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What is the most likely time frame for someone to have withdrawal symptoms after abrupt cessation of alcohol?

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JH is a 49 yo man was seen in the ED 2 days ago, diagnosed with alcohol intoxication and released after 8 hours to his brothers care.  He was brought back to the ED 12 hours ago with an active GI bleed and is being admitted to the ICU, his diagnosis is upper GI bleed and alcohol intoxication.

You are assigned to admit and care for JH for the remainder of your shift.  According to the ED notes, his admission vital signs were 84/56,110,26 and he was vomiting bright red blood.  His labs were remarkable for Hct 23%, alanine transaminase ALT 69 IU/ml. aspartate transaminase (AST) 111 IU/ml and serum alcohol 271 mg/dl.  He was given IV fluids and transfused 6 units of packed RBC’s in the ED.  On initial assessment, you note that JH’s VS are BP 154/90mmHG, pulse 98 beats/min, he has a slight tremor in his hands, and he appears anxious.  He complains of a headache and appears flushed. You note that he has not had any emesis and has not had any frank red blood in his stools or black tarry stools over the past 5 hours.  In response to your questions, JH denies that he as a alcohol problem but later admits to drinking approximately a fifth of vodka daily for the past 2 months.  He reports having been drinking just before his admission to the ED.  He admits to having had seizures while withdrawing from alcohol in the past.

  1. Which data from your assessment of JH are of concern to you? Explain your points.
  2. What are the two most likely causes of JH symptoms?
  3. What is the most likely time frame for someone to have withdrawal symptoms after abrupt cessation of alcohol?
  4. Is JH exhibiting any withdrawal symptoms now? if so identify them.
  5. If JH does not receive any additional treatment for his alcohol withdrawal what additional symptoms might he exhibit and identify the timeframe for them to occur.
  6. Identify what medications would you recommend JH receive for this alcohol withdrawal and why?
  7. What assessment tool or tools would you use to assess JH withdrawal symptoms?
  8. What are 3  priority nursing diagnosis that you would indicate on JH’s care plan and explain why they are a priority for you?
  9. What are at least 3 nursing goals or outcomes for JH?

 

Begin the process of gathering your sources by first searching for your topic. WHY is it important? Who does the health issue affect? People/population/problem (What are the characteristics of the population?

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Covid 19 Issue research-related.

• WHAT is the health issue or topic? (i.e., condition or disease or issue)
• WHY is it important?
• WHO does the health issue affect? People/population/problem (What are the characteristics of the population?
• Comparisons (What is the alternative to the intervention? How is this health issue addressed? What measures are in place to PREVENT worsening of the health issue?)
• Outcomes (What are the relevant outcomes of this health issue? i.e., morbidity, death, complications)
• HOW will your proposed solution make a difference?

Begin the process of gathering your sources by first searching for your topic in Google Scholar or using databases available through internet. Locate and record citations to articles, books and documents that may contain useful information and ideas on your topic. Choose three sources that are relevant to your health issue or topic, you will individually write three annotations that are between 150-200 words, summarizing the central theme and scope of the article. The annotation must be written in APA style.

Identify, to the extent discernible, Bastiat’s ontology, epistemology, axiology, and teleology; Judge his use of political language. Does Bastiat define terms such as authority, power, liberty, equality, and justice biblically?

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Read and evaluate Bastiat’s The Law. More specifically, you are to:

  1. Identify, to the extent discernible, Bastiat’s ontology, epistemology, axiology, and teleology;
  2. Judge his use of political language. Does Bastiat define terms such as authority, power, liberty, equality, and justice biblically?
  3. Express and defend your general agreement/disagreement with the content therein.

The paper is to 2-3 pages in length in current Turabian format.

M/W4 – O. W. Holmes, Jr Paper

Read and evaluate the Harvard Law Review article entitled The Path of the Law by Oliver Wendell Holmes, Jr. More specifically, you are to:

  1. Identify, to the extent discernible, Holmes’s ontology, epistemology, axiology, and teleology;
  2. Demonstrate which, if any, of Llewellyn’s 9-Point Manifesto of Legal Realism, are present in the article.
  3. Appraise the general tone and tenor of Holmes’ view of the nature and function of the law.

The paper is to be 2-3 pages in length in current Turabian format.

M/W6 – A Biblical Defense of Rights and Justice

In this paper you are to:

  1. Put forth a spirited, lucid, and above all, scriptural argument for the existence of the right to life, liberty, and property;
  2. Define justice considering the existence of said rights.
  3. In your analysis, utilize the conceptual distinction between negative and positive rights.

The paper is to be 2-3 pages in length in current Turabian format.

Submit this assignment by 11:59 p.m. (ET) on Sunday of Module/Week 6.

M/W8 – The Future of American Jurisprudence

In this 4-5 page paper, written in current Turabian format, you are to:

  1. Briefly review the basic premises of the major schools of jurisprudence—biblical/natural, legal positivism, legal realism, and critical legal theory;
  2. Assess the state of the current American legal landscape; and
  3. Predict, using sound logic, the future of American jurisprudence.

Prepare a Persuasive Brief to Court entitled “Defendant’s Motion for Self-Defense Jury Instruction.” For this Persuasive Brief to Court, you may use the materials and research from the Legal Memorandum

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We are getting ready to go to trial on the Jeffrey Bing matter. Since my initial interview with Mr. Bing (see the Senior Attorney Memorandum), the paralegals have found out some additional facts about the case. Discovery is now closed.

The trial is scheduled to begin in 4 weeks. Pretrial motions and supporting briefs are due soon. The judge has asked counsel to propose jury instructions. Jury instructions are a set of legal rules the judge reads to the jury that give the law of a case. The jurors should follow these instructions when deciding a criminal or a civil case. Prior to having these instructions read, the parties provide the court with proposed jury instructions. The court then determines which instructions it will give to the jury.

In this matter, the parties and the court agree that a key issue that must be resolved is how the jury should be instructed on the self-defense issue.

In Illinois, the relevant pattern jury instruction for self-defense reads:

IL-IPICRIM 24-25.06, Ill. Pattern Jury Instr.-Criminal 24-25.06

24-25.06 Use Of Force In Defense Of A Person

A person is justified in the use of force when and to the extent that he reasonably believes that such conduct is necessary to defend [ (himself) (another) ] against the imminent use of unlawful force.

[However, a person is justified in the use of force which is intended or likely to cause death or great bodily harm only if he reasonably believes that such force is necessary to prevent [ (imminent death or great bodily harm to [ (himself) (another) ]) (the commission of ) ].]

The court has asked the parties to submit briefs analyzing whether or not this instruction should be given to the jury.

We represent the defendant, Mr. Bing, in this matter, and thus your trial brief must argue why this jury instruction should be given.

Prepare a Persuasive Brief to Court entitled “Defendant’s Motion for Self-Defense Jury Instruction.”

For this Persuasive Brief to Court, you may use the materials and research from the Legal Memorandum you prepared earlier for me. The Persuasive Brief to Court must contain at least 3 cases (including the provided case) and 1 statute (the provided statute) to support your argument.

Evaluate how an organization is structured differently when it operates solely within one country versus one that operates in multiple countries. In particular, discuss the best fit of the multinational firm to its worldwide industry environment and the changing role of central headquarters as an organization expands into other countries.

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Organizations are structured to take advantage of their inherent strengths and also to minimize their inherent weaknesses. For example, an organization may outsource its purchasing functions if they can be accomplished more effectively and efficiently by a private vendor. Evaluate how an organization is structured differently when it operates solely within one country versus one that operates in multiple countries. In particular, discuss the best fit of the multinational firm to its worldwide industry environment and the changing role of central headquarters as an organization expands into other countries.

Determine the influence the implementation of the ERP systems has on the performance of the firms  Establish the criteria utilized by SMEs to select the best ERP system. Assess the consequences of selecting the wrong ERP system.

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Determine the influence the implementation of the ERP systems has on the performance of the firms.

Establish the criteria utilized by SMEs to select the best ERP system.

Assess the consequences of selecting the wrong ERP system.

Determine what influences the choice of factors when implementing the ERP systems.

Draw the impact of the ERP system by asking the participants to provide detailed accounts of how the systems influence the performance of their firms.

Determine how the company balance the influence of the ERP system to ensure smooth running of activities.

Determine the positive impacts of ERP systems on the performance of the companies.

Determine how the company previous running of operations can affect the effectiveness of an ERP system.

Determine whether the selection of the best ERP system is a guarantee that a company will perform better.

Develop an argument for the story’s theme based on an analysis of a particular character. (You may choose to analyze the character of the narrator him or herself if the narrator is internal to and part of the story).

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As you were reminded last week, all stories have a plot (the order of events that happen) and all plots consist of five basic parts, and through paying attention to the way in which these events are ordered and where it is decided a story should begin and end, a story’s theme can begin to reveal itself.

This ordered series of events, the story’s plot, does not just magically appear in our brains; the story is always delivered through and mediated by language, and not just language in general (there’s no such thing), but a particular person’s words. That person is the narrator (as opposed to the writer.) The writer creates a narrator, who tells the story in a particular way and frames it from a particular POV. The choices a writer makes regarding the story’s narrator and how he/she tells the story is one way to get at a story’s theme.

The other element of fiction you read about this week is character. As Mays reminds us, characters can range from static, stock characters or caricatures all the way to round, dynamic, convincingly and affectingly human beings who stick in our minds for the rest of our lives. However, since writers deliberately develop their characters in these particular ways (characterization), “we thus need to consider…how the text shapes our interpretation of, and degree of sympathy or admiration for, the character; what function the character serves in the narrative; and what the character might represent” (193). Answering these questions about particular characters can help you to discover what some of the story’s larger themes may be.

For this week’s Original Post, choose any one of the assigned stories – “A&P,” “Puppy,” “Happy Endings,” “Good People,” “Araby,” or “Hills Like White Elephants” – and write two paragraphs according to the following requirements:

Paragraph 1 – As you summarize the plot of the story, also discuss how the plot is delivered by the story’s narrator. Who is the narrator? What is the POV?

Paragraph 2 – Develop an argument for the story’s theme based on an analysis of a particular character. (You may choose to analyze the character of the narrator him or herself if the narrator is internal to and part of the story).

Discuss the relationship between the audience and the television industry. Using examples from television and from critical work in the area, determine where, when, and why either group assumes control of the producer–audience relationship

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Write a research essay of 2500 words that integrates library research and primary sources (i.e., television shows) as you critically explore a topic of interest. You are expected to use at least three (3) external sources in your paper, and to refer to specific television shows as often as possible to support your arguments. Main Topic: Discuss the relationship between the audience and the television industry. Using examples from television and from critical work in the area, determine where, when, and why either group assumes control of the producer–audience relationship. What degree of understanding does each party have of its situation in relation to the other party? Are there any miscalculations? Finally, evaluate whether television supports the dominant hegemony or whether the audience drives the progression of television.

What is the public choice idea or theory? Explain what rent seeking is. How can you combine the ideas of public choice and rent seeking? Choose one real-world example of combining public choice and rent seeking to evaluate.

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Prior to beginning work on this discussion, read Tim Worstall’s article, One Benefit of Nancy MacLean’s Democracy in Chains – Public Choice and Rent Seeking Popularized.
Based on the article’s information and Chapter 14 in your textbook, especially Sections 14.1 and 14.2, respond to the following:

What is the public choice idea or theory?

Explain what rent seeking is.

How can you combine the ideas of public choice and rent seeking?

Choose one real-world example of combining public choice and rent seeking to evaluate.

I require that you include the section number where you found your answers. For example: (Amacher & Pate, 2019, section 2.3).

Use these references:
Amacher, R. and Pate, J. (2019). Principles of microeconomics (2nd ed.).

Worstall, T. (2017, August 6). One benefit of Nancy MacLean’s democracy in chains – public choice and rent seeking popularised. Forbes

Write a 2- paragraph analysis of your descriptive analysis results and include a copy and paste your output from your analysis into your final document. Based on the results of your data, provide a brief explanation of what the implications for social change might be.

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Choose the same two variables you chose from your Week 2 Assignment and perform the appropriate descriptive analysis of the data.
Once you perform your descriptive analysis, review Chapter 11 of the Wagner text to understand how to copy and paste your output into your Word document.
Write a 2- paragraph analysis of your descriptive analysis results and include a copy and paste your output from your analysis into your final document.You may also want to model your analysis and summary after my Sample Summary, to produce a more professional paper.
Based on the results of your data, provide a brief explanation of what the implications for social change might be. Early in your Assignment, when you relate which dataset you analyzed, please include the mean of the following variables. If you are using the Afrobarometer Dataset, report the mean of Q1 (Age). If you are using the HS Long Survey Dataset, report the mean of X1Par1Edu.