Physician H amp P Stuart Little is a 77yearold man who p.pdf

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Physician H & P Stuart Little is a 77-year-old man who presents to Georgetown Public Hospital Corporation with a chief complaint of pain and swelling in his right leg. HPI: Patient was in his usual state of health until three days ago when he banged his right shin on the coffee table. He suffered a small abrasion which at the time seemed minor. Since that time it has not healed and is getting worse. The area surrounding the cut is bright red and warm to touch. The wound is oozing a foul smelling liquid. His right leg from the ankle to above his knee is swollen. As of last night he began to experience some fevers and chills and overall he is not feeling very well. PMH: HTN Type-2 DM Dyslipidemia OA CKD MEDS PTA: See Medication History Immunizations: Pneumonia vaccine Allergies: Sulfa SH: () Tobacco, (-) EtOH, (-) IVDA, Patient currently lives with his wife. FH: Significant for a father who died of complications of diabetes at age 75 and a mother who died of breast cancer at the age of 65 years. O: Vitals: BP=160/100mmHgHR=105bpm RR=18T=38.5C SaO2=95% on room air Ht=69 inches Wt=95kg Assessment Stuart Little is a newly admitted patient to the ER and your role as a pharmacist is to interview this patient to obtain his medication history i.e., the medications he uses at home. Please refer to the form provided to conduct this medication history..

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Assignment Details This Assignment will assess your ability to evaluate subjective and objective information in order to arrive at an appropriate diagnosis and treatment plan for the patient. Hypertension Case Study C.D is a 55-year-old African American male who presents to his primary care provider with a 2-day history of a headache and chest pressure. PMH Allergic Rhinitis Depression Hypothyroidism Family History Father died at age 49 from AMI: had HTN Mother has DM and HTN Brother died at age 20 from complications of CF Two younger sisters are A&W Social History The patient has been married for 25 years and lives with his wife and two children. The patient is an air traffic controller at the local airport. He has smoked a pack of cigarettes a day for the past 15 years. He drinks several beers every evening after work to relax. He does not pay particular attention to sodium, fat, or carbohydrates in the foods he eats. He admits to “salting almost everything he eats, sometimes even before tasting it.” He denies ever having dieted or exercised. Medications Zyrtec 10 mg daily Allergies Penicillin ROS States that his overall health has been fair to good during the past year. Weight has increased by approximately 30 pounds in the last 12 months. States he has been having some occasional chest pressure and headaches for the past 2 days. Shortness of breath at rest, headaches, nocturia, nosebleeds, and hemoptysis. Reports some shortness of breath with activity, especially when climbing stairs and that breathing difficulties are getting worse. Denies any nausea, vomiting, diarrhea, or blood in stool. Self treats for occasional right knee pain with OTC Ibuprofen. Denies any genitourinary symptoms. Vital Signs B/P 190/120, HR 73, RR 18, T. 98.8 F., Ht 6’1”, Wt 240 lbs. HEENT TMs intact and clear throughout No nasal drainage No exudates or erythema in oropharynx PERRLA Funduscopy reveals mild arteriolar narrowing without nicking, hemorrhages, exudates, or papilledema Neck Supple without masses or bruits Thyroid normal No lymphadenopathy Lungs Mild basilar crackles bilaterally No wheezes Heart RRR No murmurs or rubs Abdomen Soft and non-distended No masses, bruits, or organomegaly Normal bowel sounds Ext Moves all extremities well Neuro No sensory or motor abnormalities CN’s II-XII intact DTR’s = 2+ Muscle tone=5/5 throughout What you should do: Develop an evidence-based management plan. Include any pertinent diagnostics. Describe the patient education plan. Include cultural and lifespan considerations. Provide information on health promotion or health care maintenance needs. Describe the follow-up and referral for this patient. Prepare a 3–5-page paper (not including the title page or reference page). Assignment Requirements: Before finalizing your work, you should: be sure to read the Assignment description carefully (as displayed above); consult the Grading Rubric to make sure .

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Chief complaint: “I’m here for a medication refill because I ran out of my medicines”. HPI: Mrs. Allen is a 68-year-old African American who presents to the clinic for prescription refills. The patient indicates that she has noticed shortness of breath which started about 3 months ago. The SOB gets worse with exertion, especially when she is walking fast, and it is resolved when she is resting. She reports that she is also bothered by shortness of breath that wakes her up intermittently during her sleep. Her symptoms of shortness of breath resolve after sitting upright on 3 pillows. She also has lower leg edema pitting 1+ which started 2 weeks ago. She indicates that she often feels light headed at times with intermittent syncope episodes while going up a flight of stairs, but it resolves after sitting down to rest. She has not tried any over the counter medications at home. She started taking her medications, but failed to refill the prescriptions because she cannot afford the medications as she only works part-time and lives alone. In addition, she reports that she does not think taking all these medications would help her condition anyway. PMH: Primary Hypertension, Previous history of MI 1 year ago Surgeries: 1 year ago-Left Anterior Descending (LAD) cardiac stent placement Allergies : Penicillin Vaccination History: Up-to-date Social history: High school graduate married and no children. Drinks one 4-ounce glass of red wine daily. She is a former smoker and stopped 5 years ago. Family history: Both parents are alive. Father has history of MI and valvular heart disease; mother alive and cardiac history is unknown. He has one brother who is alive and has history of MI 5 years ago at age 52. ROS: Constitutional: Lightheaded and faint with exertion. Respiratory: Shortness of breath with exertion. + Orthopnea. Cardiovascular: + 2 pitting leg edema for 3 weeks. Psychiatric: Non-contributory. Physical examination: Vital Signs: Height: 5 feet 1 inches Weight: 175 pounds BMI: 32, Obese, BP 160/92, T 98.0, P 111, R 22 and non-labored HEENT : Normocephalic/Atraumatic, Bilateral cataracts; PERRLA, EOMI; Teeth intact. Negative for gum disease. NECK : Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement. LUNGS : + Mild Crackles on inspiratory phase not clearing with cough. Equal breath sounds. Symmetrical respiration. No respiratory distress. HEART : Normal S1 with S2 during expiration. An S4 is noted at the apex; + systolic murmur noted at the right upper sternal border without radiation to the carotids. Pulses are 2+ in upper extremities and 2+ in pedal pulses bilaterally. 2+ pitting edema to her knees noted bilaterally. ABDOMEN : No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses. GENITOURINARY : No CVA tenderness bilaterally. GU exam deferred. MUSCULOSKELETAL : + Heberden's nodes at the DIP joints, hands. + Crepitus, bilateral .

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Pharma Case Study week 8 Chief complaint: “I’m here for a medication refill because I ran out of my medicines”. HPI: Mrs. Allen is a 68-year-old African American who presents to the clinic for prescription refills. The patient indicates that she has noticed shortness of breath which started about 3 months ago. The SOB gets worse with exertion, especially when she is walking fast, and it is resolved when she is resting. She reports that she is also bothered by shortness of breath that wakes her up intermittently during her sleep. Her symptoms of shortness of breath resolve after sitting upright on 3 pillows. She also has lower leg edema pitting 1+ which started 2 weeks ago. She indicates that she often feels light headed at times with intermittent syncope episodes while going up a flight of stairs, but it resolves after sitting down to rest. She has not tried any over the counter medications at home. She started taking her medications, but failed to refill the prescriptions because she cannot afford the medications as she only works part-time and lives alone. In addition, she reports that she does not think taking all these medications would help her condition anyway. PMH: Primary Hypertension, Previous history of MI 1 year ago Surgeries: 1 year ago-Left Anterior Descending (LAD) cardiac stent placement Allergies: Penicillin Vaccination History: Up-to-date Social history: High school graduate married and no children. Drinks one 4-ounce glass of red wine daily. She is a former smoker and stopped 5 years ago. Family history: Both parents are alive. Father has history of MI and valvular heart disease; mother alive and cardiac history is unknown. He has one brother who is alive and has history of MI 5 years ago at age 52. ROS: Constitutional: Lightheaded and faint with exertion. Respiratory: Shortness of breath with exertion. + Orthopnea. Cardiovascular: + 2 pitting leg edema for 3 weeks. Psychiatric: Non-contributory. Physical examination: Vital Signs: Height: 5 feet 1 inches Weight: 175 pounds BMI: 32, Obese, BP 160/92, T 98.0, P 111, R 22 and non-labored HEENT: Normocephalic/Atraumatic, Bilateral cataracts; PERRLA, EOMI; Teeth intact. Negative for gum disease. NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement. LUNGS: + Mild Crackles on inspiratory phase not clearing with cough. Equal breath sounds. Symmetrical respiration. No respiratory distress. HEART: Normal S1 with S2 during expiration. An S4 is noted at the apex; + systolic murmur noted at the right upper sternal border without radiation to the carotids. Pulses are 2+ in upper extremities and 2+ in pedal pulses bilaterally. 2+ pitting edema to her knees noted bilaterally. ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses. GENITOURINARY: No CVA tenderness bilaterally. GU exam deferred. MUSCULOSKELETAL: + Heberden's nodes at the DIP joints, hands. + Crepitus, bil ...

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Case Study Chief complaint: “I’m here for a medication refill because I ran out of my medicines”. HPI: Mrs. Allen is a 68-year-old African American who presents to the clinic for prescription refills. The patient indicates that she has noticed shortness of breath which started about 3 months ago. The SOB gets worse with exertion, especially when she is walking fast, and it is resolved when she is resting. She reports that she is also bothered by shortness of breath that wakes her up intermittently during her sleep. Her symptoms of shortness of breath resolve after sitting upright on 3 pillows. She also has lower leg edema pitting 1+ which started 2 weeks ago. She indicates that she often feels light-headed at times with intermittent syncope episodes while going up a flight of stairs, but it resolves after sitting down to rest. She has not tried any over the counter medications at home. She started taking her medications but failed to refill the prescriptions because she cannot afford the medications as she only works part-time and lives alone. In addition, she reports that she does not think taking all these medications would help her condition anyway. PMH: Primary Hypertension, Previous history of MI 1 year ago Surgeries: 1 year ago-Left Anterior Descending (LAD) cardiac stent placement Allergies : Penicillin Vaccination History: Up-to-date Social history: High school graduates married and no children. Drinks one 4-ounce glass of red wine daily. She is a former smoker and stopped 5 years ago. Family history: Both parents are alive. Father has a history of MI and valvular heart disease; mother alive and cardiac history is unknown. He has one brother who is alive and has a history of MI 5 years ago at age 52. ROS: Constitutional: Lightheaded and faint with exertion. Respiratory: Shortness of breath with exertion. + Orthopnea. Cardiovascular: + 2 pitting leg edema for 3 weeks. Psychiatric: Non-contributory. Physical examination: Vital Signs: Height: 5 feet 1 inches Weight: 175 pounds BMI: 32, Obese, BP 160/92, T 98.0, P 111, R 22 and non-labored HEENT : Normocephalic/Atraumatic, Bilateral cataracts; PERRLA, EOMI; Teeth intact. Negative for gum disease. NECK : Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement. LUNGS : + Mild Crackles on inspiratory phase not clearing with cough. Equal breath sounds. Symmetrical respiration. No respiratory distress. HEART : Normal S1 with S2 during expiration. An S4 is noted at the apex; + systolic murmur noted at the right upper sternal border without radiation to the carotids. Pulses are 2+ in upper extremities and 2+ in pedal pulses bilaterally. 2+ pitting edema to her knees noted bilaterally. ABDOMEN : No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses. GENITOURINARY : No CVA tenderness bilaterally. GU exam deferred. MUSCULOSKELETAL : + Heberden's nodes at the DIP joints, hands. + Crep.

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Case Study: Chief complaint: “I’m here for a medication refill because I ran out of my medicines”. HPI: Mrs. Allen is a 68-year-old African American who presents to the clinic for prescription refills. The patient indicates that she has noticed shortness of breath which started about 3 months ago. The SOB gets worse with exertion, especially when she is walking fast, and it is resolved when she is resting. She reports that she is also bothered by shortness of breath that wakes her up intermittently during her sleep. Her symptoms of shortness of breath resolve after sitting upright on 3 pillows. She also has lower leg edema pitting 1+ which started 2 weeks ago. She indicates that she often feels light headed at times with intermittent syncope episodes while going up a flight of stairs, but it resolves after sitting down to rest. She has not tried any over the counter medications at home. She started taking her medications, but failed to refill the prescriptions because she cannot afford the medications as she only works part-time and lives alone. In addition, she reports that she does not think taking all these medications would help her condition anyway. PMH: Primary Hypertension, Previous history of MI 1 year ago Surgeries: 1 year ago-Left Anterior Descending (LAD) cardiac stent placement Allergies : Penicillin Vaccination History: Up-to-date Social history: High school graduate married and no children. Drinks one 4-ounce glass of red wine daily. She is a former smoker and stopped 5 years ago. Family history: Both parents are alive. Father has history of MI and valvular heart disease; mother alive and cardiac history is unknown. He has one brother who is alive and has history of MI 5 years ago at age 52. ROS: Constitutional: Lightheaded and faint with exertion. Respiratory: Shortness of breath with exertion. + Orthopnea. Cardiovascular: + 2 pitting leg edema for 3 weeks. Psychiatric: Non-contributory. Physical examination: Vital Signs: Height: 5 feet 1 inches Weight: 175 pounds BMI: 32, Obese, BP 160/92, T 98.0, P 111, R 22 and non-labored HEENT : Normocephalic/Atraumatic, Bilateral cataracts; PERRLA, EOMI; Teeth intact. Negative for gum disease. NECK : Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement. LUNGS : + Mild Crackles on inspiratory phase not clearing with cough. Equal breath sounds. Symmetrical respiration. No respiratory distress. HEART : Normal S1 with S2 during expiration. An S4 is noted at the apex; + systolic murmur noted at the right upper sternal border without radiation to the carotids. Pulses are 2+ in upper extremities and 2+ in pedal pulses bilaterally. 2+ pitting edema to her knees noted bilaterally. ABDOMEN : No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses. GENITOURINARY : No CVA tenderness bilaterally. GU exam deferred. MUSCULOSKELETAL : + Heberden's nodes at the DIP joints, hands. + Crepi.

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Comprehensive SOAP Exemplar Purpose: To demonstrate what each section of the SOAP Note should include. Remember that nurse practitioners treat patients in a holistic manner, and your SOAP Note should reflect that premise. Patient Initials: _______ Age: _______ Gender: _______ SUBJECTIVE DATA: Chief Complaint (CC): Coughing up phlegm and fever History of Present Illness (HPI): Sara Jones is a 65-year-old Caucasian female who presents today with a productive cough x 3 weeks and fever for the last 3 days. She reported that the “cold feels like it is descending into her chest.” The cough is nagging and productive. She brought in a few paper towels with expectorated phlegm – yellow/brown in color. She has associated symptoms of dyspnea of exertion and fever. Her Tmax was reported to be 102.4 last night. She has been taking Ibuprofen 400mg about every 6 hours and the fever breaks, but it returns after the medication wears off. She rated the severity of her symptom discomfort at 4/10. Medications: 1.) Lisinopril 10mg daily 2.) Combivent 2 puffs every 6 hours as needed 3.) Serovent daily 4.) Salmeterol daily 5.) Over-the-counter Ibuprofen 200mg -2 PO as needed 6.) Over-the-counter Benefiber 7.) Flonase 1 spray each night as needed for allergic rhinitis symptoms Allergies: Sulfa drugs - rash Past Medical History (PMH): 1.) Emphysema with recent exacerbation 1 month ago – deferred admission – RX’d with outpatient antibiotics and hand held nebulizer treatments. 2.) Hypertension – well controlled 3.) Gastroesophageal reflux (GERD) – quiet, on no medication 4.) Osteopenia 5.) Allergic rhinitis Past Surgical History (PSH): 1.) Cholecystectomy 1994 2.) Total abdominal hysterectomy (TAH) 1998 Sexual/Reproductive History: Heterosexual G1P1A0 Non-menstruating – TAH 1998 Personal/Social History: She has smoked 2 packs of cigarettes daily x 30 years; denied ETOH or illicit drug use. Immunization History: Her immunizations are up to date. She received the influenza vaccine last November and the Pneumococcal vaccine at the same time. Significant Family History: Two brothers – one with diabetes, dx at age 65, and the other with prostate CA, dx at age 62. She has one daughter in her 30s, healthy, living in nearby neighborhood. Lifestyle: She is retired, has been widowed x 8 years, and lives in the city in a moderate crime area with good public transportation. She is a college graduate, owns her home, and receives a pension of $50,000 annually – financially stable. She has a primary care nurse practitioner provider and goes for annual and routine care twice annually and as needed for episodic care. She has medical insurance but often asks for drug samples for cost savings. She has a healthy diet and eating pattern. There are resources and community groups in her area at the senior center that she attends regularly. She enjoys bingo. She has a good support system composed of family and friends. Review of Systems: General: + fatigue .

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Discussion # 13: Discuss the FDA approach for liver safety for new drugs. Support discussion with 1 journal no older than 5 years. Discussion Question #14 Discuss an advantage and one disadvantage of one non-narcotic drug used for chronic pain syndrome. Discussion week 15: (Worth 1 point) Discuss a current issue on a pharmacological agent and your opinion. Support with 1 peer reviewed journals no older than 5 years. Discussion #12 CARDIOVASCULAR CASE STUDY ACC/AHA Guidelines Chief complaint: medication refill " I ran out of medicines" HPI: E.D a 65-year-old AA male presents to the clinic for prescription refills. The patient also indicates that she has noticed shortness of breath which started about 4 months ago. The SOB gets worse with exertion, especially when she is walking fast and it is resolved when he is resting. He reports that she is also bothered by shortness of breath that wakes her up intermittently during her sleep. His symptoms of shortness of breath resolve after sitting upright on 3 pillows. He also has lower leg edema pitting 1+ which started 2 weeks ago. He also indicates that she often feels light headed at times with intermittent syncope episodes while going up a flight stairs, but it resolves after sitting down to rest. He has not tried any over the counter medications at home. He never filled her prescriptions that he received at her checkup 6 months ago, she did not think it was important. PMH: Primary Hypertension Previous history of MI 1 year ago Surgeries: 1 year ago-Left Anterior Descending (LAD) cardiac stent placement Allergies: Penicillin Vaccination History: He receives an annual flu shot. Last flu shot was this year Has not had a Td in over 10 years Has not had the herpes zoster vaccine Social history: High school graduate, married and no children. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago. Family history: Both parents are alive. Father has history of MI and valvular heart disease; mother alive and cardiac history is unknown. He has one brother who is alive and has history of MI 5 years ago at age 52. ROS: Constitutional: Lightheaded and faint with exertion. Respiratory: Shortness of breath with exertion. + Orthopnea Cardiovascular: + 2 pitting leg edema for 3 weeks. Psychiatric: Pt sated not taking medications for 6 months - "ran out and did not get refills" Physical examination: Vital Signs Height: 5 feet 1 inches Weight: 163 pounds BMI: 31 obesity, BP 157/87 T 98.0 po P 110 R 22, non-labored HEENT: Normocephalic/Atraumatic, Bilateral cataracts; PERRL, EOMI; No teeth loss seen. Gums no redness. NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement. LUNGS: + Mild Crackles on inspiratory phase no clearing with cough. Equal breath sounds. Symmetrical respiration. No respiratory distress. HEART: Normal S1 with S2 during expiration. An S4 is noted at the apex; + systolic murmur noted at the right upper sternal border without ra.

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Give an example from your own experience or research an article or the media in which a business executive did something of significance that is morally right. Use APA format to cite your material from your sources. Is there a relationship between obesity and socio-economic status? Should obese people be considered a protected class under Title VII of the Civil Rights Act? 1: 2: 3. 4. 5. Comprehensive SOAP Exemplar Purpose: To demonstrate what each section of the SOAP Note should include. Remember that nurse practitioners treat patients in a holistic manner, and your SOAP Note should reflect that premise. Patient Initials: _______ Age: _______ Gender: _______ SUBJECTIVE DATA: Chief Complaint (CC): Coughing up phlegm and fever History of Present Illness (HPI): Sara Jones is a 65-year-old Caucasian female who presents today with a productive cough x 3 weeks and fever for the last 3 days. She reported that the “cold feels like it is descending into her chest.” The cough is nagging and productive. She brought in a few paper towels with expectorated phlegm – yellow/brown in color. She has associated symptoms of dyspnea of exertion and fever. Her Tmax was reported to be 102.4 last night. She has been taking Ibuprofen 400mg about every 6 hours and the fever breaks, but it returns after the medication wears off. She rated the severity of her symptom discomfort at 4/10. Medications: 1.) Lisinopril 10mg daily 2.) Combivent 2 puffs every 6 hours as needed 3.) Serovent daily 4.) Salmeterol daily 5.) Over-the-counter Ibuprofen 200mg -2 PO as needed 6.) Over-the-counter Benefiber 7.) Flonase 1 spray each night as needed for allergic rhinitis symptoms Allergies: Sulfa drugs - rash Past Medical History (PMH): 1.) Emphysema with recent exacerbation 1 month ago – deferred admission – RX’d with outpatient antibiotics and hand held nebulizer treatments. 2.) Hypertension – well controlled 3.) Gastroesophageal reflux (GERD) – quiet, on no medication 4.) Osteopenia 5.) Allergic rhinitis Past Surgical History (PSH): 1.) Cholecystectomy 1994 2.) Total abdominal hysterectomy (TAH) 1998 Sexual/Reproductive History: Heterosexual G1P1A0 Non-menstruating – TAH 1998 Personal/Social History: She has smoked 2 packs of cigarettes daily x 30 years; denied ETOH or illicit drug use. Immunization History: Her immunizations are up to date. She received the influenza vaccine last November and the Pneumococcal vaccine at the same time. Significant Family History: Two brothers – one with diabetes, dx at age 65, and the other with prostate CA, dx at age 62. She has one daughter in her 30s, healthy, living in nearby neighborhood. Lifestyle: She is retired, has been widowed x 8 years, and lives in the city in a moderate crime area with good public transportation. She is a college graduate, owns her home, and receives a pension of $50,000 annually – financially stable. She has a primary care nurse practitioner provider and goes for annual and r ...

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Chief Complaint “My left foot feels weak and numb. I have a hard time pointing my toes up.” History of Present Illness D.T. is 42-year-old Caucasian woman who has had an elevated blood sugar and cholesterol 2 years ago but did not follow up with a clinical diagnostic work-up. She had participated in the state’s annual health screening program and noticed her fasting blood sugar was 160 and her cholesterol was 250. However, she felt “perfectly fine at the time” and did not want to take any more medications. Except for a number of “female infections,” she has felt fine recently.Today, she presents to the clinic complaining that her left foot has been weak and numb for nearly 3 weeks and that the foot is difficult to flex. She denies any other weakness or numbness at this time. She does report that she has been very thirsty lately and gets up more often at night to urinate. She has attributed these symptoms to the extremely warm weather and drinking more water to keep hydrated. She has gained a total of 50 pounds since her last pregnancy 10 years ago, 20 pounds in the last 6 months alone. Past Medical History Seasonal allergic rhinitis (since her early 20s)Breast biopsy positive for fibroadenoma at age 30Gestational diabetes with second child 10 years agoMultiple yeast infections during the past 3 years that she has self-treated with OTC antifungal creams and salt bathHypertension for 10 years Past Surgical History C-section 14 years ago OB-GYN History Menarche at age 11Last pap smear 3 years ago Family History Type 2 DM present in older brother and maternal grandfather. Both were diagnosed in their late 40s. Brother takes both pills and shots.Mother alive and wellFather has COPDTwo other siblings alive and wellAll three children are alive and well Social History Married 29 years with 3 children; husband is a school teacherFamily lives in a four bedroom single family homePatient works as a seamstressSmokes 1 pack per day (since age 16) and drinks two alcoholic drinks 4 days per weekDenies illegal drug usesNever exercises and has tried multiple fad diets for weight loss with little success. She now eats a diet rich in fats and refined sugars. Allergies NKDA Medications Lisinopril 10 mg dailyLoratadine 10 mg daily Review of SystemsGeneral Admits to recent onset of fatigue HEENT Has awakened on several occasions with blurred vision and dizziness or lightheadedness upon standing: Denies vertigo, head trauma, ear pain, difficulty swallowing or speaking Cardiac Denies chest pain, palpitations, and difficulty breathing while lying down Lungs Denies cough, shortness of breath, and wheezing GI Denies nausea, vomiting, abdominal bloating or pain, diarrhea, or food intolerance, but admits occasional episodes of constipation GU Has experienced increased frequency and volumes of urination, but denies pain during urination, blood in the urine, or urinary incontinence EXT Denies leg cramps or swelling in the ankles and feet; has never experienced weakness, tin ...

Chief ComplaintMy left foot feels weak and numb. I have a hard ti

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An 80-year-old White male was admitted s/p L hemiarthroplasty yesterday after a fall. No other acute injuries were treated. Patient is married and his wife and daughter are at the bedside. Patient has a history of type 2 diabetes but does not require medication normally, though he is currently on a sliding scale of insulin since surgery. He had an Ivor-Lewis esophagectomy secondary to adenocarcinoma of the esophagus and stomach 9 months ago. He also had gamma knife radiation for a left temporal mass ( 7 months agol which was found coincidentally when diagnosed with a CVA. He has a port-a-cath in his right upper chest which is not accessed. He has a left-hand peripheral IV of normal saline at 100 cc / hour and the pump that is alarming (which is what brought you into the room). His IV site is swollen and red. He is alert and oriented X s 3. HOB must be at 30 degrees at all times. Patient is 6 feet 6 inches tall and weighs 168 pounds. Skin is extremely fragile and tears easily. He currently has a reddened area over his coccyx, though skin is intact. Patient must not drink fluids within 30 minutes of meals, must eat a small, high-protein meal every 2 to 3 hours, and must rest at least 20 minutes after eating; otherwise he experiences dumping syndrome. Vitals: BP 150/68 (supine); P 70; R 24; O2 at 97% on room air. Breath sounds diminished in lower lobes bilaterally. Bowel sounds are decreased in all quadrants. Left hip dressing is dry and intact. Client states his pain is a 6 out of 10; he was last medicated 4 hours ago and has asked to have pain medicine and nausea medicine at the next opportunity. Pedal pulses are present bilaterally, no swelling. Blood work indicates Hgb of 8.1. When PT attended earlier, patient stood at bedside with walker and assistance, but quickly became nauseous and weak and was unable to transfer to the chair. Client lives with wife of 60 years. There are two steps into the residence, and patient was independent with all ADLs prior to the fall. He is currently resting; a soft meal was brought in, but patient has refused to eat or drink since he fell 2 days ago. Based on this case answer the following tasks and questions: 1. List the relevant cues. 2. What additional information do you need? 3. Which cues require immediate attention, and which need attention, but are not urgent? 4. Which are the most likely hypotheses? Which of these are serious? 5. Generate solutions based on evidence. 6. What actions should be taken and in what order? 7. How and when would you evaluate the outcomes? .

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what information do you need? Problem 03-02 Refer to the News Wire and graph below. NEWS WIRE: SUPPLY SHIFT Rents Rising in Hurricane's Wake Lake Charles Hurricane Laura wiped out a massive chunk of housing in southwest Louisiana. According to the governor's office, 10,000 homes were demolished and another 130,000 damaged by Laura's punishing 150mile-an-hour winds. With thousands of families seeking new shelter and a depleted stock of intact units, rents rose quickly. In the Lake Charles area, rents on spared properties jumped 10 -20 percent in the wake of the disaster. Source: Media reports of August 2531,2020. Market for Apartmentsinstructions: triter your resporises ds a wrivie nurnver. a. what is the initial (pre-hurricane) equilibrium rent per month? $ per month b. what is the pre-hurricane equilibrium quantity? thousand units per month c. how large is the pre-hurricane shortage? thousand units per month d. what is the post-hurricane equilibrium rent? $ per monthc. how large is the pre-hurricane shortage? thousand units per month d. what is the post-hurricane equilibrium rent? $ per month e. what is the post-hurricane equilibrium quantity? thousand units per month f. how large is the post-hurricane shortage at the pre-hurricane equilibrium rent? thousand units per month.

what information do you need Problem 0302 Refer to the Ne.pdf

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Versin:0.9 StartHTML:0000000105 EndHTML:0000008234 StartFragment:0000000141 EndFragment:0000008194 PREGUNTA UNO La pandemia de COVID-19 est abrumando el funcionamiento y los resultados de la educacin. sistemas en todo el mundo. Afecta a alumnos y estudiantes, aunque en diferente grado dependiendo de mltiples factores, incluido el pas, la regin o los distritos donde viven. Mientras Los pases con buenos recursos han logrado gestionar las consecuencias del COVID-19 pandemia en sus sistemas educativos al proporcionar sistemas innovadores para la educacin ininterrumpida. aprendizaje, los pases menos dotados estn luchando para hacer frente a la situacin. En el caso de Ghana, el cierre de escuelas el 15 de marzo de 2020, agravado por la las crisis econmicas y de salud pblica asociadas, plantearon grandes desafos para los estudiantes y sus maestros Si bien no conocemos los impactos exactos, sabemos que el trabajo acadmico, especialmente, en instituciones preterciarias se ha visto afectada negativamente por la pandemia. En contraste, la mayora de las instituciones terciarias pblicas recurrieron al uso de varias plataformas virtuales/electrnicas como Zoom, Google Meet, equipos de Microsoft, Google Classroom, Moodle y similares para ensear Y aprendiendo. Cabe sealar que el uso de plataformas virtuales para el trabajo acadmico (conferencias, evaluacin, etc.) tiene sus propios desafos. Con el fin de abordar los desafos asociados con el uso de plataformas virtuales para conferencias entre los estudiantes de Ghana, el gobierno ha contratado a NAKQUAYE Consult para realizar una estudio para determinar las consecuencias del acceso a las instalaciones de internet, la fiabilidad de internet instalacin, costo de los datos, tipo de proveedor de servicios de Internet y acceso a telfonos inteligentes/computadoras porttiles en el uso de plataformas virtuales para conferencias con estudiantes de pregrado de la Universidad de Estudiantes profesionales, Accra como estudio de caso. Un nmero total de 4.000 estudiantes de pregrado. considerados para el estudio provienen de seis departamentos que comprenden Contabilidad, Banca y Finanzas, Administracin, Marketing, Relaciones Pblicas y Tecnologas de la Informacin. como el oficial principal de investigacin de NAKQUAYE Consultar: a. Formular un tema de investigacin e indicar las variables dependientes e independientes. [4 puntos] b. Indique el objetivo general y dos objetivos especficos de este estudio. [3 puntos] C. Con base en los objetivos especficos identificados, enunciar dos hiptesis de investigacin, ambas la nula y la alternativa [2 puntos] d. Identificar el tipo de enfoque de investigacin a adoptar y justificarlo. [3 puntos] mi. Cul es la poblacin de su estudio propuesto y la(s) tcnica(s) de muestreo a adoptar? al seleccionar un tamao de muestra de 600? Justificar la(s) tcnica(s) de muestreo a utilizar. [3 puntos] F. Indique el tipo y las fuentes de datos que utilizar para el estudio. [2 puntos] gramo. Suponiendo que .

Versin09 StartHTML0000000105 EndHTML0000008234 StartFra.pdf

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The data on Table 4 is taken from the 2013 annual report for Synovus, which reported $812 million in NII before provisions and $26.3 billion in average assets in 2013. Review the information and answer the following questions: f* Average loans are shown net of deferred fees and costs. Nom-performing loans are included. (interest income includes loan fees as follows: 2013-$25.6 million, 2012-$19.8 million, and 2011- $17.3 million. (*Reflects taxable-equivalent adjustments, using the statutory federal tax rate of 35%, adjusting interest on tax-exempt loans and investment securities to a taxable-equivalent basis. *includes average net unrealized gains on investment securities available for sale of $12.0 million, $66.3 million, and $88.6 million for the years ended December 31, 2013, 2012, and 2011, respectively AVERAGE CONSOLIDATED AVERAGEBALANCES, INTEREST, ANDYIELDS 2013 2012 2011.

The data on Table 4 is taken from the 2013 annual report for.pdf

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Seleccione una de las tres opciones enumeradas a continuacin: Necesita un informe de pgina de Obras citadas utilizando el estilo de informe MLA. Necesitar un mnimo de dos fuentes (cada fuente debe tener un mnimo de una cita), un mnimo de una nota al pie y una pgina de trabajos citados. Consulte la rbrica para conocer los criterios de calificacin. Asegrese de enviar un archivo de Word y no un pdf. Opcin 1 : Ha decidido comprar una nueva computadora mvil o de escritorio para sus necesidades personales, educativas y/o profesionales. Considere cmo usar este dispositivo. Determine qu funciones de hardware son necesarias. Las fuentes pueden estar basadas en la web, una entrevista con un vendedor en una tienda de computadoras o alguien con conocimiento de hardware y/o software de computadora como una de sus fuentes. Identifique las necesidades de su aplicacin, su presupuesto y qu software planea ejecutar en su computadora. Incluya esta informacin en su informe. Esto debera ser parte de su introduccin. Debe incluir una definicin de cada uno de los tipos de computadoras, es decir, de escritorio, todo en uno, porttil, tableta. Explique al lector cules son las diferencias entre estas clasificaciones. Decida qu tipo de computadora se adapta mejor a sus necesidades e indique por qu. Considere qu plataforma comprar. Conceptos Mdulo 3 cubre diferentes tipos de hardware. Esta podra ser una de sus fuentes. Seleccione un mnimo de dos computadoras para comparar (estas deben ser del mismo tipo, es decir, computadora de escritorio, computadora porttil, tableta y la misma plataforma). Compare sus caractersticas, costos y confiabilidad. Esto podra hacerse con una lista de vietas o una tabla. Las tablas se incluyen en el Mdulo 3 de Word. En su conclusin, revise sus criterios para seleccionar una computadora e indique qu computadora comprara y por qu. Asegrese de tener las fuentes requeridas, las citas, las notas al pie y la pgina de trabajos citados. Opcion 2: Cules son los riesgos de privacidad y seguridad para aquellos que usan sitios de redes sociales? Cmo puede proteger su privacidad en lnea? Qu puede hacer para protegerse del robo de identidad? Crees que almacenar informacin confidencial en la nube es riesgoso? Almacenaras tus datos financieros personales en lnea? Realiza operaciones bancarias en lnea, paga facturas en lnea o realiza compras con su tarjeta de crdito en lnea? Cmo saber si un sitio web es seguro? Alguna vez ha sido vctima de un delito en Internet? El contenido de los Mdulos 6 u 11 en el texto de conceptos de Tecnologa para el xito podra usarse como una de sus fuentes; sin embargo, necesitar un mnimo de dos fuentes adicionales. Asegrese de usar citas para identificar cualquier contenido tomado de una fuente. 2 Su introduccin debe incluir definiciones y ejemplos de redes sociales, comercio electrnico y comunicacin digital. Considere cmo las empresas y los individuos utilizan Internet hoy en da y los riesgos involucrados. El cuerpo de su informe deb.

Seleccione una de las tres opciones enumeradas a continuaci.pdf

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Stella's scores X=87 on her first exam, for which the entire class scored a mean of =77 and standard deviation of =2. The instructor wants to standardize thye distribution of exam scores to have =97 and =14. What will Stella's grade on the exam be in the new distribution? Question 7 For a population with a standard deviation of =4, what is the 2 -score corresponding to a score that is 4 points below the mean?.

Stellas scores X87 on her first exam for which the entire.pdf

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Relax The General Social Survey asked 1675 people how many .pdf

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necesito ayuda para responder las preguntas del artculo por favor Lea el siguiente artculo y luego responda las preguntas que siguen segn corresponda: - Conozca a los antepasados Qu lo hace ser quien es? Parte de la respuesta est en el pasado de su familia. Convirtete en detective y encuentra pistas sobre la historia de tu familia. 1)- Cuando te miras al espejo, ves la sonrisa de tu padre? Tal vez te pareces a tu madre. Si tienes los ojos de tu abuela, es por el ADN. Contiene genes que son el conjunto nico de instrucciones de nuestro cuerpo, incluido el aspecto que tenemos. Los genes se transmiten de generacin en generacin, y si se pregunta de qu parte del mundo eran sus antepasados, una prueba cientfica, conocida como prueba de ADN, puede mostrarle t. Heredamos nuestro aspecto y mucho ms. De una generacin a la siguiente, las familias transmiten comidas, tradiciones e historias favoritas. 2)- De hecho, el pasado de tu familia tiene muchas historias diferentes. Es posible que los haya escuchado compartir en una reunin familiar. Quines fueron los abuelos de tus padres? Dnde vivan y cmo eran? Historias nicas como estas te hacen especial a ti y a tu familia. 3)- La historia de tu familia puede ser un misterio para ti, pero hay una forma de conocerla. Se llama genealoga, y es el estudio de las personas con las que ests relacionado. La genealoga le ayuda a reconstruir su historia familiar. Comienza con los parientes que conoces, como padres y abuelos, y luego te lleva atrs en el tiempo. Puedes aprender sobre antepasados que vivieron y murieron mucho antes de que nacieras. 4)- No es difcil aprender sobre tu pasado. Puede comenzar haciendo preguntas a sus familiares sobre sus antepasados. Quines eran)? Dnde crecieron? Mientras habla con miembros de la familia, tome notas. Esto le ayuda a organizar cualquier informacin que obtenga. Asegrese de anotar cualquier nombre, fecha o lugar que la gente mencione. Despus de haber hablado con los miembros de su familia, puede comenzar a juntar las piezas. Dibuja tu rbol genealgico y escribe tu nombre en la parte superior. Trabaja hasta tus padres, abuelos y bisabuelos. 5)- Hay casillas en blanco en tu rbol? Entonces es hora de un poco de trabajo de detective! Muchas personas comienzan su investigacin en una biblioteca donde pueden buscar apellidos en peridicos viejos. Los registros pblicos tambin suelen ser algo muy bueno para verificar. All se pueden encontrar pistas sobre registros como certificados de nacimiento, matrimonio y defuncin. Algunos registros muestran cundo las personas inmigraron a un pas. A veces, los registros te dicen dnde fue la gente a la escuela, cul era su profesin o cundo compraron la tierra. Tambin puedes buscar en internet. Con cada pedacito de investigacin que haces, ests descubriendo la historia de tu familia. A. El ADN es responsable de --------------------------------- nuestra apariencia y mucho ms. Obligatorio para responder. Eleccin nica. a. heredando b. nutricin C. respiracin B. E.

necesito ayuda para responder las preguntas del artculo por.pdf

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Let A and B be two events defined on a sample space S of an .pdf

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Morrison Corporation had the following common stock record during the current calendar year: Outstanding-January 1 2,180,000 Additional shares issued 3/31 118,000 Distributed a 10% stock dividend on 6/30 Additional shares issued 9/30 118,000 What is the number of shares to be used in computing basic EPS? Morrison Corporation had the following common stock record during the current calendar year: What is the number of shares to be used in computing basic EPS? Multiple Choice 2,524,850 2, 557,300. 2,403,900..

Morrison Corporation had the following common stock record d.pdf

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Copenhagen Covered (B). Heidi Hi Jensen, a foreign exchange trader at J.P. Morgan Chase, can invest $4.9 million, or the foreign currency equivalent of the bank's short term funds, in a covered interest arbitrage with Denmark. She is now evaluating the arbitrage profit potential in the same market after interest rates change: LOADING... . (Note that anytime the difference in interest rates does not exactly equal the forward premium, it must be possible to make CIA profit one way or another.) Question content area bottom Part 1 The CIA profit potential is enter your response here%, which tells Heidi that she should borrow Danish krone U.S. dollars and invest in the higher lower interest rate currency, the dollar the krone , gaining on the re-exchange of dollars for krone at the end of the period. (Round to three decimal places and select from the drop-down menus.) Part 2 The CIA profit amount is krenter your response here. (Round to two decimal places.) Financial calculator Time Remaining: 02:05:26 Next pop-up content starts Data table (Click on the following icon in order to copy its contents into a spreadsheet.) Arbitrage funds available $4,900,000 (kr=$1.00) 6.1717 (kr=$1.00) 6.1984 U.S. dollar 3-month interest rate 4.000% Danish krone 3-month interest rate 5.100% Arbitrage funds available $4,900,000 Spot exchange rate 6.1717 (kr=$1.00) 3-month forward rate 6.1984 (kr=$1.00) U.S. dollar 3-month interest rate 4.000% Danish krone 3-month interest rate 5.100%.

Copenhagen Covered B Heidi Hi Jensen a foreign exchange.pdf

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Inmediatamente antes del proceso de liquidacin, los socios Paco, Peca y Pito tienen saldos de capital de $80.000, $30.000 y $40.000 respectivamente. Hay un saldo de efectivo de $10 000, los activos no monetarios totalizan $190 000 y los pasivos totalizan $50 000. Los socios comparten las utilidades y prdidas netas en la proporcin de 50%, 35% y 15% respectivamente. Escriba en el diario las entradas para registrar la liquidacin que se describe a continuacin, utilizando Activos como ttulo de cuenta para los activos que no son en efectivo y Pasivos como ttulo de cuenta para todos los reclamos de los acreedores. 1. Vendi los activos no monetarios por $90 000 en efectivo. 2. Dividida la prdida en la realizacin. 3. Pag las obligaciones. 4. Recibi dinero en efectivo del socio con la deficiencia. 5. Distribuy el efectivo a los socios..

Inmediatamente antes del proceso de liquidacin los socios .pdf

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Feet and Meters Converter Create a program that uses a separate module to convert feet to meters and vice versa. Example runtime. User input is italicized for the example. Allow the user to enter their own input: The formula for converting feet to meters is: feet = meters / 0.3048 The formula for converting meters to feet is: meters = feet * 0.3048 Store the code that performs the feet to meters and meters to feet conversions in functions within a module. Store the code that displays the title in its own function, and store the code that displays the menu in its own function, but store the rest of the code that gets input and displays output in the main() function. Allow the user to repeat this process as many times as they like The program should round results to a maximum of two decimal places..

Feet and Meters Converter Create a program that uses a separ.pdf

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Assignment Primary endosymbiosis is known to be important in the origin of certain organelles (mitochondria and chloroplasts) in eukaryotes, and in the origin of photosynthesis in red algae, green algae, and land plants. In addition, secondary endosymbiosis has been important in the origin of photosynthetic capacity in various protist lineages (algae). Given that: 1. phagocytic events result a single membrane around the engulfed endosymbiont, an 2. there are fundamental differences in chromosome and gene structure between the genomes of extant prokaryotes and eukaryotes make a rationale prediction of cell and chloroplast structure in photosynthetic eukaryotes that have resulted from both primary and secondary endosymbioses. Describe chloroplast structure in terms of the total number of membranes surrounding the organelle, the nature of the organellar genome or genomes (prokaryotic or eukaryotic) present, and the compartmental location of the genomes. Describe cellular structure by adding one additional membrane (the plasma membrane) around the organelle and giving the compartmental location of the nucleus..

Assignment Primary endosymbiosis is known to be important in.pdf

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2 Suppose XBinomial104 and YBinomial204 respective.pdf

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Aequired:Precart fouthal cmines for 2021 to recind the froneactions desenbed foredt "varkas occounts" for cunstric Journal entry worksheetTrepare jourial eitiks for 2022 to tecmed the to arom a bevif (orede "Variners actounte" for concetruct Journal entry worksheet <123 Aecoud the gicses prefit ar losecotafations, Hourd pour anises to the fiese pet dellar anteure)Whilalish. Reand voor miswers io the nesest deder arnount.).

AequiredPrecart fouthal cmines for 2021 to recind the fr.pdf

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9. Argument que las personas intentan satisfacer sus necesidades de nivel inferior y luego progresan hacia las necesidades de nivel superior. Opcin multiple Elton Mayo Guillermo Procter frederick taylor Abraham Maslow fritz roethlisberger 10 Lillian Gilbreth estudi cmo la satisfaccin laboral motivaba a los empleados, cmo los estudios de movimiento podan usarse para ayudar a las personas discapacitadas a realizar trabajos y cmo la fatiga y el estrs afectaban el bienestar y la productividad de los trabajadores. Por qu enfoc su atencin en estas reas? Opcin multiple Estaba ms interesada en el lado humano de la gestin. Desautoriz la utilidad de los principios de la gestin cientfica. Ella no crea que los puestos burocrticos puedan fomentar habilidades especializadas. Se dio cuenta de cmo el sistema de pago por pieza afectaba la productividad. Entendi cmo la Revolucin Industrial foment la produccin en masa. 11 En el contexto de los 14 principios de gestin de Henri Fayol, _____ se refiere a aclarar las expectativas y castigar las infracciones. Opcin multiple orden autoridad cadena escalar subordinacin del inters individual al inters general disciplina 12 El enfoque __________________ fue el primero en enfatizar las relaciones laborales informales y la satisfaccin de los trabajadores, y surgi de un estudio cientfico de administracin que result en el descubrimiento del efecto Hawthorne. Opcin multiple relaciones humanas estudios de Hawthorne burocracia gerencia Administrativa gestin cientfica 13 Cul de las siguientes culturas organizacionales se caracteriza fuertemente por el logro de objetivos, el intercambio de entornos y la competitividad? Opcin multiple adhocracia clan jerarqua mercado colaboracin 14 Johnny y Tom se asociaron con xito como una pequea empresa independiente de exploracin de petrleo ("wildcatter") durante 30 aos. Trabajaban informalmente juntos como una familia y eran intensamente leales entre s, con sus clientes y proveedores. Sin embargo, ms adelante en sus carreras, Johnny y Tom vendieron su empresa y fueron contratados como empleados de MegaOil, Inc., uno de los 5 principales conglomerados energticos mundiales. Su empleo no dur, renunci exasperado a los seis meses. No pudieron adaptarse a la cultura de MegaOil, que se caracteriza por produccin/logro, orientacin a resultados, ventaja competitiva y superioridad en el mercado (cultura de mercado/competencia). En retrospectiva, Johnny y Tom se dieron cuenta de que se perdieron el Opcin multiple estabilidad, previsibilidad y fluidez de una cultura de jerarqua/control. tradicin, confianza, trabajo en equipo, cohesin y sentido de familia de la cultura de un clan. flexibilidad, asuncin de riesgos, innovacin y espritu empresarial de una adhocracia/cultura creativa. nfasis en las necesidades individuales de los empleados de una cultura de empoderamiento. 15. Una estructura organizacional jerrquica valora _____ y asume que las personas cumplirn con los mandatos organizacionales cuando los ro.

9 Argument que las personas intentan satisfacer sus neces.pdf

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3 10 points Given a binary search tree T with a root node.pdf

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b You are given three events CD and E with probabilities P.pdf

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### The Operating System data is a dataset from a Intro to Data Science class ## at a large university several years ago. The professor queried the students ### asking which operating system they had installed on their computer. This ### dataframe contains two variables: college id and operating system. It is ### not tidy and could be tidied in many ways. Make it so.## Operating System Data ## 1. Import the data. Pay attention to the many factors that may influence ## the success of importing and the amount of fixing (cleaning) that you may ## have to do later. Make it easy on yourself now. operatingsys <- read_csv("Data/operatingsys. csv") operatingsys # 2. Why isn't the data tidy? ## 3. What do you need to do (in words, not code) to make it tidy? ## 4. Write the code and tidy it.

The Operating System data is a dataset from a Intro to D.pdf

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Physician H amp P Stuart Little is a 77yearold man who p.pdf

1. Physician H & P Stuart Little is a 77-year-old man who presents to Georgetown Public Hospital Corporation with a chief complaint of pain and swelling in his right leg. HPI: Patient was in his usual state of health until three days ago when he banged his right shin on the coffee table. He suffered a small abrasion which at the time seemed minor. Since that time it has not healed and is getting worse. The area surrounding the cut is bright red and warm to touch. The wound is oozing a foul smelling liquid. His right leg from the ankle to above his knee is swollen. As of last night he began to experience some fevers and chills and overall he is not feeling very well. PMH: HTN Type-2 DM Dyslipidemia OA CKD MEDS PTA: See Medication History Immunizations: Pneumonia vaccine Allergies: Sulfa SH: () Tobacco, (-) EtOH, (-) IVDA, Patient currently lives with his wife. FH: Significant for a father who died of complications of diabetes at age 75 and a mother who died of breast cancer at the age of 65 years. O: Vitals: BP=160/100mmHgHR=105bpm RR=18T=38.5C SaO2=95% on room air Ht=69 inches Wt=95kg Assessment Stuart Little is a newly admitted patient to the ER and your role as a pharmacist is to interview this patient to obtain his medication history i.e., the medications he uses at home. Please refer to the form provided to conduct this medication history.

Physician H amp P Stuart Little is a 77yearold man who p.pdf

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Physician H amp P Stuart Little is a 77yearold man who p.pdf