Case 5 History and Physical Essay

b. What medium would you use to reach each of these parties and what would your relative resource allocation be to each?

SKIN: She has some mild ecchymosis on her skin, and some erythema. She has patches but no obvious skin breakdown. She has some fissuring in the buttocks crease. PULMONARY: Clear to percussion and auscultation bilaterally. CARDIOVASCULAR: No murmurs or gallops noted. ABDOMEN: Soft, nontender, protuberant, no orgonomegaly, and positive bowel sounds. NEUROLOGIC EXAM: Cranial nerves II through XII are grossly intact. Diffuse hyporeflexia. MUSCULOSKELETAL: Erosive, destructive changes in the elbows, wrists, and hands consistent with rheumatoid arthritis. Has bilateral total knee replacements with stovepipe legs, and perimalleolar pitting edema 1 +. I feel no pulses distally in either leg. PSYCHIATRIC: Patient is a little anxious about these new symptoms and their significance. We discussed her situation and I offered her psychologic services. She refused for now.

Sparkle Company is a Nigerian diamond mining company. Sparkle is a joint venture, 50 percent owned by Shine and 50 percent owned by Brighten. Both Shine and Brighten are U.S.-based companies with their functional currency being the American dollar. Sparkle Companies functional currency is that of Nigeria, being the Naira. During 2009, Sparkle had several transactions with its joint venture owners and outside parties. The details of Sparkle’s transactions are three loans, three expenditures, and one revenue stream. The loans the company took out were $1 million from Brighten, $1 million from Shine, and 300 million Naira from a local Nigerian bank. The expenditures

Prior to diagnosis the individual may show signs of forgetfulness due to an incline in memory functions. They may even show signs of a decline in reasoning and communication

Question #1: How would Sheryl Sandberg’s leadership style be described based on the four behavioral leadership styles?

Certain qualities are consistently observed in the Alzheimer’s victim. These dysfunction’s, though, are not exclusive to Alzheimer’s disease. Consequently, declaring Alzheimer’s by these parameters is a matter of degree rather than an absolute. Characteristic dysfunction’s have been noted in Alzheimer’s victims, but the degree and severity of these varies from patient to patient. Thus, evaluation of the patient’s mental status must be made based on the sum, rather than a single characteristic. Memory is one of the first noticed deficiencies, beginning typically with the recent and short term memory, and progressing from there as the disease grows more severe. In addition, deterioration in language skills, attention span, praxis (performance of an action), and visuospatial skills are commonly seen. Also observed are changes in the actions and personality of the Alzheimer’s victim. These include changes in mood, motor activities, activities of daily living, socialization skills, psychotic disturbances, vegetative symptomology, and rise in anxiety levels. Again, the

This case is talking about an executive retreat. It was introduced by John Matthews who was a executive had been selected to attend the two-and-a-half-week retreat. The retreat was more like a competition about academic and athletic. The team members should not only get know each other and cooperate with teammates but also need to compete with others. The whole participants were broken into five groups and their aim was to win the competition. There are several sessions about academic and athletic that the participants should complete. After the introduction part the case showed the experience of John. Before the group meeting John was wondering and worried about this retreat. When he was taking the first group meeting, he tried to learn

Dementia describes a set of symptoms that may include memory loss and difficulties with thinking, problem-solving or language. These changes are often small to start with, but for someone with dementia they have become severe enough to affect daily life.

Impaired memory R/T neurologic disturbances AEB patient unable to recall recent events. She was to take part in the nursing facilities exercise program more often; this was to promote her physical and psychological well-being (Cox, 2007). Upon visiting her the second time it was clear that she had followed my suggestions. She was able to walk around her room more freely with the aid of her walker, which she did not use as much before. She was also able to recall our last meet in some detail, verbalizing recall of some recent events. The patient is consistent in her routine of care, which aided in her ability to recall events (Cox, 2007). The sense of familiarity form a consistent routine assisted the patient in being able to recall events.

As people get old a few of them will experience changes in cognition with age related capacity rather than intellectual capacity. There are some people who get both disparities of mentally and physically impaired that will led into depression due to aging process of their body. Even though, the forgetfulness is a common among older adults, we as healthcare providers must evaluate altered mental status of the patients. “The evaluation and management of altered mental status are broad and require careful history and physical examination to eliminate life-threatening situations”(Patti & Dulebohn, 2017). Therefore, it is very important to recognize the importance of difference between normal age-related symptoms and developing new health problems that can arise in this specific population. As elders get older their memory lapses it frustrating to them leading them to be more worried about changes in their memory. Nurses have a unique capability to promote a cognitive health and determine the possibilities of potential cases of the impairment in elders. The movie “On Golden Pond” Mr. Norman was a perfect example and showed that his symptoms were interfering with his everyday live when he almost burns down the house with fire, calling Bill by his daughter’s name Chelsea and getting lost in on the lake. Even though, Mr. Norman had heart and dementia problems his wife never discouraged him to do what he liked such as

155). There are many types of tests and approaches to cognitive assessments depending on the age of the person and symptoms currently experienced (Cordell et al. 147). These assessments are combined to ensure that there is a clear reason for concern, however, in the film, simply memory testing is done. During sessions with a neurologist, it is important if an informant, someone who has witnessed the change in cognition, is present during the diagnostic process (Cordell et al. 147). After informing Alice of this, she, alongside her husband, is tested through the repetition of sentences and ability to memorize a name and address. Alice’s neurologist merely tests her memory, while excluding other important examinable areas. If the cognitive assessments cause further concerns, a full dementia evaluation is conducted (Cordell et al. 147).

On a snowy January evening, the Midwestern Medical Group (MMG) management team held a retirement party for Judith Olsen, MMG president. During the evening, Olsen reflected back on the years she had worked for MMG with mixed feelings about her experience. Over the course of their eight-year integration

Shakespeare Inc., a private publishing company issued its F/S on March 20, 2012. There were several accruals and events that the management of Shakespeare is considering to determine if they should be recognized or disclosed in Dec 31, 2011 F/S. In my opinion, the important things to focus on subsequent events are the period they effect and if their influence is material or not, so that in conclusion, the F/S are fairly presented.

During the very early stages of Alzheimer’s disease, there may be a decline in other aspects of cognition such as word-finding, vision/spatial issues, and impaired reasoning or judgment.

Dementia effects your memory and a person’s ability to achieve a normal everyday task and activities.