What evidence-based treatment options may be employed to maintain Joel whilst he is in the ICU. Assuming Joel recovers from this acute episode discuss the ongoing care he may need to help him rehabilitate and in relation to the management of potential ongoing chronic kidney disease, including any multi-disciplinary team involvement.

/in /by

Care of deteriorating patient

Joel Johnson

Joel is a 72 year-old retired architect. He continues to work informally as a consultant on some projects in addition to having had a number of books of poetry published in recent years. Joel has been married to Sylvia for 49 years, and they have been planning a cruise to celebrate their golden wedding next year. They have four grown up children, and nine grandchildren, who they see regularly and often assist their parents by providing child care. In addition, Joel and Sylvia also care for Sylvia’s 94 year-old mother who is increasingly frail.

Joel attended the practice nurse at his GP surgery with a painful and inflamed injury to his left fore-arm sustained whilst clearing his garden shed last week, he believes he caught it on a rusty bow saw that was hanging on the shed wall. Concerned about the state of the wound and his observations the nurse called an ambulance for Joel to be transferred to the accident and emergency unit for potential admission.

Joel has mild osteoarthritis for which he takes over-the-counter NSAIDs and is prescribed Ramipril 5mg od for hypertension. Joel was a heavy smoker until giving up twenty years ago.

 

OBSERVATIONS ON ARRIVAL AT ACCIDENT AND EMERGENCY

AIRWAY: Unable to talk in full sentences as needs to catch his breath.

BREATHING: RR: 28pm, SpO2 93% on air. Some sounds of gurgling as he breathes.

CIRCULATION: HR: 112bpm, regular but thready, BP: 72/58 – Joel complains of feeling dizzy. Joel seems to think he has been passing less urine in the last couple of days.

DISABILITY: AVPU: Alert but seems a little muddled and shows signs of slurred speech

EXPOSURE: Temperature: 38.4C. Joel has an inflamed wound on his left arm and his skin feels clammy to the touch. Joel also admits to feeling nauseous.

Blood Results:

  • Sodium 142mmol/L
  • Potassium 5.1mmol/L
  • Urea  39 mmol/L
  • Creatinine 259 µmol/L
  • FBC Hb 100.2g/L, WCC 16.2×109/L
  • Lactate 4.1mmol/L
  • CRP 136mg/L

 

 Problem 1:

Using the A-E approach what are the nursing priorities for Joel’s immediate care including any further tests that may be required?

Problem 2:

Provide the rationale for the care you have suggested in problem 1 .

  • Make use of appropriate pathophysiology
  • Include relevant pharmacology
  • Use appropriate national guidelines.

Developing Scenario

After three days on the ward Joel’s condition has deteriorated and he is now confirmed as having stage 3 acute kidney injury (AKI) with serum creatinine of  403µmol/L and no urine output for 18 hours. He needs renal replacement therapy.

 

Problem 3: What evidence-based treatment options may be employed to maintain Joel whilst he is in the ICU. Assuming Joel recovers from this acute episode discuss the ongoing care he may need to help him rehabilitate and in relation to the management of potential ongoing chronic kidney disease, including any multi-disciplinary team involvement.

Discuss the technique of aerobraking as it applies to interplanetary space missions. How does it work, why is it used, and describe at least two examples where the concept has been applied?

/in /by

Aerobraking

Discuss the technique of aerobraking as it applies to interplanetary space missions. How does it work, why is it used, and describe at least two examples where the concept has been applied?

Write a paper on how the U.S. manned spacecraft engineers decided on the blunt shape for the Mercury, Gemini, and Apollo capsules. What other alternatives exist for the safe re-entry of humans? What are the primary issues?

/in /by

Spacecraft engineers

Write a paper on how the U.S. manned spacecraft engineers decided on the blunt shape for the Mercury, Gemini, and Apollo capsules. What other alternatives exist for the safe re-entry of humans? What are the primary issues?

If the price of a portrait during Month 21 is $10, what would you predict for sales in Month 21? Does there appear to be a problem with autocorrelation of the residual? Explain your answer.

/in /by

Multiple Regression

For this assignment, you may find it helpful to review the Youtube video that is attached in the word document. Excel will be needed for this assignment. Show all your work.

Let Yt be the sales during month t (in thousands of dollars) for a photography studio. Let Pt be the price charged for the portraits during month t. The data will be in the file named week 4 assignment chapter 12 problem that is attached. Use regression to fit the following model to these data:

Yt = a + b1Yt−1 + b2Pt + et

This equation indicates that last month’s sales and the current month’s price are explanatory variables. The last term, et, is an error term.

For your assignment, complete the following:

Part A: If the price of a portrait during Month 21 is $10, what would you predict for sales in Month 21?

Part B: Does there appear to be a problem with autocorrelation of the residual? Explain your answer.

In your Excel spreadsheet,
-Utilize the regression model.
-Utilize the support tool of Excel.
-Predict sales as described in Part A.
-Explain any problem as described in Part B

Discuss how observations about self-awareness in the article relate to the principles of K&V’s Core Reflection model.

/in /by

Self-reflection

This assignment reinforces the importance of self-reflection. Discussing how the Core Reflection model relates to self-awareness will enhance your ability to be a reflective leader.

Discuss how observations about self-awareness in the article relate to the principles of K&V’s Core Reflection model.

Prepare loads for overvalued shipments, and prepare customs clearance paperwork. Facilitate the shipping of products from one destination to another. Arrange transportation, schedule staff, and orchestrate deliveries to meet customer demand with little to no delay.

/in /by

Alhanouf Alghamdi’s Personal Statement

Business System Analyst

To achieve professional growth in the field of risk management through a process of continuous learning & improvement, and to match pace with Saudi Arabia’s 2030 vision to serve my country and my organization in line with the dynamics of global rapid competition.

WORK EXPERIENCE
Business System Analyst
-Saudi Aramco/Corporate Emergency Management & Continuity Division
-Project Lead for Corporate Resilience KPI to establish a basis for measuring Operational, Cyber, Financial, and Reputational elements across Saudi Aramco.
-Project Team Member and Administrator for the Corporate Mass Notification System to communicate with all employees and stakeholders to alert them to any immediate threat.
-Member of the Corporate Incident Response Team during crisis. Operational Excellence Assessor for Business Continuity element.
-Establish and maintain a Corporate Emergency Dashboard to monitor several KPIs related to Risk Mitigation and Emergency Response.
-Conduct Business Continuity sessions for Saudi Aramco’s Joint Ventures and Subsidiaries.

Exempt Logistics Advisor
-Prepare loads for overvalued shipments, and prepare customs clearance paperwork.
-Facilitate the shipping of products from one destination to another.
-Arrange transportation, schedule staff, and orchestrate deliveries to meet customer demand with little to no delay.

Where do you stand on this spectrum, and use empirical evidence to support your position by giving specific references to the course material and additional materials that you can find, such as the Green New Deal.

/in /by

What is International Political Economy?

There are various approaches to deal with ecological illness, and we can all place them on a spectrum between libertarianism (no government intervention, free and atomic individuals can decide what is best for their own interests) vs. benevolent authoritarianism (government should intervene and take necessary steps to save the environment). Where do you stand on this spectrum, and use empirical evidence (surveys, statistics, interviews, policies, etc.) to support your position by giving specific references to the course material and additional materials that you can find, such as the Green New Deal.

Discuss what could happen to the slope of a regression of Y versus a single X when an outlier is included versus when it is not included. Will this necessarily happen when a point is an outlier?

/in /by

Outliers and Time Series Analysis and Forecasting

Assess the use of various decision support tools and explain why outliers are sometimes called influential observations.

Discuss what could happen to the slope of a regression of Y versus a single X when an outlier is included versus when it is not included. Will this necessarily happen when a point is an outlier?

You are required to give at least two examples in your response.

Provide a good exploration of the social context of the client, their background in terms of culture, ethnicity, gender, class, sexuality and any other relevant areas. Discuss the context in which you work where you have assessed this client and how this shapes the work taking into consideration yourself as a clinician and your client and an examination of the similarities and/or differences between you.

/in /by

Assessment of clients for counselling and psychotherapy

• My Model of Assessment – an introduction

o Present an introductory section demonstrating your familiarity with the wide ranging literature on client assessment and offer a critical review that justifies the rationale for your model of assessment – ask yourself – Why this model of assessment for this client? Why did I assess the client in this way? What are my influences ?

• Your task is to Illustrate this ‘model’ applied to the assessment of one client

• Introduction to the client

• The task is to produce an assessment report on a client that you have assessed for talking therapy. This report should include a detailed formulation which incorporates the relevant theoretical perspectives you have drawn upon and a rationale for the way you will proceed to work therapeutically with this client.

  • The client details:
  • Age: 29th years.
  • Gender: Male
  • Ethnicity: British
  • Sexual orientation: heterosexual
  • Religion: not known
  • Number of sessions so far: 6 sessions
  • Number of sessions of therapy in total: ongoing length
  • Disability: none
  • Organisation: The client received counselling therapy at Change Grow Live organisation because of his addicts to alcohol.

Client problems:, childhood trauma, social anxiety and Depression, fear of separation.

• This section should incorporate a consideration of the client’s presenting problem, and the client’s goals for therapy, and an explanation of how you are going to work with this presenting problem and with these goals

What needs to be included

• Relevant information you have found out at assessment which pertains to the client’s presenting problem(s),

• Provide a good exploration of the social context of the client, their background in terms of culture, ethnicity, gender, class, sexuality and any other relevant areas. Consider their access to resources and how all of this information shapes the assessment process for you and the client

• Discuss the context in which you work where you have assessed this client and how this shapes the work taking into consideration yourself as a clinician and your client and an examination of the similarities and/or differences between you

The formulation

 The formulation is based on information you obtained at the assessment.
 The formulation provides your understanding of the client in the light of the relevant theory and research which you have chosen to draw upon
 It should also include an exploration of how your own experience of the client has informed your approach
 Your formulation will be influenced by your chosen integrative model

Critical Perspectives

 Critically discuss theory and research relevant to the client’s clinical presentation
 Any prior clinical diagnosis the client has disclosed may be discussed here and reflected on in terms of how you plan to work with the meaning of this diagnostic label for this client
 Discuss the implications of your chosen therapeutic interventions and why you have chosen to work with this client in this way.
 Incorporate a reflection on any discussion you may have had regarding pre-existing diagnostic labels that the client may have been assigned

Meta-Analysis

 Reflect critically on how you conducted the assessment session.
 Demonstrate an understanding of the impact of this assessment session on the client and on the therapeutic relationship.
 If you have continued to work with the client, critically reflect on your ongoing work together including how the relationship has changed over time.
 Through the medium of this meta-analysis, you need to demonstrate your grasp of theory and research findings and their implications for treatment/therapeutic intervention, and to be able to reflect critically on your work with the client.

Why does the author argue that the first American trials (1847) were illegal? Why was New Mexico’s statehood delayed for 64 years? Explain how the Spanish and American racial system created a “double colonization” of Mexican Americans? Explain which racial narrative was used to prevent New Mexico from achieving statehood?

/in /by

Race in the United states

Answer the chapter questions using at least 3 sentences.
Introduction:
How does this book fit into what is already known about race in the United states? Identify and explain the author’s main argument?

CH 1:
Why does the author argue that the first American trials (1847) were illegal? Why was New Mexico’s statehood delayed for 64 years?

Ch 2:
Explain how the Spanish and American racial system created a “double colonization” of Mexican Americans? Explain which racial narrative was used to prevent New Mexico from achieving statehood?

Ch 3:
Explain how Mexican Americans became “legally” white, socially non-white? Explain the racial positioning of Mexican American elites in relation to African Americans?

Ch 4:
Explain how United states vs Sandoval (1897) court cases lead to loss of land for Mexican Americans? Why did the 1897 Rodriguez case encourage Mexican Americans to distance themselves from blacks and indians?

Epilogue and Postscript:
Why do you feel Mexican Americans still feel insecure about their racial status in U.S society? How will Mexican Americans fit into the racial landscape in the 21st century?