A hospital uses a particular medicine about 10,662 capsules per
year.
At the moment, the hospital purchases the medicine from a
supplier
who has a lead time of 7 days.
The hospital has a holding cost of 1.83 per capsule per year
and
an ordering cost of 85 dollars per order.
What is the optimal annual holding cost?
Assume EOQ model is appropriate.
Use at least 4 decimal places.
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Part II To calculate the percentage of calories (kcal) derived from each of the energy nutrients when the total number of calories is known, divide the calories from each nutrient by the total number of calories, and multiply by 100. (3 x 5 points each = 15 points) Example: A person consumed 600 kcal from CHO, 360 kcal from Fat and 240 kcal from Pro. How many kcal did she consume? What percentage of the total kcal in her diet was derived from each of the three nutrients? 600 CHO kcal from CHO 600 = 50% CHO 360 Fat total kcal 1200 240 Pro 1200 Total kcal kcal from Fat 360 = 30% Fat total kcal 1200 kcal from Pro 240 = 20% Pro total kcal 1200
1. If you consumed 400 kcal from CHO, 630 kcal from fat and 540 kcal from protein, what percentage of the total kcal was derived from each of the three energy providing nutrients?
2. A bran muffin contains 12 kcal from protein, 45 kcal from fat and 17 kcal from CHO. How many total kcal does the muffin provide? What percentage of the kcal in the muffin comes from each of the three macronutrients? If you know the number of grams of each nutrient in a food item, multiply the grams times how many calories per gram that nutrient provides.
3. A cup of chocolate ice cream contains 34 g fat, 50g CHO and 12 g protein. How many kcal are in the 1 cup portion? What is the percentage of calories from each nutrient?
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Epidemiology & relating health sciences.
What challenges do epidemiologists face in studying social determinants of health? Please provided details
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what partnership category does an Accountable Care organization fall within?
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Hand written not allowed
Write at least one page and a half about Healthcare planning in relation to vision 2030.
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Prepare an F-DAR chart note with the following scenario;
SCENARIO A:
Mrs. Rose Tiny is a resident at Good View’s Nursing Home. She has dementia in the early stages. She takes direction well, but often must be assisted due to her memory problems. Sometimes she forgets to call for assistance when she needs to be toileted. You did her VS they are 100/68-37-64-20 and during that time, you noticed a smell. Mrs. Tiny is sitting in a geri chair by her bed. You noticed that she is a bit agitated and she started to cry. When you checked Mrs. Tiny you noticed that she was incontinent of both urine and stool. As the assigned PSW you will need to provide care for her but her care plan states she is times 2 assist in transfers..Document the care provided it is now 1400 hrs.
SCENARIO B:
At 09:30 hrs you complete your initial assessment. One of your clients Mrs. Kup is 90 years old. She had a fall at home & went for right hip surgery a week ago.
You notice that she is confused at times & she thinks she is at home. She is often trying to get out of bed to go to the bathroom. You gave her a bedpan & she voided. Her VS 140/76-88-16-36.9.. At breakfast, she refused half her meal, but she is drinking fluids as well. She said she is not hungry. Document the care provided it is now 1000 hrs.
Fill the information using this chart.
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Date/Time |
Discipline |
Focus |
DAR: Data, Action, Response |
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name one healthcare organization that uses the joint operating agreement partnership
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Read each of the case studies presented, and explain, What your opinion is and how you arrived at it.
Case Studies
A. Brent underwood, a health insurance professional in the Beach Front Medical Clinic, is convinced by Bertha Parker, a 60-year-old patient of the clinic, that she is a "financial hardship" case. Brent tells Ms. Parker that he will send in a claim to her insurance company and "write off" any balance that they do not pay. Determine if Brent is within this legal rights as a health insurance professional to do this for Bertha. If not, decide if his actions constitute fraud or abuse.
B. Mary Larson visits Dr. Jacob Astor, her obstetrician, for a suspected pregnancy. Dr. Astor performs an examination, determines she is pregnant, and asks you, one of his versatile healthcare professionals, to arrange for an ultrasound. The office is busy, so you inform Mary that you will schedule the procedure later and call her with the appointment date and time. Later that day, you telephone Mary’s residence and her husband answers the telephone. You inform him of the appointment time that has been set up for Mary’s ultrasound. Is this a breach of confidentiality? Why or why not?
C. You are employed as a health insurance professional for Dr. Gail Lorber, a family practice physician. Dr. Ian Sutton telephones from the State University epidemiology laboratory. He informs you that he is doing a clinical study on infectious diseases and is requesting a list of all patients who have been treated for hepatitis A, B, and C in the past 5 years. Do you need to procure a written release from each patient to give this information to Dr. Sutton? Why or why not?
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ICD 10
1. A 70-year-old female presented to the hospital with fever, myalgia, arthralgia, tachycardia, and dehydration and was believed to be septic. This patient has a history of hypertension, CHF, and migraines. Routine medications include Lasix 40 milligrams by mouth each morning, if needed, for significant pedal edema and Isordil 20 milligrams by mouth four times a day.
A variety of studies were obtained to further delineate the source of her problem. Urine cultures were negative. Blood cultures grew Escherichia coli. The blood urea nitrogen level was 22, and a random glucose was 149. An anterior-posterior film of the chest taken at the same time showed acute pulmonary edema.
The patient received intravenous fluids. The patient's routine medications were continued, and she received intravenous antibiotics. On the fourth day of her hospital stay, it was believed that the patient had reached maximal hospital benefit and was therefore switched to oral antibiotics and was discharged. The patient left the hospital in good condition.
DISCHARGE DIAGNOSES:
Septicemia due to Escherichia coli
Dehydration
Hypertensive heart disease
with heart failure
2. A 2-year-old male presented with fever, vomiting, and abdominal pain. The patient was severely dehydrated with a blood urea nitrogen level of 54, indicating acute renal failure. Blood cultures obtained grew Staphylococcus aureus. The patient was treated with a 10-day course of intravenous vancomycin. The patient also received intravenous fluids and had improved renal function. Upon admission, the patient was noted to have a rash on his buttocks and was treated with topical ointment. The patient improved and was discharged.
DISCHARGE DIAGNOSES:
Sepsis due to Staphylococcus aureus
Severe sepsis with septic shock
Acute kidney failure
Dehydration
Diaper rash
3. A 94-year-old male was admitted to the hospital with a chief complaint of abdominal pain and loss of weight. The patient had a history of coronary artery disease and myocardial infarction. There is no history of coronary bypass surgery. The patient had a nebulizer at home and takes metoprolol. These medications were continued during the patient's stay. Physicalrevealed abdomen to be tender to palpation in the left mid and lower quadrants with some rebound. Bowel sounds were present, and there was no guarding. Blood pressure was normal. Pulse, respirations, and temperature were normal.
During hospitalization, EKG showed sinus rhythm with myocardial changes of ischemia. Sputum cytology was suggestive of adenocarcinoma, compatible with bronchoalveolar growth. Chest x-ray showed metastatic lesions and chronic obstructive lung disease in both lung fields. Barium enema showed adenocarcinoma of proximal sigmoid colon. Abdominal series showed no evidence of obstruction, but moderate dilation of his transverse colon was evident. Patient was seen in consultation, and it was decided to do as little as possible at this time due to the patient's age and lung conditions. The patient agreed with this approach and requested discharge to home to receive hospice care.
DISCHARGE DIAGNOSES:
Carcinoma of sigmoid colon
Probable metastatic bronchogenic carcinoma, right lung
and left lung
Chronic obstructive lung disease
Coronary artery disease
Previous myocardial infarction
4.
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This patient is a 43-year-old female with a long history of joint pain. Lately she had been feeling very tired and weak. She also has had intermittent abdominal pain with nausea and vomiting. Her joint showed tenderness of the knees. She denied any problems suggestive of hypothyroidism (myxedema). The patient's hematocrit was 27.6, serum iron was found to be decreased at 27, and thyroid functions were found to be markedly low. Upper GI series showed a 4-millimeter ulcer at the posterior wall of the duodenal bulb. The patient was transfused 2 units of packed red cells. She was started on ferrous sulfate 300 milligrams twice a day. She was also begun on Tagamet for the ulcer. Further questioning revealed that she had indeed been hypothyroid in the past and has been on thyroid medication until stopped by another physician. The patient was restarted on Synthroid 0.2 milligrams per day. She was discharged on the sixth hospital day. DISCHARGE DIAGNOSES: Hypothyroidism Anemia due to myxedema Acute duodenal ulcer 5. This patient is a 14-year-old African American male who was admitted due to sickle cell crisis and acute chest syndrome. His mother has sickle cell anemia, and his father has the sickle cell trait. Because of this, the patient was tested at birth; a blood sample was drawn, and it was sent to the laboratory for hemoglobin electrophoresis to obtain a definitive diagnosis. Unfortunately, the test was positive for sickle cell disease. The patient was given intravenous fluids and was started on Darvocet for pain management. When the Darvocet failed to keep his pain at an acceptable level, he was switched to Vicodin. The patient is to be discharged with follow-up in the pediatrician's office tomorrow. DISCHARGE DIAGNOSES: Sickle cell crisis with acute chest syndrome Family history of sickle cell anemia 6. A 31-year-old white male presented to the emergency room reportedly having taken 8 to 10 naproxen at home in a suicide attempt. He reported that he had been having trouble with his wife, and he is unemployed. He had apparently become despondent over this and attempted to take his own life with his girlfriend's pills. The patient is admitted to the telemetry unit due to paroxysmal ventricular tachycardia. The patient was started on metaraminol for the tachycardia. Fortunately, the patient seemed to sustain no other ill effects from the naproxen. The mental health service was consulted, and an appointment was made for outpatient services. He was given Prozac to treat his depression. At this time, the patient does not appear to be a threat to himself or to others. He appears remorseful and denies any suicidal ideations. He was discharged in good condition. DISCHARGE DIAGNOSES: Suicide attempt with naproxen Paroxysmal ventricular tachycardia Depression Unemployment Marital relationship problems Home (place of occurrence) |
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