Week 3 Short-term memory loss Discussion response

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As someone with Attention Deficit Hyperactivity Disorder (ADHD), I have struggled with short-term memory issues for my entire life. However, since I was diagnosed later in life, I spent the bulk of my school-age years developing strategies to deal with what I thought were typical memory issues that everyone faced. By the time I entered university I knew that unless I physically wrote out my notes with a pen on paper, I would not remember them because it was too easy for me to type notes while my mind was ‘elsewhere’ not paying attention. If I needed to remember a list of things, I needed to write it somewhere I would see it repeatedly, like the back of my hand or the leg of my jeans; a list on paper in my pocket was quickly forgotten – out of sight out of mind.

The working memory model, developed by Baddeley and Hitch in 1974, focuses on the idea that working memory has a limited capacity to store information temporarily as it processes where the information is to go, such as into long-term memory to action (Baddeley, 2003). The information that is gathered falls into different subsets of the overall system, determined by the central executive: the phonological loop (spoken or written information) or visuospatial sketchpad (visual or spatial information) or the episodic buffer (a general category) (Mcleod, 2012).

Issues with short-term memory loss as related to ADHD and the working memory model comes from reported deficits in the ability to control attention and an oversaturation of information input into the central executive (Ortega et al., 2020; Mcleod, 2012). This results in information input being disorganized and not always making it to the long-term memory. Meaning, my central executive may not function in the manner in which Baddeley (2003) suggests it should and it can get easily overwhelmed, resulting in the interference of informational input and encoding. Issues with short-term memory are often considered to be as a result of decay or interference, though decay is difficult to prove due to issues with testability and overall understanding of the cause (Jonides et al., 2008).

It was explained to me that many people who have unknowingly existed with ADHD throughout their lives have developed both conscious and unconscious strategies to manage any cognitive processing issues they deal with. I mentioned writing things down as a conscious strategy that I have implemented over the years. Another strategy that I’ve used and continue to practice is repeating someone’s name back to them when being introduced. The act of saying their name out loud forces my attention to be focused on that singular piece of information, allowing for a better chance of it being appropriately encoded and therefore retrieved. Another option is to use a multisensory strategy when possible, allowing for auditory and visual input of the same information. Saying someone’s name out loud and reading it on a name tag for example. I’ve also asked people in the past how their name was spelled, as it allows for me to visualize the name, as well as hear it.

Reference:

Baddeley, A. (2003). Working memory: Looking back and looking forward. Nature Reviews Neuroscience, 4(10), 829–839.

Jonides, J., Lewis, R. L., Nee, D. E., Lustig, C. A., Berman, M. G., & Moore, K. S. (2008). The mind and brain of short-term memory. Annual Review of Psychology, 59, 193–224.

Mcleod, S. (2012). Working Memory Model. Working Memory Model. https://www.simplypsychology.org/working%20memory.html.

Ortega, R., López, V., Carrasco, X., Escobar, M. J., García, A. M., Parra, M. A., & Aboitiz, F. (2020). Neurocognitive mechanisms underlying working memory encoding and retrieval in Attention-Deficit/Hyperactivity Disorder. Scientific reports, 10(1), 1-13.

Response to a discussion post. Advanced Pharmacology

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Respond to this discussion . Add some facts with at least 2 citations APA Format

Discussion: Community-Acquired Pneumonia

                                                                                                              Case  Study

HH is a 68-yr M who has been admitted to the medical ward with community-acquired pneumonia for the past three days. His PMH is

significant for COPD, HTN, hyperlipidemia, and diabetes. He remains on empiric antibiotics, including ceftriaxone 1 g IV q day (day 3) and

azithromycin 500 mg IV q day (day 3). Since admission, his clinical status has improved, with decreased oxygen requirements. He is not tolerating a

diet at this time, complaining of nausea and vomiting. Ht: 5’8″ Wt: 89 kg Allergies: Penicillin (rash).

Diagnosis: Community-Acquired Pneumonia (CAP)

CAP is the term used to describe an acute infection of the lungs that develops outside the hospital setting by an immune-competent

individual who has not been recently hospitalized (Shoar & Musher, 2020). Adults with CAP typically present with cough, fever, sputum production or

shortness of breath, oxygen desaturation, confusion, leukocytosis or leukopenia, and pleuritic chest pain, along with the presence of an acute

infiltrate on the chest radiograph (Shoar & Musher, 2020).

Antibiotic suggested for CAP’s empiric treatment is based on agents useful against CAP’s major treatable bacterial causes. The bacterial

pathogens responsible for CAP include Streptococcus pneumoniae, Mycoplasma pneumoniae, Chlamydia pneumoniae, Haemophilus

influenzae, Staphylococcus aureus, Legionella species, and Moraxella catarrhalis (Metlay et al., 2019).

The patient is on right treatment, his clinical status has improved, with decreased oxygen requirement. Recommended treatment plan for

patients with comorbidities such as alcoholism, COPD, post influenza, asplenia, diabetes mellitus, lung/liver/renal diseases include: Combination

of a beta-lactam (ceftriaxone 1 g IV q24h or cefotaxime 1 g IV q8h or ceftaroline 600 mg IV q12h) plus azithromycin 500 mg IV q24h (Donovan, 2019).

The therapy duration is a minimum of 5 days. The patient needs to be afebrile for 48-72 hours, controlled blood pressure, adequate oral intake, and

room air oxygen saturation of greater than 90% and treatment duration can be extended if symptoms are not recovered in some cases (Donovan,

2019).

             In this case, the patient symptoms are improving, his oxygen requirement is decreased, but he is not tolerating a diet at this time,

complaining of nausea and vomiting. The patient received antibiotics for three days, so antibiotics need to be continued. With appropriate antibiotic

therapy, some improvement in the patient’s clinical course is usually seen within 48 to 72 hours (File, 2020).

                                                                                     Health Needs and Treatment Regimen

The patient is not tolerating diet and complaining of nausea and vomiting. Gastrointestinal (GI) manifestations such as nausea, vomiting,

and diarrhea are considered possibly due to adverse drug (antibiotics) effects (Lin et al., 2009). Changing the antibiotic can help patients to avoid

these side effects. Levofloxacin 750 mg IV or PO q24h is a recommended dose to treat CAP patients (Donovan, 2019).

              Levofloxacin possesses greater bioavailability and a longer serum half-life that allows for rapid step-down from intravenous administration

to oral therapy, minimizing unnecessary hospitalization, which may decrease costs and improve patient quality of life (Lynch III et al., 2006). Several

randomized clinical trials to evaluate levofloxacin to treat CAP demonstrate that levofloxacin is effective and safe for CAP treatment, displaying

relatively mild adverse effects. Levofloxacin has much to offer in terms of bacterial eradication (Lynch III et al., 2006). The other studies also

concluded that monotherapy with oral levofloxacin is as effective as treatment with Ceftriaxone plus, Azithromycin combination in patients with CAP

who required hospitalization (Izadi et al., 2019).

             Probiotics can be added to the treatment plan. Probiotics replenish the natural GI flora with nonpathogenic organisms. Few studies found

probiotics to be useful for preventing and treating antibiotic-associated diarrhea related to antibiotic treatment (Rodgers et al., 2013).

An antiemetic medication such as ondansetron can be added. It is a selective 5-HT3 serotonin-receptor antagonist and acts on central and

peripheral areas to prevent and treat nausea and vomiting (Griddine & Bush, 2020).

As the patient is diabetic, his blood sugar needs to monitor carefully because of sickness, nausea, and vomiting. Sliding scale insulin (SSI) is

recommended. Both hyperglycemia and hypoglycemia in hospitalized patients result in adverse outcomes, including increased infection rates,

longer hospital length of stay, and even death. The use of oral antidiabetic treatments during hospitalization is generally not recommended because

of their safety and efficacy and their significant risk of hypoglycemia and contraindications (Marín-Peñalver et al., 2016).

                                                             Patient Education for the management of Their Health Needs

The patient needs to be educated and encouraged to use an incentive spirometer (IS). Incentive spirometry is commonly used to break up

fluid that builds up in the lungs in people with pneumonia. IS helps to open the airways and help manage COPD symptoms (Yetman, 2020).

The patient needs to be educated about importance of the pneumococcal conjugate vaccine (PCV) and influenza vaccines.

As per International Journal of Chronic Obstructive Pulmonary Disease study, these vaccines decrease the risk of exacerbations in patients with

chronic obstructive pulmonary disease (COPD) (Ely, 2018). Patients over 65 years of age are more susceptible to community-acquired pneumonia

(CAP), and COPD patients are 20 times more prone to develop CAP (Ely, 2018). The Community-Acquired Pneumonia Immunization Trial in Adults

(CAPITA) provided evidence of the benefits of vaccinating with PCV13, which protects against 13 pneumococcal bacteria types (Ely, 2018).

              At the time of discharge, the patient needs to be educated to continue his home medications and finish the prescription of antibiotics if

prescribed, even if he starts to feel better. Taking the entire course of antibiotics is one way to prevent recurring and more severe infections and

combat antibiotic resistance (Rosenthal & Burchum, 2020).

                                                                                                                Conclusion

              Community-acquired pneumonia (CAP) is one of the most common acute infections requiring hospital admission. Age is a dominant risk

factor, with CAP’s incidence increasing markedly in patients who are over 65 years of age. Aging increases the mucosal cell surface protein

expression that bacteria can adhere to, enabling potential pathogens to avoid normal clearance mechanisms better. There is evidence that age

directly affects innate and adaptive immunity, a process called immunosenescence, which weakens lung immunity to invading microbes (Brown,

2012). Few behavior changes like quitting smoking and alcohol abuse and administering the vaccine can prevent or decrease CAP’s severity.

References

Brown, J. S. (2012). Community-acquired pneumonia. Clinical Medicine, 12(6), 538–543. https://doi.org/10.7861/clinmedicine.12-6-538

Donovan, F. M. (2019). Community-acquired pneumonia empiric therapy: Empiric therapy regimens. https://emedicine.medscape.com/article/2011819-

overview

Ely, K. (2018). Study Shows the Efficacy of Vaccination in Patients With COPD. https://www.ajmc.com/view/study-shows-the-efficacy-of-vaccination-in-

patients-with-copd

File, T. M. (2020). Treatment of community-acquired pneumonia in adults who require hospitalization. UpToDate.

https://www.uptodate.com/contents/treatment-of-community-acquired-pneumonia-in-adults-who-require-hospitalization

Griddine, A., & Bush, J. S. (2020). Ondansetron – statpearls – ncbi bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK499839/

Izadi, M., Dadsetan, B., Najafi, Z., Jafari, S., Mazaheri, E., Dadras, O., Heidari, H., SeyedAlinaghi, S., & Voltarelli, F. (2019). Levofloxacin versus

            ceftriaxone and azithromycin combination in the treatment of community acquired pneumonia in hospitalized patients. Recent Patents on

            Anti-Infective Drug Discovery, 13(3), 228–239. https://doi.org/10.2174/1574891×13666181024154526

Lin, R. Y., Nuruzzaman, F., & Shah, S. N. (2009). Incidence and impact of adverse effects to antibiotics in hospitalized adults with pneumonia. Journal

             of Hospital Medicine, 4(2), E7–E15. https://doi.org/10.1002/jhm.414

Lynch III, J. P., File Jr, T. M., & Zhanel, G. G. (2006). Levofloxacin for the treatment of community-acquired pneumonia. Expert Review of Anti-infective

            Therapy, 4(5), 725–742. https://doi.org/10.1586/14787210.4.5.725

Marín-Peñalver, J., Martín-Timón, I., & del Cañizo-Gómez, F. (2016). Management of hospitalized type 2 diabetes mellitus patients. Journal of

           Translational Internal Medicine, 4(4), 155–161. https://doi.org/10.1515/jtim-2016-0027

Metlay, J. P., Waterer, G. W., Long, A. C., Anzueto, A., Brozek, J., Crothers, K., Cooley, L. A., Dean, N. C., Fine, M. J., Flanders, S. A., Griffin, M. R.,

           Metersky, M. L., Musher, D. M., Restrepo, M. I., & Whitney, C. G. (2019). Diagnosis and treatment of adults with community-acquired

           pneumonia. an official clinical practice guideline of the american thoracic society and infectious diseases society of america. American Journal

           of Respiratory and Critical Care Medicine, 200(7), e45–e67. https://doi.org/10.1164/rccm.201908-1581st

Rodgers, B., Kirley, K., & Mounsey, A. (2013). Prescribing an antibiotic? pair it with probiotics. PubMed Central (PMC).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3601687

Rosenthal, L. D., & Burchum, J. R. (2020). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.). Saunders.

Shoar, S., & Musher, D. M. (2020). Etiology of community-acquired pneumonia in adults: A systematic review. Pneumonia, 12(1).

https://doi.org/10.1186/s41479-020-00074-3

Yetman, D. (2020). Incentive spirometer: What it’s for and how to use it. Healthline. https://www.healthline.com/health/incentive-spirometer

Research Summary Assignment

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Purpose

This assignment provides the opportunity for the student to find and appraise resources related to the PICOT question from Week 2. The focus of this assignment is to evaluate pertinent literature that supports the practice change intervention.

Note: You are to locate original studies with research conducted and published by the primary investigator. You may also use systematic reviews or Clinical Practice Guidelines (CPGs).

Course Outcomes

This assignment enables the student to meet the following course outcomes:

CO1: Integrate evidence-based and research to support advancement of holistic nursing care in diverse healthcare settings. (PO 1,4)

CO2: Integrate knowledge related to evidence-based practice and person-centered care to improve health outcome. (PO 1, 2)

CO4: Develop knowledge related to research and evidence-based practice as a basis for designing and critiquing research studies. (PO 1, 5)

CO5: Analyze research findings and evidence-based practice to advance holistic care initiatives that promote positive healthcare outcomes. (PO 1, 2, 5)

Requirements

Find and review ten (10) scholarly, peer-reviewed research articles, systematic reviews, or CPGs in support of the practice change intervention. Complete the Research Summary Worksheet table for each article.

  1. State the PICOT question
  2. For each article, supply the following:
    1. The complete reference for the article in current APA format
    2. Description of the purpose of the study/review/practice guideline
    3. Description of the evidence type
      1. Research article/systematic review/CPG
      2. If a source is a research article
        1. Is the study quantitative, qualitative, or mixed methods?
        2. Is the study experimental, quasi-experimental, or descriptive?
    4. Description of the sample, sample size, and setting (not used for CPG)
    5. Discussion of the data collection methods used (not used for CPG)
    6. Discussion of the study findings or CPG content
    7. Assessment of the limitations of the study (not used for CPG)
    8. Discussion of the relevance the study to the PICOT question and advanced practice nursing

Preparing the Assignment:

  1. Use the designated Research Summary Table Worksheet to supply the required information.
  2. All scholarly, peer-reviewed research articles must be current – within a 5-year time frame – unless a valid rationale is provided, and the instructor has approved the use of an older reference.
  3. Use APA formatting for references

Describe the characteristics of the aging process

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 Topic 5 DQ 1

    With aging, humans start experiencing lots of physical limitations and cognitive impairments. The aging process is gradual and as a result one may start to notice a decline in functionality of the senses and activities of daily living, and increased susceptibility to disease, frailty, as well as disabilities associated with aging, such as arthritis, frailty, decreased in physical activities and generalized Weakness to name a few(National Institute on Aging [NIH], 2020). Also, almost all the parts of a human body from hairs to toe with noticeable changes, such as hairs first turns gray and white. Different body systems and reflexes like digestion, nervous system, overall cardiac output and renal functions slows down. The elderly can begin to develop eye problems like cataracts and glaucoma, hearing loss, fatty deposits over coronary arteries, wrinkles, looses bone density and muscle shrinkage and other sensory impairments(NIH, 2020). As a result, elderly people are mostly dependent on others for help and support. This increases their risk of being abused and often face inadequate support from their caregivers and often experience episodes of depression and emotional stress. Due to these conditions, the elderly are more vulnerable to physical imbalance, impaired body coordination, falls and bone fracture. The abuse might continue if the elderly person becomes more dependent on others for support he/she can no longer provide like before(NIH, 2020).

    There are lots of considerations that a nurse must be mindful of while performing a health assessment on a geriatric patient as compared to a middle-aged adult. While assessing an elderly patient, a nurse must take an account of patient’s sensory functions like hearing, speaking, vision and taste. Vital signs must be assessed including glucose and sodium levels, bowel and bladder pattern, motor evaluation and most importantly nutritional assessment. Elderly people have a lot of limitations and issues with memory, a nurse should wait on the time for proper response(NIH, 2020).

In the case of the middle-aged adult the nurse should consider and focus on the following in order to obtain a comprehensive assessment. Begin by assessing the age-related changes, such as past medical history, allergies or past surgery if any, medications, cultural views on health, dietary habits, mobility and physical challenges, use of folks medicine or alternative/traditional treatment , use of illicit drugs or alcohol, psychosocial assessment etc(U.S National Library of Medicine, 2021).

Respond using 250-300 words APA format with references to support the discussion.

 Describe the characteristics of the aging process. Explain how some of the characteristics may lead to elder abuse (memory issues, vulnerability, etc.). Discuss the types of consideration a nurse must be mindful of while performing a health assessment on a geriatric patient as compared to a middle-aged adult. 

END OF COURSE REFLECTION ESSAY (NEED IT BY 2/24/2021 AT 6PM) NO PLAGARISM…PLEASE PAT ATTENTION TO DETAILS LISTED.

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Required Resources
Read/review the following resources for this activity:

  • Textbook: all chapters
  • Lesson: all weeks
  • Feedback from peers and instructor

Instructions
Complete the following as either a written essay or video reflection. If video is chosen, you should include all these same requirements.

  • Reflect on your learning experiences over these 8 weeks. Choose a word, phrase, or quote that you would use to describe it overall and explain why you chose it and what this experience has added to your life.
  • Select and describe 3 of your most significant learning and how you will apply what you learned from each to your personal worldview or professional practice.
  • Describe 3 challenges you had to overcome during these weeks and what you learned in overcoming them that can be applied in your professional practice.
  • How has this course impacted your life, thinking, or spirituality? Which origin of religion theory or theories do you believe to be the description of your own views on religion? Explain your answer including an example.

Cite sources if used.

Writing Requirements (APA format)

  • Length: 500-1000 words (not including title page or references page)
  • 1-inch margins
  • Double spaced
  • 12-point Times New Roman font
  • Title page
  • References page (as needed)

Week 4 Discussion 1 Response

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FOR THIS ASSIGNMENT YOU WOULD HAVE TO RESPOND TO THE RESPONSE THAT IS POSTED BELOW. THE RESPONSE HAS TO BE 100 WORDS.

Netflix Inc.’s current ratio improved from 2017 to 2018 but then deteriorated significantly from 2018 to 2019. Netflix Inc.’s quick ratio improved from 2017 to 2018 and from 2018 to 2019.

Netflix Inc. Financial Ratios 2018 & 2019:

Current Ratio 2018:  1.49

Current Ratio 2019:  0.90

Quick Ratio 2018:  0.67

Quick Ratio 2019:  0.87

The industry is heavily reliant on consumers’ access to the internet and internet-connected devices. While broadband internet availability is approaching saturation, mobile internet devices have exploded in popularity, supporting industry growth. IBISWorld expects the number of mobile internet connections in the United States to increase an annualized 4.3% to 336.9 million over the five years to 2020.

Industry Financial Ratios 2018 & 2019:

Current Ratio          1.4      1.0                             

Quick Ratio              1.1      0.9                             

Over the past five years up to 2020, Netflix’s industry-specific revenue is expected to grow at an annualized rate of 24.6% to $12.6 billion, with operating income expected to increase to $2.2 billion in 2020. Netflix’s strong financial performance the company has added new subscribers worldwide over the past five years, while also raising subscription service fees and offering different tiers of service.

2018

8281.5    34.6      841.7       90.7

2019

10051.0       21.4       1298.6        54.3

2020

12557.1       24.9        2197.5        69.2

As of September 30, 2019, the company had $19.1 billion of obligations comprised of $4.9 billion included in “Current content liabilities” and $3.4 billion of “Non-current content liabilities” on the consolidated balance sheets and $10.8 billion of obligations that are not reflected on the consolidated balance sheets as they did not yet meet the criteria for asset recognition.  That $10.8 billion is a contingent liability — a cost that may come due in the future depending on certain circumstances, or may not.

Netflix Inc.’s current liabilities increased from 2017 to 2018 and from 2018 to 2019. Netflix Inc.’s non-current liabilities increased from 2017 to 2018 and from 2018 to 2019. Netflix Inc.’s total liabilities increased from 2017 to 2018 and from 2018 to 2019.  Netflix says those contingent liabilities are $10.8 billion, by definition the costs are estimable — but since they are only in the footnotes, that also means those costs are not yet probable.  The pace isn’t quite as torrid as liabilities reported on the balance sheet, but liabilities have still more than doubled. That’s a lot of potential obligations lingering out there, not yet come to pass. If subscriber growth keeps charging along and Netflix can get away with more price hikes, that might just mean enough revenue to reboot investor interest in the stock. The contingent liabilities does not change my assessment of the company.

Assignment: Ethical and Legal Implications of Prescribing Drugs

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What type of drug should you prescribe based on your patient’s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should you be prescribing drugs to this patient? How might different state regulations affect the prescribing of this drug to this patient?

These are some of the questions you might consider when selecting a treatment plan for a patient.  

As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives every day. Patients and their families will often place trust in you because of your position. With this trust comes power and responsibility, as well as an ethical and legal obligation to “do no harm.” It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. Additionally, it is important to ensure that the treatment plans and administration/prescribing of drugs is in accordance with the regulations of the state in which you practice. Understanding how these regulations may affect the prescribing of certain drugs in different states may have a significant impact on your patient’s treatment plan. In this Assignment, you explore the ethical and legal implications of scenarios and consider how to appropriately respond.

To Prepare
  • Review the Resources for this module and consider the legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure.
  • Review the scenario assigned by your Instructor for this Assignment.
  • Search specific laws and standards for prescribing prescription drugs and for addressing medication errors for your state or region, and reflect on these as you review the scenario assigned by your Instructor.
  • Consider the ethical and legal implications of the scenario for all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
  • Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario, including whether you would disclose any medication errors.
By Day 7 of Week 1

Write a 2- to 3-page paper that addresses the following:

  • Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
  • Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state.
  • Explain two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario, including whether you would disclose your error. Be sure to justify your explanation. 
  • Explain the process of writing prescriptions, including strategies to minimize medication errors.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The College of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.

Write out five medical terms, abbreviations, or acronyms from the record and define them

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Read the medical record below. Write out five medical terms, abbreviations, or acronyms from the record and define them. This assignment isn’t timed.

CC: Epigastric pain

HPI: This 66-year-old male presents for a re-evaluation of his epigastric pain. He continues to report epigastric pain secondary to chronic pancreatitis. He states he has also been diagnosed with a tumor on his pancreas, and he is going to begin chemotherapy. He is taking MS Contin 60 mg at 7 a.m. and 9 p.m. This does help his pain without side effects. He denies renal or hepatic dysfunction.

Active Problems:

1. Chronic pancreatitis

2. Hypercholesterolemia

3. Essential hypertension

4. Degenerative arthritis of both hands

5. h/o right hip fx in 2009

PHYSICAL EXAM: Reveals a well-developed, well-nourished patient in no acute distress. He is alert and answers questions appropriately. HEENT: Head is normocephalic, atraumatic. NECK: Supple with no thyromegaly. ABDOMEN: There is no tenderness to palpation throughout the abdomen. There is no rebound tenderness. CARDIOVASCULAR: Regular rate and rhythm. RESPIRATORY: Clear to auscultation bilaterally. No wheezes, rales, or rhonchi. EXTREMITIES: No clubbing, cyanosis, or edema.

IMPRESSION:

Chronic epigastric pain secondary to chronic pancreatitis

PLAN:

Rx MS Contin 60 mg at 7 a.m. and 9 p.m.

RTO in 3 months

Type your list or chart into a Microsoft Word document or a Notepad document. Be sure to save your file using this naming protocol: lastname_firstinitial_Assignment7. So if your last name is Jones and your first name is Wanda, you would name your file Jones_W_Assignment7. Then use the “Browse” button below to locate the file on your computer and the “Upload this file” button to send it to your facilitator.

Component A2: Individual reflection (1000 words) (20%) Task: individual written reflection This reflective piece needs to highlight the transferrable skills

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 Component A2: Individual reflection (1000 words) (20%) Task: individual written reflection This reflective piece needs to highlight the transferrable skills that have been gained/developed and how you believe your learning from the programme can be applied to your future career. (1000 words) This reflection focuses on the programme experience as a whole (not just on this module). Building on their initial personal development plans and skills audit, students will be required to critically reflect on their individual learning throughout the programme and how this has, or they believe will, help shape their future career. https://smartwriterblog.com/business-and-management/c%e2%80%8c%e2%80%8d%e2%80%8d%e2%80%8d%e2%80%8c%e2%80%8d%e2%80%8d%e2%80%8c%e2%80%8c%e2%80%8d%e2%80%8d%e2%80%8d%e2%80%8c%e2%80%8d%e2%80%8d%e2%80%8d%e2%80%8d%e2%80%8c%e2%80%8d%e2%80%8domponent-a2-indivi/ The critical reflection should provide evaluation of the extent to which they have used relevant concepts and theories to make a contribution to their future career as well as their own learning. Students must use a reflective model to underpin their reflection and also some references to support their evaluations. What is reflective writing? See: https://youtu.be/QoI67VeE3ds Marking Criteria: Component A2 The following criteria will be used in evaluating this assessment: You are asked to write an individual reflection. The most important elements in this reflection are: that you are ab‌‍‍‍‌‍‍‌‌‍‍‍‌‍‍‍‍‌‍‍le to write them in a clear manner, that you are able to use and apply adequately a reflective model, select relevant experiences/examples, identify patterns of attitudes and behaviours by critically reflecting on those experiences, use some references to support your evaluations. Please see Appendix A for the detailed marking grid. Formative feedback and support during the module Formative feedback provides opportunities to reflect on your ongoing work and preparation for your assignment. You will have opportunities to discuss your work in the lectures and sessions organised in the module. Further information about this assessment is available on the Blackboard site for this module and includes: FAQs, module handbook, https://smartwriterblog.com/business-and-management/c%e2%80%8c%e2%80%8d%e2%80%8d%e2%80%8d%e2%80%8c%e2%80%8d%e2%80%8d%e2%80%8c%e2%80%8c%e2%80%8d%e2%80%8d%e2%80%8d%e2%80%8c%e2%80%8d%e2%80%8d%e2%80%8d%e2%80%8d%e2%80%8c%e2%80%8d%e2%80%8domponent-a2-indivi/ reading list. Formatting Please use the following file format(s): Word, .pdf and .ppt. We cannot ensure that other formats are compatible with markers’ software and cannot guarantee to mark incorrect formats. All work should be word processed in 12-point font Times New Roman or Arial and single spaced. The first page of your coursework must include: Your student number The module name and number Your word count Word Limit The maximum word limit for this coursework is: Component A2: 1000 wo‌‍‍‍‌‍‍‌‌‍‍‍‌‍‍‍‍‌‍‍rds 

3 page essay on corporate merger or acquisition

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You may choose any recent merger or acquisition (within the last 5 years). And analyze the success of the merger or acquisition.

The completed project should include the information listed below.

v Provide an introduction to the companies involved in the merger or acquisition. 

v Include the companies’ background information and the reasons for the merger.

v Evaluate the financial statements of both companies (balance sheet, income statement, cash flow statement).

v Evaluate the potential and actual risks that occurred during the merger and what the companies could have done differently to mitigate these risks.

v Discuss the companies’ management of human capital in the merger or acquisition.

v Evaluate the soundness of the company’s financial policies after the merger (e.g., capital structure, debt, leverage, dividend policy, enterprise risk management, and others.) based on the material covered during class.

v Include a synopsis of your findings, including your recommendations and rationale for whether the merger or acquisition was beneficial to both companies and your recommendation on best practices for moving forward.

· This analysis should be at least three (3) pages in length, not counting the title and reference pages.

· Support your findings and recommendations with evidence from the annual report and at least five scholarly sources, industry reports. 

· Use APA 7th edition format to cite and reference all sources, including any websites that were used to access company information.