Lab Assignment: Assessing The Abdomen

ABDOMINAL ASSESSMENT

Subjective:

  • CC: “My stomach hurts, I have diarrhea and nothing seems to help.”
  • HPI: JR, 47 yo WM, complains of having generalized abdominal pain that started 3 days ago. He has not taken any medications because he did not know what to take. He states the pain is a 5/10 today but has been as much as 9/10 when it first started. He has been able to eat, with some nausea afterwards.
  • PMH: HTN, Diabetes, hx of GI bleed 4 years ago
  • Medications: Lisinopril 10mg, Amlodipine 5 mg, Metformin 1000mg, Lantus 10 units qhs
  • Allergies: NKDA
  • FH: No hx of colon cancer, Father hx DMT2, HTN, Mother hx HTN, Hyperlipidemia, GERD
  • Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)

Objective:

  • VS: Temp 99.8; BP 160/86; RR 16; P 92; HT 5’10”; WT 248lbs
  • Heart: RRR, no murmurs
  • Lungs: CTA, chest wall symmetrical
  • Skin: Intact without lesions, no urticaria
  • Abd: soft, hyperactive bowel sounds, pos pain in the LLQ
  • Diagnostics: None

Assessment:

  • Left lower quadrant pain
  • Gastroenteritis

 

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The O stands for outcomes that we would hope to see, which would be a decrease in hospital acquired infections. The T is the last and final letter and stands for time. In my hospital, the study was conducted over a three-month period to see if we saw a decrease in our hospital acquired infections. Using evidence based research I will find the conclusion to this question.

Need a response to this discussion 3 pages long APA format 3 references 1 from Walden University Library.  Willing to pay 15 dollars

 

 

Introduction

In the healthcare profession, it is very important that decision making is evidence based. For a decision to be evidence based the question must be clearly articulated, you must search for relevant evidence and you much choose the evidence of highest quality (Robeson, Dobbins, DeCorby, Tirilis, 2010. Pg.1). “A crucial first step in EBP involves converting information needs into well-worded clinical questions that can be answered with research evidence (Polit & Beck, 2017. Pg. 31).”

PICOT

The PICOT guidelines are questions that help clinicians discover the answers to their research (Walden Student Center for Success, 2012). With these guidelines in mind I formulated the question “Is the daily use of CHG for all pediatric inpatients who have no allergy to CHG associated with a lower incidence of bacterial infection in these same patients?” The P in the acronym stands for population or patients, in the case the characteristics of the population would be all patients who are staying in the hospital, especially for an extended period or those who have risk factors such as central lines. The I stands for the intervention, which would be the daily chlorahexadine baths. This intervention would help reduce the risk of hospital acquired infections such as MRSA or c diff. Comparison is the next step and is what the C stands for. In this case the comparison of the effectiveness of daily CHG baths would be compared to not doing CHG baths. The O stands for outcomes that we would hope to see, which would be a decrease in hospital acquired infections. The T is the last and final letter and stands for time. In my hospital, the study was conducted over a three-month period to see if we saw a decrease in our hospital acquired infections. Using evidence based research I will find the conclusion to this question.

 

Evidence Based Research

            When conducting research, it is very important to have filtered information and unfiltered information. “Filtered information is information that has been appraised for quality and clinical relevance (Hierarchy of Evidence Pyramid).” Filtered information includes systematic review, critically appraised topics and critically appraised individual articles (Hierarchy of Evidence Pyramid). “Unfiltered information is evidence that has not necessarily been appraised for quality. This information tends to come from primary sources (Hierarchy of Evidence Pyramid).” Unfiltered information includes randomized controlled trials, cohort studies, case-controlled studies and expert opinion (Hierarchy of Evidence Pyramid).

When searching the Walden Database for articles on my PICOT question, I used the search terms “CHG Bath,” “CHG Bath in Pediatric Patients,” and “Reducing infection using CHG Bath.” The first article I found multiple studies done on multiple patients with bone marrow transplants. The purpose of the study was to see if bathing them daily with CHG would decrease the acquired infections, which it did. This article would be considered a systemic review because it had multiple resources and multiple studies. When searching for critically appraised topics it was very difficult to find one that had a cohort study that had to do with CHG baths, there were some articles about other ways to reduce infection, but none that involved CHG.

The next article I found falls under the topic of expert opinion, in the case the expert opinion came from the nurses. In this study done in 2017, they interviewed nurses, nurse’s aides and nurse managers. They found that all interviewed did find a decrease in infection when CHG baths were used, however many times the nurses did not have time to administer the baths.

Research Advice

            I think that when conducting a search for evidence base practice it is important to stay open minded and patient. Staying open minded will help you think of different search terms that may yield different search results. It is also important to be patient while searching so that you can stay focused and weed out the unwanted results.

References

Laureate Education (Producer). 2012g). Hierarchy of evidence pyramid. Baltimore, MD:Author

Musuuza, J. S., Roberts, T. J., Carayon, P., & Safdar, N. (2017). Assessing the sustainability of daily chlorhexidine bathing in the intensive care unit of a Veteran’s Hospital by examining nurses’ perspectives and experiences. BMC Infectious Diseases, 17(1)

Polit, D.F., & Beck C.T. (2017). Nursing research: Generating and assessing evidence for

nursing practice (10Th ed.). Philadelphia, PA: Wolters Kluwer

Robeson, P., Dobbins, M., DeCorby,K., &Tirillis, D. (2010). Facilitating access to pre-processed research evidence in public health. BMC Public Health,10,95.

Rosselet, R., Termuhlen, A., Skeens, M., Garee, A., Laudick, M., & Ryan-Wenger, N. (2009). CH

 

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Prepare your recommendation on Agarwal Cast Company

Prepare your recommendation on Agarwal Cast Company
Caselet 1
Case1: Credit Decision – Agarwal Case
On August 30, 2006, Agarwal Cast Company Inc., applied for a $200,000 loan from the main office of the National bank of New York. The application was forwarded to the bank’s commercial loan department. Gupta, the President and Principal Stockholder of Agarwal cast, applied for the loan in person. He told the loan officer that he had been in business since February 1976, but that he had considerable prior experience in flooring and carpets since he had worked as an individual contractor for the past 20 year. Most of this time, he had worked in Frankfert and Michigan. He finally decided to “work for himself” and he formed the company with Berry Hook, a former co-worker. This information seemed to be consistent with the Dun and Bradstreet report obtained by the bank According to Gupta, the purpose of the loan was to assist him in carrying his receivables until they could be collected. He explained that the flooring business required him to spend considerable cash to purchase materials but his customers would not pay until the job was done. Since he was relatively new in the business, he did not feel that he could compete if he had to require a sizeable deposit or payment in advance. Instead, he could quote for higher profits, if he were willing to wait until completion of the job for payment. To show that his operation was sound, he included a list of customers and projects with his loan application. He also included a list of current receivables.
Gupta told the loan officer that he had monitored his firm’s financial status closely and that he had financial reports prepared every six months. He said that the would send a copy to the bank. In addition, he was willing to file a personal financial statement with the bank.
Question:
1. Prepare your recommendation on Agarwal Cast Company
Caselet 2
This case has been framed in order to test the skills in evaluating a credit request and reaching a correct decision. Perluence International is large manufacturer of petroleum and rubber-based products used in a variety of commercial applications in the fields of transportation, electronics, and heavy manufacturing. In the northwestern United States, many of the Perluence products are marketed by a wholly-owned subsidiary, Bajaj Electronics Company. Operating from a headquarters and warehouse facility in San Antonio, Strand Electronics has 950 employees and handles a volume of $85 million in sales annually. About $6 million of the sales represents items manufactured by Perluence. Gupta is the credit manager at Bajaj electronics. He supervises five employees who handle credit application and collections on 4,600 accounts. The accounts range in size from $120 to $85,000. The firm sells on varied terms, with 2/10, net 30 mostly. Sales fluctuate seasonally and the


 This section consists of Case lets.
 Answer all the questions.
 Each Case let carries 20 marks.
 Detailed information should form the part of your answer (Word limit 150 to 200 words).

IIBM Institute of Business Management 3
Examination Paper of Financial Management
average collection period tends to run 40 days. Bad-debt losses are less than 0.6 per cent of sales. Gupta is evaluating a credit application from Booth Plastics, Inc., a wholesale supply dealer serving the oil industry. The company was founded in 1977 by Neck A. Booth and has grown steadily since that time. Bajaj Electronics is not selling any products to Booth Plastics and had no previous contact with Neck Booth. Bajaj Electronics purchased goods from Perluence International under the same terms and conditions as Perluence used when it sold to independent customers. Although Bajaj Electronics generally followed Perluence in setting its prices, the subsidiary operated independently and could adjust price levels to meet its own marketing strategies. The Perluence’s cost-accounting department estimated a 24 per cent markup as the average for items sold to Pucca Electronics. Bajaj Electronics, in turn, resold the items to yield a 17 per cent markup. It appeared that these percentages would hold on any sales to Booth Plastics. Bajaj Electronics incurred out-of pocket expenses that were not considered in calculating the 17 per cent markup on its items. For example, the contact with Booth Plastics had been made by James, the salesman who handled the Glaveston area. James would receive a 3 per cent commission on all sales made Booth Plastics, a commission that would be paid whether or not the receivable was collected. James would, of course, be willing to assist in collecting any accounts that he had sold. In addition to the sales commission, the company would incur variable costs as a result of handling the merchandise for the new account. As a general guideline, warehousing and other administrative variable costs would run 3 per cent sales. Gupta Holmstead approached all credit decisions in basically the same manner. First of all, he considered the potential profit from the account. James had estimated first-year sales to Booth Plastics of $65,000. Assuming that Neck Booth took the, 3 per cent discount. Bajaj Electronics would realize a 17 per cent markup on these sales since the average markup was calculated on the basis of the customer taking the discount. If Neck Booth did not take the discount, the markup would be slightly higher, as would the cost of financing the receivable for the additional period of time. In addition to the potential profit from the account, Gupta was concerned about his company’s exposure. He knew that weak customers could become bad debts at any time and therefore, required a vigorous collection effort whenever their accounts were overdue. His department probably spent three times as much money and effort managing a marginal account as compared to a strong account. He also figured that overdue and uncollected funds had to be financed by Bajaj Electronics at a rate of 18 per cent. All in all, slow – paying or marginal accounts were very costly to Bajaj Electronics. With these considerations in mind, Gupta began to review the credit application for Booth Plastics.
Questions:
1. How would you judge the potential profit of Bajaj Electronics on the first year of sales to Booth Plastics and give your views to increase the profit?
2. Suggestion regarding Credit limit. Should it be approved or not, what should be the amount of credit limit that electronics give to Booth Plastics.

 

 

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Project Documentation Aspects

There are two aspects that can be considered during project documentation. They are:

Documenting the project after achieving each milestone.
Documenting the project after completing the project.
Based on your understanding of the topic, create a report in a Microsoft Word document to express your

views on the following:

Which of the two is a better option and why?
What are four different types of performance reporting? For each of them, describe the following:
Who will be the target audience?
How often you will use this type of reporting?

Sample Solution

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