response is
cursory or illogical
Does not discuss financial
decisions for informing future
approaches to increase the
company’s value
4.52
Future Risks and
Challenges: Ethical
and Legal
Considerations
[FIN-336-01]
Meets “Proficient” criteria and
response demonstrates a
nuanced understanding of
ethical and legal considerations
that support the company’s
value in global markets
Discusses ethical and legal
considerations and approaches
the company may consider for
supporting its value in global
markets
Discusses ethical and legal
considerations and approaches
the company may consider for
supporting its value in global
markets, but response is cursory
or illogical
Does not discuss ethical and
legal considerations and
approaches the company may
consider
7.92
7
Critical Elements Exemplary (100%) Proficient (85%) Needs
Improvement (55%) Not Evident (0%) Value
Future Risks and
Challenges: Risk
Mitigation
Strategies
[FIN-336-02]
Meets “Proficient” criteria and
response demonstrates a
nuanced understanding of risk
mitigation strategies that inform
strategic financial decisions
Discusses risk mitigation
strategies the company may use
for avoiding potential financial
crisis and informing strategic
financial decisions
Discusses risk mitigation
strategies the company may use
for avoiding potential financial
crisis and informing strategic
financial decisions, but response
is cursory or illogical
Does not discuss risk mitigation
strategies the company may use
for avoiding potential financial
crisis
6.33
Articulation of
Response
Submission has no major errors
related to grammar, spelling,
syntax, or organization
Submission has few minor errors
related to organization,
grammar, and style
Submission has several errors
related to grammar, spelling,
syntax, or organization
Submission has major errors
related to grammar, spelling,
syntax, or organization that
negatively impact readability and
articulation of main ideas
5.03
Total 100%
8
FIN 336 Final Project Guidelines and
RubricOverviewPromptMilestonesMilestone One: Multinational
Company SelectionMilestone Two: Economic Environments
and Risk MitigationFinal Submission: Multinational
Performance ReportFinal Project Rubric
Comprehensive Health Assessment Form
(50 points)
Health History (5 pts total)
Biographical data: (1 pts)
No name or initial required
Age: ________ Marital status: ____M _____ S
_____Sep. ____Cohab.
Birth date: _____________________ Number of dependents:
___________________
Educational level: ________________________ Gender:
_____F _____ M _____Other
Occupation (current or, if retired, past):
______________________________________
Ethnicity/nationality: _____________________
Source of history (who gave you the information and how
reliable is that person):
_____________________________________________________
__________________
Present health history: (4 pts)
Current medical conditions/chronic illnesses:
Current medications:
Medication/food/environmental allergies:
Past health history:
(10 pts total)
Childhood illnesses: Ask about history of mumps, chickenpox,
rubella, ear infections, throat infections, pertussis, and asthma.
Hospitalizations/Surgeries: Include reason for hospitalization,
year, and surgical procedures.
Accidents/injuries: Include head injuries with loss of
consciousness, fractures, motor vehicle accidents, burns, and
severe lacerations.
Major diseases or illnesses: Include heart problems, cancer,
seizures, and any significant adult illnesses.
Immunizations (dates if known):
Tetanus _______ Diphtheria ________ Pertussis ________
Mumps ________
Rubella _______ Polio _____________ Hepatitis B ______
Influenza _______
Varicella ______ Other
____________________________________________
Recent travel/military services: Include travel within past year
and recent and past military service.
Date of last examinations:
Physical examination _________ Vision ___________ Dental
___________
Family History (Genogram) (
10points)
Mother/Father/Siblings/Grandparents: include age (date of
birth, if known), any major health issues, and, if indicated,
cause and age at death Present as a genogram.
Review of Systems (
12 points total) Be sure to ask about symptoms
specifically.
General health status (1 pt): Ask about fatigue, pain,
unexplained fever, night sweats, weakness, problems sleeping,
and unexplained changes in weight.
Integumentary (1 pt):
Skin: Ask about change in skin color/texture, excessive
bruising, itching, skin lesions, sores that do not heal, change in
mole. Do you use sun screen? How much sun exposure do you
experience?
Hair: Ask about changes in hair texture and recent hair loss.
Nails: Ask about changes in nail color and texture, splitting,
and cracking.
HEENT (2 pts):
Head: Ask about headaches, recent head trauma, injury or
surgery, history of concussion, dizziness, and loss of
consciousness.
Neck: Ask about neck stiffness, neck pain, lymph node
enlargement, and swelling or mass in the neck.
Eyes: Ask about change in vision, eye injury, itching, excessive
tearing, discharge, pain, floaters, halos around lights, flashing
lights, light sensitivity, and difficulty reading. Do you use
corrective lenses (glasses or contact lenses)?
Ears: Ask about last hearing test, changes in hearing, ear pain,
drainage, vertigo, recurrent ear infections, ringing in ears,
excessive wax problems, use of hearing aids.
Nose, Nasopharynx, Sinuses: Ask about nasal discharge,
frequent nosebleeds, nasal obstruction, snoring, postnasal drip,
sneezing, allergies, use of recreational drugs, change in smell,
sinus pain, sinus infections.
Mouth/Oropharynx: Ask about sore throats, mouth sores,
bleeding gums, hoarseness, change voice quality, difficulty
chewing or swallowing, change in taste, dentures and bridges.
Respiratory (1 pt):
Ask about frequent colds, pain with breathing, cough, coughing
up blood, shortness of breath, wheezing, night sweats, last chest
x-ray, PPD and results, and history of smoking.
Cardiovascular (1 pt.):
Ask about chest pain, palpitations, shortness of breath, edema,
coldness of extremities, color changes in hands and feet, hair
loss on legs, leg pain with activity, paresthesia, sores that do
not heal, and EKG and results.
Breasts (1 pt.): (Remember men have breasts too)
Ask about breast masses or lumps, pain, nipple discharge,
swelling, changes in appearance, cystic breast disease, breast
cancer, breast surgery, and reduction/enlargement. Do you
perform BSE (when and how)? Date of last clinical breast
examination, and mammograms and results.
Gastrointestinal (1 pt.):
Ask about changes in appetite, heartburn, gastroesophageal
reflux disease, pain, nausea/vomiting, vomiting blood, jaundice,
change in bowel habits, diarrhea, constipation, flatus, last fecal
occult blood test and colonoscopy and results.
Genitourinary (1 pt.):
Ask about pain on urination, burning, frequency, urgency,
incontinence, hesitancy, changes in urine stream, flank pain,
excessive urinary volume, decreased urinary volume, nocturia,
and blood in urine.
Female/male reproductive (1 pt.):
Both: Ask about lesions, discharge, pain or masses, change in
sex drive, infertility problems, history of STDs, knowledge of
STD prevention, safe sex practices, and painful intercourse. Are
you current involved in a sexual relationship? If yes,
heterosexual, homosexual,, bisexual? Number of sexual partners
in the last 3 months. Do you use birth control? If yes, method(s)
used.
Female: Ask about menarche, description of cycle, LMP,
painful menses, excessive bleeding, irregular menses, bleeding
between periods, last Pap test and results, painful intercourse,
pregnancies, live births, miscarriages, and abortions.
Male: Ask about prostate or scrotal problems, impotence or
sterility, satisfaction with sexual performance, frequency and
technique for TSE, and last prostate examination and results.
Musculoskeletal (1 pt.):
Ask about fractures, muscle pain, weakness, joint swelling,
joint pain, stiffness, limitations in mobility, back pain, loss of
height, and bone density scan and results.
Neurological (1 pt.): Ask about pain, fainting, seizures,
changes in cognition, changes in memory, sensory deficits such
as numbness, tingling and loss of sensation, problems with gait,
balance, and coordination, tremor, and spasm.
Psychosocial Profile (
10pts)
Health practices and beliefs/self-care activities: Ask about type
and frequency of exercise, type and frequency of self
examination, oral hygiene practice (frequency of
brushing/flossing), screening examinations (blood pressure,
prostate, breast, glucose, etc.)
Nutritional patterns: Ask about daily intake (24 hour recall) and
appetite.
Functional Ability: Ask if able to perform activities of daily
living such as dressing, bathing, eating, toileting and
instrumental activities of daily living like shopping, driving,
cooking.
Sleep/rest patterns: Ask about number of hours of sleep per
night, whether sleep is restful, naps, and use of sleep aids.
Personal habits (tobacco, alcohol, caffeine, and drugs): Ask
about type, amount, and years used.
Environmental history: Identify environment as urban/rural,
type of home (apartment, own home, condo)
Family/social relationships: Ask about significant others,
individuals in home
Cultural/religious influences: Identify any cultural and religious
influences on health.
Mental Health: Ask about anxiety, depression, irritability,
stressful events, and personal coping strategies.
Now answer the question below: (
3 pts)
Using the instructions below, identify 1 physical strength, 1
psychosocial/cognitive strength, and 1 weakness in either
category. State why you think this to be true.
With the information you collected, you can begin developing
an idea of a client’s weakness and strengths. What is a strength?
This might be that a person’s nutritional status appears to be
excellent. It may be that there is no impairment of mobility.
They may have lots of friends with them so be socially active.
What is a weakness? This might be that a person does have
impaired mobility or perhaps imbalanced nutrition – more than
or less than body requirements. It might be that they have a
communication issue that you note or perhaps seem to have a
depressed mood, seem alone/isolated.

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Title of Assignment Comprehensive Health History P.docx

  • 1. Title of Assignment: Comprehensive Health History Purpose of Assignment: The first part of a health assessment is the history. It is contains critical information about the client. It is important for the nurse to feel comfortable asking all types of questions and to be able to identify the pertinent information for that client. This assignment is a comprehensive health history which would normally be done for a new client to a practice or admission. Course Competency(s): Identify the foundations of health assessment. Instructions: Using the provided form to guide the interview, collect as much information as the client is willing to divulge. In a combination of bulleted and narrative formatting, document the information gathered. Try not to be too wordy but, at the same time, be comprehensive in your documentation. Remember this is subjective information and should only be what the client tells you. Avoid making judgments until you determine what the strengths and weaknesses are. Submit this as a word document Grading Rubric: See history form.
  • 2. FIN 336 Final Project Guidelines and Rubric Overview The final project for this course is the creation of a multinational performance report. The report will investigate the motivation behind expanding business internationally, whether revenue-related, cost-related, or a combination of both. You will gain a better understanding of international business and the factors that make multinational business complex (e.g., risk management, ethical and legal compliance). As you work though this project, you will explore how the 2007–2008 financial crisis affected multinational corporations (MNCs), with both additional opportunities and potential risks.
  • 3. The project is divided into two milestones, which will be submitted at various points throughout the course to scaffold learning and ensure quality final submissions. These milestones will be submitted in Modules Two and Five. The final product will be submitted in Module Seven. In order to successfully complete this project, you will choose a multinational company from the Final Project Company List document and access the following financial reports: ement of cash flows –2008 annual report In order to access this information, follow the steps in the Mergent Online Instructions document to access the Mergent Online database. P lease ensure that you select forms based on the company’s most recent tax submission. The annual report is also available on the U.S. Securities and Exchange Commission website. In this assignment, you will demonstrate your mastery of the following course outcomes: -336-01: Analyze the impact of legal and ethical
  • 4. challenges on stakeholders for supporting an organization’s conduct and decision making in global markets -336-02: Analyze risks and financial factors associated with multinational corporate expansion for informing strategic financial decisions and mitigating risk -336-03: Assess multinational expansion factors for ensuring alignment with corporate strategies based on economic environments and market conditions 1 https://learn.snhu.edu/d2l/lor/viewer/view.d2l?ou=6606&loIdent Id=21599 https://learn.snhu.edu/d2l/lor/viewer/view.d2l?ou=6606&loIdent Id=21598 http://www.sec.gov/
  • 5. Prompt Develop a report that analyzes one company’s approach to multinational expansion and includes financial factors such as economic environments and market conditions, risk mitigation strategies, and ethical and legal practices. Specifically, the following critical elements must be addressed: I. Company Overview: Use the company’s website and 10-K report to support responses for this section. A. Describe the company’s background, including its industry and extent of its multinational reach for identifying expansion factors and corporate strategies. [FIN-336-03] II. Economic Environments and Market Conditions: Use the 2007-2008 annual report and the most current annual report to support responses for this section. A. Identify international financial markets in which the company operates, such as stock markets, bond markets, and money markets, for explaining how the company raises capital within these markets. [FIN-336-03] B. Discuss effects of the global credit crisis on the company’s
  • 6. ability to raise capital required to support its expansion and operations, and provide examples to support your claims. [FIN-336-03] C. Explain the role of international financial markets and institutions in global environments in evaluating their impact on the company’s risk management strategies. [FIN-336-03] D. Analyze impacts of exchange rate on the company’s performance for determining if a loss occurred because of fluctuations or devaluations of foreign currencies, providing examples from the past year to support your claims. [FIN-336-03] E. Assess the impact of the global financial crisis as it relates to transaction, economy, and translation exposures with consideration of liabilities and assets in foreign currencies, and support your assessment with financial information. [FIN-336-03] III. Risk Mitigation: Examine sources of risk and risk reduction methods available to multinational corporations. Use the 2007– 2008 annual report and the most current annual report to support responses in this section. A. Discuss techniques the company used to hedge foreign exchange exposure such as the use of forwards, futures, options, money markets, or swap agreements, and support with financial information from the past year. [FIN-336-02] B. Discuss risks and financial factors associated with exchange rates and interest rates for assessing how they inform the company’s financial management approaches. [FIN-336-02]
  • 7. C. Discuss diversification in the company’s expansion model for examining advantages or disadvantages, and provide examples and financial information from the past year to support your claims. [FIN- 336-02] D. Discuss company strategies before and after the 2007–2008 crisis for determining possible reasons for the company’s current financial performance, and provide examples to support your claims. [FIN-336-02] 2 IV. Ethical and Legal Considerations: Explain how the
  • 8. company is maximizing shareholders’ value while maintaining ethical and legal practices. A. Discuss the company’s ethical and legal management during the 2007–2008 crisis for evaluating its impacts on international investing. [FIN-336- 01] B. Analyze the impact of ethical and legal decisions on internal stakeholders, including shareholders, for identifying strengths and areas of improvement in international expansion strategies. Provide examples to support your claims. [FIN-336-01] C. Discuss the impact of the company’s ethical and legal decisions on external stakeholders, including the government, culture, and environment into which the company expanded, for identifying strengths and areas of improvement in expansion strategies. Provide examples to support your claims. [FIN-336-01] V. Future Risks and Challenges: Based on the company’s financial information and your research, make informed predictions about the company’s future risks and challenges. A. Discuss financial decisions for informing future approaches to increase the company’s value based on trends in corporate strategies and financial information. [FIN-336-03] B. Discuss ethical and legal considerations and approaches the company may consider for supporting its value in global markets. [FIN-336-01] C. Discuss risk mitigation strategies the company may use
  • 9. for avoiding potential financial crisis and informing strategic financial decisions. [FIN- 336-02] Milestones Milestone One: Multinational Company Selection In Module Two, you will submit a company overview based on your selected company as well as specific critical elements from Section II: Economic Environments and Market Conditions and Section IV: Ethical and Legal Considerations. This milestone will be graded with the Milestone One Rubric. Milestone Two: Economic Environments and Risk Mitigation In Module Five, you will submit specific elements of Section II: Economic Environments and Market conditions and Section III: Risk Mitigation. This milestone will be graded with the Milestone Two Rubric. Final Submission: Multinational Performance Report In Module Seven, you will submit your final project. It should be a complete, polished artifact containing all of the critical elements of the final product. It should reflect the incorporation of feedback gained throughout the course. This submission will be graded with the Final Project Rubric. Please note that Section II: Economic Environments and Market Conditions, Section III: Risk Mitigation, and Section IV: Future Risks and Challenges need to be submitted in addition to the revised milestones. 3
  • 10.
  • 11. Final Project Rubric Guidelines for Submission: Your multinational performance report must be 5 to 8 pages in length (plus a cover page and references) and must be written in APA format. Use double spacing, 12-point Times New Roman font, and one-inch margins. Cite references in APA format. Critical Elements Exemplary (100%) Proficient (85%) Needs Improvement (55%) Not Evident (0%) Value Company Overview: Company
  • 12. Background [FIN-336-03] Meets “Proficient” criteria and description demonstrates sophisticated awareness of expansion factors and company’s corporate strategies Describes the company’s background, including its industry and extent of its multinational reach for identifying expansion factors and corporate strategies Describes the company’s background, including its industry and extent of its multinational reach for identifying expansion factors and corporate strategies, but description is cursory or contains inaccuracies Does not describe the company’s background 4.52 Economic Environments and Market Conditions: International Financial Markets
  • 13. [FIN-336-03] Meets “Proficient” criteria and explanation demonstrates a nuanced understanding of how the company raises capital in identified markets Identifies international financial markets in which the company operates, such as stock markets, bond markets, and money markets, for explaining how the company raises capital within these markets Identifies international financial markets in which the company operates for explaining how the company raises capital within those markets, but explanation is cursory, illogical, or missing key elements Does not identify international financial markets in which the company operates 4.52 Economic Environments and Market Conditions: Global Credit Crisis
  • 14. [FIN-336-03] Meets “Proficient” criteria and examples used illustrate a sophisticated understanding of the effects of the global credit crisis on the company’s ability to raise capital required to support its expansion and operations Discusses effects of the global credit crisis on the company’s ability to raise capital required to support its expansion and operations, and provides examples to support claims Discusses effects of the global credit crisis on the company’s ability to raise capital required to support its expansion and operations, but discussion is cursory or contains inaccuracies or examples provided are illogical Does not discuss effects of the global credit crisis on the company’s ability to raise capital required to support its expansion and operations 4.52 Economic Environments and
  • 15. Market Conditions: Financial Markets and Institutions [FIN-336-03] Meets “Proficient” criteria and explanation demonstrates a nuanced understanding of the role of international financial markets and institutions and their impact on the company’s risk management strategies Explains the role of international financial markets and institutions in global environments in evaluating their impact on the company’s risk management strategies Explains the role of international financial markets and institutions in global environments in evaluating their impact on the company’s risk management strategies, but explanation is cursory, illogical, or missing key elements Does not explain the role of international financial markets and institutions in global environments 4.52
  • 16. 4
  • 17. Critical Elements Exemplary (100%) Proficient (85%) Needs Improvement (55%) Not Evident (0%) Value Economic Environments and Market Conditions: Impacts of Exchange Rate
  • 18. [FIN-336-03] Meets “Proficient” criteria and examples provided illustrate a nuanced understanding of the impacts of exchange rate Analyzes impacts of exchange rate on the company’s performance for determining if a loss occurred because of fluctuations or devaluations of foreign currencies, and provides examples from the past year to support claims Analyzes impacts of exchange rate on the company’s performance for determining if a loss occurred because of fluctuations or devaluations of foreign currencies, and provides examples from the past year to support claims, but analysis or examples provided are cursory, illogical, missing key elements or contain inaccuracies Does not analyze impacts of exchange rate on the company’s performance 4.52 Economic Environments and
  • 19. Market Conditions: Global Financial Crisis [FIN-336-03] Meets “Proficient” criteria and supporting financial information demonstrates a sophisticated awareness of the impact of the global financial crisis on transaction, economy, and translation exposures Assesses the impact of the global financial crisis as it relates to transaction, economy, and translation exposures with consideration of liabilities and assets in foreign currencies, and supports assessment with financial information Assesses the impact of the global financial crisis as it relates to transaction, economy, and translation exposures with consideration of liabilities and assets in foreign currencies, and supports assessment with financial information, but assessment or supporting information is cursory, illogical, missing key elements or contains inaccuracies
  • 20. Does not assess the impact of the global financial crisis as it relates to transaction, economy, and translation exposures 4.52 Risk Mitigation: Hedge Foreign Exchange Exposure [FIN-336-02] Meets “Proficient” criteria and supporting financial information demonstrates a sophisticated awareness of techniques the company used to hedge foreign exchange exposure Discusses techniques the company used to hedge foreign exchange exposure such as the use of forwards, futures, options, money markets, or swap agreements, and supports with financial information from the past year Discusses techniques the company used to hedge foreign exchange exposure such as the use of forwards, futures, options, money markets, or swap agreements, and supports with
  • 21. financial information from the past year, but discussion or supporting information is cursory or illogical or contains inaccuracies Does not discuss techniques the company used to hedge foreign exchange exposure 6.33 5
  • 22. Critical Elements Exemplary (100%) Proficient (85%) Needs Improvement (55%) Not Evident (0%) Value Risk Mitigation: Exchange Rates and Interest Rates [FIN-336-02] Meets “Proficient” criteria and the discussion demonstrates sophisticated awareness of how exchange rates and interest rates inform the company’s financial management approaches Discusses risks and financial factors associated with exchange
  • 23. rates and interest rates for assessing how they inform the company’s financial management approaches Discusses risks and financial factors associated with exchange rates and interest rates for assessing how they inform the company’s financial management approaches, but discussion is cursory or illogical or contains inaccuracies Does not discuss risks and financial factors associated with exchange rates and interest rates 6.33 Risk Mitigation: Diversification [FIN-336-02] Meets “Proficient” criteria and supporting financial information demonstrates a nuanced understanding of diversification in the company’s expansion model Discusses diversification in the company’s expansion model for examining advantages or disadvantages, and provides examples and financial
  • 24. information from the past year to support claims Discusses diversification in the company’s expansion model for examining advantages or disadvantages, and provides examples and financial information from the past year to support claims, but discussion or supporting financial information is cursory or illogical or contains inaccuracies Does not discuss diversification in the company’s expansion model 6.33 Risk Mitigation: Company Strategies [FIN-336-02] Meets “Proficient” criteria and articulation of supporting examples demonstrates a complex grasp of how the 2007– 2008 crisis impacted the company Discusses company strategies before and after the 2007–2008 crisis for determining possible
  • 25. reasons for the company’s current financial performance, and provides examples to support claims Discusses company strategies before and after the 2007–2008 crisis for determining possible reasons for the company’s current financial performance, and provides examples to support claims, but discussion or supporting examples are cursory or illogical or contain inaccuracies Does not discuss company strategies before and after the 2007–2008 crisis for determining possible reasons for the company’s current financial performance 6.33 Ethical and Legal Considerations: Ethical and Legal Management [FIN-336-01] Meets “Proficient” criteria and response demonstrates a sophisticated understanding of ethical and legal management
  • 26. during the 2007–2008 crisis and its impacts on international investing Discusses the company’s ethical and legal management during the 2007–2008 crisis for evaluating its impacts on international investing Discusses the company’s ethical and legal management during the 2007–2008 crisis for evaluating its impacts on international investing, but discussion is cursory, inaccurate, or missing key elements Does not discuss the company’s ethical and legal management during the 2007–2008 crisis 7.92 6
  • 27.
  • 28. Critical Elements Exemplary (100%) Proficient (85%) Needs Improvement (55%) Not Evident (0%) Value Ethical and Legal Considerations: Impact on Internal Stakeholders [FIN-336-01]
  • 29. Meets “Proficient” criteria and articulation of supporting examples demonstrates a sophisticated awareness of the impact of ethical and legal decisions on internal stakeholders Analyzes the impact of ethical and legal decisions on internal stakeholders, including shareholders, for identifying strengths and areas of improvement in international expansion strategies, and provides examples to support claims Analyzes the impact of ethical and legal decisions on internal stakeholders, including shareholders, for identifying strengths and areas of improvement in international expansion strategies, and provides examples to support claims, but analysis or examples are cursory or illogical Does not analyze the impact of ethical and legal decisions on internal stakeholders 7.92 Ethical and Legal
  • 30. Considerations: Impact on External Stakeholders [FIN-336-01] Meets “Proficient” criteria and articulation of supporting examples demonstrates a sophisticated awareness of the impact of ethical and legal decisions on external stakeholders Discusses the impact of the company’s ethical and legal decisions on external stakeholders, including the government, culture, and environment into which the company expanded, for identifying strengths and areas of improvement in expansion strategies, and provides examples to support claims Discusses the impact of the company’s ethical and legal decisions on external stakeholders, including the government, culture, and environment into which the company expanded, for identifying strengths and areas of improvement in expansion strategies, and provides
  • 31. examples to support claims, but response or supporting examples are cursory or illogical Does not discuss the impact of the company’s ethical and legal decisions on external stakeholders 7.92 Future Risks and Challenges: Financial Decisions [FIN-336-03] Meets “Proficient” criteria and response demonstrates a sophisticated awareness of financial decisions based on trends in corporate strategies and financial information Discusses financial decisions for informing future approaches to increase the company’s value based on trends in corporate strategies and financial information Discusses financial decisions for informing future approaches to increase the company’s value based on trends in corporate strategies and financial
  • 32. information, but response is cursory or illogical Does not discuss financial decisions for informing future approaches to increase the company’s value 4.52 Future Risks and Challenges: Ethical and Legal Considerations [FIN-336-01] Meets “Proficient” criteria and response demonstrates a nuanced understanding of ethical and legal considerations that support the company’s value in global markets Discusses ethical and legal considerations and approaches the company may consider for supporting its value in global markets Discusses ethical and legal considerations and approaches the company may consider for supporting its value in global markets, but response is cursory
  • 33. or illogical Does not discuss ethical and legal considerations and approaches the company may consider 7.92 7 Critical Elements Exemplary (100%) Proficient (85%) Needs Improvement (55%) Not Evident (0%) Value Future Risks and Challenges: Risk Mitigation
  • 34. Strategies [FIN-336-02] Meets “Proficient” criteria and response demonstrates a nuanced understanding of risk mitigation strategies that inform strategic financial decisions Discusses risk mitigation strategies the company may use for avoiding potential financial crisis and informing strategic financial decisions Discusses risk mitigation strategies the company may use for avoiding potential financial crisis and informing strategic financial decisions, but response is cursory or illogical Does not discuss risk mitigation strategies the company may use for avoiding potential financial crisis 6.33 Articulation of Response Submission has no major errors related to grammar, spelling, syntax, or organization
  • 35. Submission has few minor errors related to organization, grammar, and style Submission has several errors related to grammar, spelling, syntax, or organization Submission has major errors related to grammar, spelling, syntax, or organization that negatively impact readability and articulation of main ideas 5.03 Total 100% 8 FIN 336 Final Project Guidelines and RubricOverviewPromptMilestonesMilestone One: Multinational Company SelectionMilestone Two: Economic Environments and Risk MitigationFinal Submission: Multinational Performance ReportFinal Project Rubric Comprehensive Health Assessment Form (50 points) Health History (5 pts total) Biographical data: (1 pts) No name or initial required Age: ________ Marital status: ____M _____ S _____Sep. ____Cohab.
  • 36. Birth date: _____________________ Number of dependents: ___________________ Educational level: ________________________ Gender: _____F _____ M _____Other Occupation (current or, if retired, past): ______________________________________ Ethnicity/nationality: _____________________ Source of history (who gave you the information and how reliable is that person): _____________________________________________________ __________________ Present health history: (4 pts) Current medical conditions/chronic illnesses: Current medications: Medication/food/environmental allergies: Past health history: (10 pts total) Childhood illnesses: Ask about history of mumps, chickenpox, rubella, ear infections, throat infections, pertussis, and asthma. Hospitalizations/Surgeries: Include reason for hospitalization, year, and surgical procedures. Accidents/injuries: Include head injuries with loss of consciousness, fractures, motor vehicle accidents, burns, and severe lacerations.
  • 37. Major diseases or illnesses: Include heart problems, cancer, seizures, and any significant adult illnesses. Immunizations (dates if known): Tetanus _______ Diphtheria ________ Pertussis ________ Mumps ________ Rubella _______ Polio _____________ Hepatitis B ______ Influenza _______ Varicella ______ Other ____________________________________________ Recent travel/military services: Include travel within past year and recent and past military service. Date of last examinations: Physical examination _________ Vision ___________ Dental ___________ Family History (Genogram) ( 10points) Mother/Father/Siblings/Grandparents: include age (date of birth, if known), any major health issues, and, if indicated, cause and age at death Present as a genogram. Review of Systems ( 12 points total) Be sure to ask about symptoms specifically. General health status (1 pt): Ask about fatigue, pain, unexplained fever, night sweats, weakness, problems sleeping, and unexplained changes in weight. Integumentary (1 pt): Skin: Ask about change in skin color/texture, excessive
  • 38. bruising, itching, skin lesions, sores that do not heal, change in mole. Do you use sun screen? How much sun exposure do you experience? Hair: Ask about changes in hair texture and recent hair loss. Nails: Ask about changes in nail color and texture, splitting, and cracking. HEENT (2 pts): Head: Ask about headaches, recent head trauma, injury or surgery, history of concussion, dizziness, and loss of consciousness. Neck: Ask about neck stiffness, neck pain, lymph node enlargement, and swelling or mass in the neck. Eyes: Ask about change in vision, eye injury, itching, excessive tearing, discharge, pain, floaters, halos around lights, flashing lights, light sensitivity, and difficulty reading. Do you use corrective lenses (glasses or contact lenses)? Ears: Ask about last hearing test, changes in hearing, ear pain, drainage, vertigo, recurrent ear infections, ringing in ears, excessive wax problems, use of hearing aids. Nose, Nasopharynx, Sinuses: Ask about nasal discharge, frequent nosebleeds, nasal obstruction, snoring, postnasal drip, sneezing, allergies, use of recreational drugs, change in smell, sinus pain, sinus infections.
  • 39. Mouth/Oropharynx: Ask about sore throats, mouth sores, bleeding gums, hoarseness, change voice quality, difficulty chewing or swallowing, change in taste, dentures and bridges. Respiratory (1 pt): Ask about frequent colds, pain with breathing, cough, coughing up blood, shortness of breath, wheezing, night sweats, last chest x-ray, PPD and results, and history of smoking. Cardiovascular (1 pt.): Ask about chest pain, palpitations, shortness of breath, edema, coldness of extremities, color changes in hands and feet, hair loss on legs, leg pain with activity, paresthesia, sores that do not heal, and EKG and results. Breasts (1 pt.): (Remember men have breasts too) Ask about breast masses or lumps, pain, nipple discharge, swelling, changes in appearance, cystic breast disease, breast cancer, breast surgery, and reduction/enlargement. Do you perform BSE (when and how)? Date of last clinical breast examination, and mammograms and results. Gastrointestinal (1 pt.): Ask about changes in appetite, heartburn, gastroesophageal reflux disease, pain, nausea/vomiting, vomiting blood, jaundice, change in bowel habits, diarrhea, constipation, flatus, last fecal occult blood test and colonoscopy and results. Genitourinary (1 pt.): Ask about pain on urination, burning, frequency, urgency, incontinence, hesitancy, changes in urine stream, flank pain, excessive urinary volume, decreased urinary volume, nocturia, and blood in urine. Female/male reproductive (1 pt.): Both: Ask about lesions, discharge, pain or masses, change in
  • 40. sex drive, infertility problems, history of STDs, knowledge of STD prevention, safe sex practices, and painful intercourse. Are you current involved in a sexual relationship? If yes, heterosexual, homosexual,, bisexual? Number of sexual partners in the last 3 months. Do you use birth control? If yes, method(s) used. Female: Ask about menarche, description of cycle, LMP, painful menses, excessive bleeding, irregular menses, bleeding between periods, last Pap test and results, painful intercourse, pregnancies, live births, miscarriages, and abortions. Male: Ask about prostate or scrotal problems, impotence or sterility, satisfaction with sexual performance, frequency and technique for TSE, and last prostate examination and results. Musculoskeletal (1 pt.): Ask about fractures, muscle pain, weakness, joint swelling, joint pain, stiffness, limitations in mobility, back pain, loss of height, and bone density scan and results. Neurological (1 pt.): Ask about pain, fainting, seizures, changes in cognition, changes in memory, sensory deficits such as numbness, tingling and loss of sensation, problems with gait, balance, and coordination, tremor, and spasm. Psychosocial Profile ( 10pts) Health practices and beliefs/self-care activities: Ask about type and frequency of exercise, type and frequency of self examination, oral hygiene practice (frequency of brushing/flossing), screening examinations (blood pressure,
  • 41. prostate, breast, glucose, etc.) Nutritional patterns: Ask about daily intake (24 hour recall) and appetite. Functional Ability: Ask if able to perform activities of daily living such as dressing, bathing, eating, toileting and instrumental activities of daily living like shopping, driving, cooking. Sleep/rest patterns: Ask about number of hours of sleep per night, whether sleep is restful, naps, and use of sleep aids. Personal habits (tobacco, alcohol, caffeine, and drugs): Ask about type, amount, and years used. Environmental history: Identify environment as urban/rural, type of home (apartment, own home, condo) Family/social relationships: Ask about significant others, individuals in home Cultural/religious influences: Identify any cultural and religious influences on health. Mental Health: Ask about anxiety, depression, irritability, stressful events, and personal coping strategies. Now answer the question below: ( 3 pts)
  • 42. Using the instructions below, identify 1 physical strength, 1 psychosocial/cognitive strength, and 1 weakness in either category. State why you think this to be true. With the information you collected, you can begin developing an idea of a client’s weakness and strengths. What is a strength? This might be that a person’s nutritional status appears to be excellent. It may be that there is no impairment of mobility. They may have lots of friends with them so be socially active. What is a weakness? This might be that a person does have impaired mobility or perhaps imbalanced nutrition – more than or less than body requirements. It might be that they have a communication issue that you note or perhaps seem to have a depressed mood, seem alone/isolated.