Read the following scenario and write three (3) nursing diagnosis/PES statements that would be appropriate for Millie. Identify your problem, etiology, and sign/symptoms.

Correct Nursing Dx/PES statement for scenario

Identification of problem, etiology, and signs/symptoms

I’m Millie. I have lived in the same small house for the last 50 years. Harold and I raised our dear daughter Dina here and we had many good years together as a family. Harold passed last year, he was 91 you know, and I miss him terribly. I think about him every day. We were married for 68 years, most of them were happy. We did struggle with money at times, but who didn’t? All of our family lived close by and I spent many a Sunday cooking for 15 - 20 after church. Our home was always full of people; many of them are gone now. Snuggles, my cat, keeps me company. Snuggles is about 10 years old; she is a stray who just showed up on my doorstep one day and she’s been here ever since.

I’ve always kept myself busy, I sing when I can in the church choir and I volunteer in the church kitchen. I still love to cook; the church is always asking me to make my famous chicken and dumplings when we have special dinners. I can’t do as much as I used to, but that’s ok. I am fortunate to have many close friends from church.

I also enjoy gardening and I am known for growing my prize roses. My rose garden is not quite as big as it used to be, but I still like to get outside and work with the soil and the flowers. The fresh air does me some good. There are enough roses to cut several large bouquets every summer and I share them with my daughter and my friends. Did you know that my roses used to win blue ribbons at the county fair almost every year? Since Harold is gone, I go over to my daughter Dina’s house every week to visit and see my grandkids. Dina is a good cook, but her dumplings aren’t quite as good a mine and I try to make a batch to take with me when I can. Dina works every day at school so she is busy most of the time. She is a good daughter and she helps me when I need to get to the doctor. She also picks up groceries for me once and awhile. I have three grandchildren. Jessica is 17 and she graduates from high school this year. Daniel is 14 and he is a handful! He can give his mother trouble about getting his homework done and I don’t think his grades are very good. I know Dina worries about him. Megan is 12 and she is such a sweet child. She likes to help me with my roses in the summer.

I went to the doctor last week to get my blood pressure and my cholesterol checked. He wants to start me on a new pill for cholesterol. I already take about six or eight pills every day. I hope this new pill isn’t too expensive, I already have to pay a lot for my medications and I don’t get the pension anymore since Harold died. I don’t know how Harold paid all the bills, it doesn’t hardly seem like there’s enough money for all that medicine.

I am lucky that I can still get around pretty well and my house is not too big. My knees are pretty bad; I think they are just worn out. They hurt a lot. I am thankful that I can still tend my roses. My bladder isn’t as good as it used to be, I have to use Depends now and I worry that someone will notice the odor. I can’t laugh anymore; the leakage is getting so bad. But things like that happen when you get to be as old as I am. I can’t complain.

In August in September 2005, hurricanes Katrina and Rita caused extraordinary flooding in New Orleans, Louisiana. Many homes were severely damaged or destroyed, and of those that survived, many required extensive cleaning. It was thought that cleaning flood-damaged homes might present a health hazard due to the large amount of mold present in many of the homes. In a sample of 365 residents of Orleans Parish who had participated in the cleaning of one or more homes, 77 had experienced symptoms of wheezing, and in a sample of 179 residents who had not participated in cleaning, 23 reported wheezing symptoms. Can you conclude that the proportion of residents with wheezing symptoms is greater among those who participated in the cleaning of flood-damaged homes?

a. State whether the test is:

i) a two-sample t-test (independent samples)

ii) a matched pairs

iii) a two sample proportion test

b. Write H0 and H1

c. Using Minitab, list the test statistic the p-value your conclusion: reject H0 or do not reject H0. Note: if α is not provided, use a 0.05 significance level

d.   Write a sentence that explains your conclusion in context with the claim. Include the significance level and p-value in this sentence.

e.   Copy and paste the relevant Minitab output into the document. Answers alone are sufficient, you do not need to copy the exercise into the document.

After reading this case study, complete the exercises following:

Mr. T.Y. is a 51-year-old Caucasian male scheduled for cardiac catheterization. His risk factors for heart disease are prior congestive heart disease, transient ischemic attack involving left arm, former prolonged tobacco use, a diet high in saturated fat, hyperlipidemia, obesity, hypertension, and poorly controlled diabetes. He made some attempts at risk reduction, stopping smoking two years ago and losing 40 pounds. However, he currently enjoys eating red meat at least twice a day. A butcher, he states he has no intention of quitting because he loves meat which is high in saturated fat.

Mr T. Y. has questions about this pending heart catheterization, though he had undergone one in 2002. He was concerned about the risks of possible new percutaneous interventions, and fearful that his disease might be too advanced for any treatment. Mr. T. Y. is coping with his anxiety by reading his Bible and praying, talking to his family on the phone, and asking numerous questions of the staff about the procedure.

His nurse assessed him as eager and motivated to learn about the cardiac catheterization procedure, but only somewhat motivated to learn about the appropriate dietary management of his heart condition. He did ask questions about what would be healthy to eat, but when he was told what an optimal diet would be, he shook his head “No,” indicating that a heart healthy diet as described was unacceptable.

1. Identify at least three high-priority learning needs (as evidenced by need for behavioral changes, not just by knowledge deficit) for Mr. T.Y.

2. Using the four indicators of physical, emotional, experiential and knowledge readiness, contrast Mr. T.Y.s readiness to learn about the imminent procedure with his readiness to learn about healthy dietary changes.

The president of State University wants to forecast student enrollment for this academic year based on the following historical data:

What is the forecast for this year using exponential smoothing with alpha = 0.5, if the forecast for two years ago was 16,000?

The following is adapted for academic purposes from the original speech: “Staying on Top of Our Game” by Singapore Minister Mr Ong Ye Kung during the launch of the Financial Services Industry Transformation Map on 30th Oct 2017.

“The regulator facilitates the development of infrastructure upon which new services and ideas can thrive. A good example is the payments infrastructure. Three years ago, MAS worked with the banking industry to launch FAST, to conduct direct real-time transfers between bank accounts. This year, the banks launched PayNow, which links bank accounts to NRIC or mobile numbers, making transfers more convenient. More importantly, PayNow will activate the full potential of FAST. It currently works only for P2P, but will be progressively expanded for P2B and B2B next year. To further facilitate this, we will introduce by the end of the year a common QR code that can accept all payments using QR readers…..”

Question 3:
Appraise and discuss how a well-regulated payment system will enable the Singapore financial market to perform its functions effectively.

_{The following is adapted for academic purposes from the original speech: “Staying on Top of Our Game” by Singapore Minister Mr Ong Ye Kung during the launch of the Financial Services Industry Transformation Map on 30th Oct 2017.
“The regulator facilitates the development of infrastructure upon which new services and ideas can thrive. A good example is the payments infrastructure. Three years ago, MAS worked with the banking industry to launch FAST, to conduct direct real-time transfers between bank accounts. This year, the banks launched PayNow, which links bank accounts to NRIC or mobile numbers, making transfers more convenient. More importantly, PayNow will activate the full potential of FAST. It currently works only for P2P, but will be progressively expanded for P2B and B2B next year. To further facilitate this, we will introduce by the end of the year a common QR code that can accept all payments using QR readers…..”}

Question 1:
To regulate the payment systems in Singapore, MAS requires financial institutions to comply with the relevant licensing and ongoing licensing requirement to control and minimise certain regulatory risks. Appraise one (1) of these risks that you think MAS would be most concerned with?

An enzyme was found that catalyzes the reaction between students, S and academic success, P (for pass); the enzyme was called studyase.

An enzyme assay was run on studyase. 10μg of studyase (molecular weight 20,000D) was placed in a set of test tubes each of which contained 1mL of the substrate student at varying concentrations and the amount of product, academic success (P) was determined.

The following results were determined:

Note 1mM = 1millimole/L = 1μmol/mL

Plot a Lineweaver-Burk plot of 1/V versus 1/S

Determine Vmax and Km for the enzyme studyase.

Calculate Kcat and the catalytic constant (kcat/km) for the enzyme. (find [E]_T as total μmoles/mL)

Another enzyme called partyase was analyzed and when 0.010 μmoles of this enzyme was assayed it was found to have a Vmax of about 50 μmol/mL/sec and a Km of 5 mM. Calculate Kcat and the catalytic constant for this enzyme.

i.Compare the 2 enzymes on the basis of affinity for the binding site and kinetic efficiency.

In a study conducted to determine the role that sleep disorders play in academic performance, researcher Jane Gaultney conducted a survey of 1845 college students to determine if they had a sleep disorder (such as narcolepsy, insomnia, or restless leg syndrome). Of the 503 students with a sleep disorder, the mean grade point average was 2.65 with a standard deviation of 0.87. Of the 1342 students without a sleep disorder, the mean grade point average was 2.82 with a standard deviation of 0.83. Is there evidence to suggest sleep disorders adversely affect one’s GPA at the a = 0.05 level of significance?