Case Study Mr. Aponi Neuro/ Dementia Vs Delirium 85-year-old, Native American male living in a long-term care facility. Wife passed away 5 years ago, and he has no children. Preexisting condition is progressive dementia over the past seven years. Unable to care for himself independently due to cognitive decline and has urinary incontinence. Impaired communication secondary to altered mental status. Client Profile Mr. Aponi has a history of dementia. His dementia limits his ability to respond appropriately to questions and at times Mr. Aponi is easily agitated and resistant to nursing care. He refuses to take his medications, spitting them back out, gripping the bedside rail when the nurse tries to turn him, and yelling out for his wife to save him. Case Study Aponi is an 85 year old man with a history of dementia. He is a resident of a long-term facility. Mr. Aponi’s frequent incontinence necessitates the development of therapeutic communication to facilitate activities of daily living (ADL) care and frequent skin hygiene. The nurse caring for Mr. Aponi for the first time soon learns that talking slowly and softly is the most effective way of focusing the client’s attention and prompting him to follow basic instructions such as turning side to side. The nurse fools uneasy about speaking to Mr. Aponi as if he were a child in some ways. However, the nurse finds that this manner of speech keeps Mr. Aponi calm and that he responds well to praise and compliments and that he is very helpful to the nurse in assisting with his own care. On the second day of caring for him, the nurse notes that Mr. Aponi is more agitated and needs frequent reorientation regarding where he is. The nurse needs the assistance of another person to hold Mr. Aponi’s arm steady while assessing his blood pressure since Mr. Aponi keeps pulling his arm away yelling “no”. At one point in the day, Mr. Aponi tells the nurse, “There was a little boy in the room a minute ago. Where did he go?” The nurse knows there was not a little boy in the room, but does not know how to respond. The nurse ignores Mr. Aponi’s comment and redirects his attention to what is on television. When saying good-bye to Mr. Aponi at the end of the second day, the nurse is disappointed that Mr. Aponi does not seem to recognize the nurse nor remember that the nurse has been caring for him for the past two days. The nurse is saddened to see him so confused and is emotionally exhausted after two day of responding to his frequent changes in behavior. Questions: 1. The nurse caring for Mr. Aponi overhears another nurse state, “Well of course he is confused. He is 85 year old.” How should Mr. Aponi’s nurse respond? 2 2. Discuss the characteristics that define delirium and dementia. What is the principal difference between the diagnoses of delirium and dementia? 3. Describe the following strategies for caring for a confused client: validation, reality orientation, redirection, and reminiscence. 4. Explain why Mr. Aponi may state, “There was a little boy in the room a minute ago. Where did he go”? Which of the above strategies (in question 3) would be most effective in responding to his statement? 5. What are three nursing diagnoses appropriate for Mr. Aponi’s plan of care? 6. Discuss the importance of nonverbal communication when communicating with a person who is confused and agitated. Consider Mr. Aponi’s ethnicity.

[The following information applies to the questions displayed below.]

Tony and Suzie are ready to expand Great Adventures even further in 2019. Tony believes that many groups in the community (for example, Boy Scouts, church groups, civic groups, and local businesses) would like to hold one-day outings for their members. Groups would engage in outdoor activities such as rock climbing, fishing, capture the flag, paintball, treasure hunts, scavenger hunts, nature hikes, and so on. The purpose of these one-day events would be for each member of the group to learn the importance of TEAM (Together Everyone Achieves More).

Tony knows that most people are not familiar with these types of activities, so to encourage business he allows groups to participate in the event before paying. He offers a 6% quick-payment discount to those that pay within 10 days after the event. He also guarantees that at least eight hours of outdoor activities will be provided or the customer will receive a 20% discount. For the first six months of the year, the following activities occur for TEAM operations.

Jan. 24   Great Adventures purchases outdoor gear such as ropes, helmets, harnesses, compasses, and other miscellaneous equipment for $4,000 cash.
Feb. 25   Mr. Kendall’s Boy Scout troop participates in a one-day TEAM adventure. Normally, Tony would charge a group of this size $2,500, but he wants to encourage kids to exercise more and enjoy the outdoors so he charges the group only $2,000. Great Adventures provides these services on account.
Feb. 28   The Boy Scout troop pays the full amount owed, less the 6% quick-payment discount.
Mar. 19   Reynold’s Management has its employees participate in a one-day TEAM adventure. Great Adventures provides services on account for $3,000, and Reynold’s agrees to pay within 30 days
Mar. 27   Reynold’s pays the full amount owed, less the 6% quick-payment discount.
Apr. 7   Several men from the Elks Lodge decide to participate in a TEAM adventure. They pay $6,500, and the event is scheduled for the following week.
Apr. 14   The TEAM adventure is held for members of the Elks Lodge.
May. 9   Myers Manufacturing participates in a TEAM adventure. Great Adventures provides services on account for $5,000, and Myers agrees to pay within 30 days.
Jun. 1−30   Several MBA groups participate in TEAM adventures during June. Great Adventures provides services on account for $19,000 to these groups, with payment due in July.
Jun. 30   Myers Manufacturing fails to pay the amount owed within the specified period and agrees to sign a three-month, 9% note receivable to replace the existing account receivable.

Required:

1. Record TEAM adventure transactions occurring during the first six months of 2019. (If no entry is required for a transaction/event, select "No journal entry required" in the first account field.)

2. As of June 30, 2019, Great Adventures finishes its first 12 months of operations. If Suzie wants to prepare financial statements, part of the process would involve allowing for uncollectible accounts receivable.

a. Suppose Suzie estimates uncollectible accounts to be 5% of accounts receivable (which does not include the $5,000 note receivable from Myers Manufacturing). Record the adjustment for uncollectible accounts on June 30, 2019. (If no entry is required for a transaction/event, select "No journal entry required" in the first account field.)

b. Prepare a partial balance sheet showing the net accounts receivable section. (Amounts to be deducted should be indicated by a minus sign.)

In a survey of 1000 randomly selected adults in the United States, participants were asked what their most favorite and what their least favorite subject was when they were in school (Associated Press, August 17, 2005). In what might seem like a contradiction, math was chosen more often than any other subject in both categories! Math was chosen by 228 of the 1000 as the favorite subject, and it was also chosen by 366 of the 1000 as the least favorite subject.

(a) Construct a 95% confidence interval for the proportion of U.S. adults for whom math was the favorite subject in school. (Give the answers to four decimal places.)

( , )

(b) Construct a 95% confidence interval for the proportion of U.S. adults for whom math was the least favorite subject. (Give the answers to four decimal places.)

( , )

Because of its short history, CityU wants to strengthen its connection with its alumni using different sources of information including channels of social media, discussion forums, press media, etc. This is to increase alumni’s donation s to help their mother university, spread good word-of-mouth to their friends and relatives to promote CityU, and attract good quality students to study there. In this regard, CityU is undertaking a feasibility study related to adopting a big data project for their alumni database. You are required to answer the following questions:

1. Discuss any THREE possible benefits that CityU may obtain in developing this alumni system.
2. Discuss the organizational fitness of this potential big data project for CityU.
3. What are your considerations in selecting suitable hardware (MPP or SMP) for this project

How then can we reconcile the problems with assessment and diagnosis that are presented by Conrad &Stults, Matthew, and Neighbors and colleagues? Should we discard assessment and diagnoses as fundamentally flawed methods and tools? Should we (the public) press mental health professionals to be clearer about the limits and bias that appear to exist in assessment and diagnosis? Should we embrace assessment and diagnosis as our best tools for understanding mental health conditions, regardless of their flaws, since there is unlikely to be a perfect method.

Your post is a a 400 - 650 word brief essay in which you state your perspective (thesis) and use the assigned literature to support your argument. You may also draw upon other source though you must provide an appropriate citation and reference for any work you include that is not part of the posted readings.

Mandelker Corp. forecasts that a new lathe will enable them to increase sales by $800,000 at a cost of $540,000 per year for the next 3 years. The press will cost $600,000 and will be depreciated, using straight-line depreciation, over 3 years down to a value of zero. The project requires an initial increase in net working capital of $40,000 that will be recovered in the terminal year. The firm will also be able to sell the lathe for $90,000 after the project is over. The firm’s marginal tax rate is 40%. The required return is 15%.

a. What is the firm’s cash flow in year 0?
-290,000
-440,000
-600,000
-640,000
none of the above

b. What is the firm’s Operating Cash Flow in year 2?
350,000
236,000
150,000
297,500
290,000

c. What is the NPV of the project?

39,352
87,977
83,942
36,357
104,025

Capstone Course: Cases in Health Care Management

Career Navigation

Reflect on where you are in your career.

In a 2- to 3-page essay, answer the following questions:

What steps will you take to navigate and set goals for your future career? What is your time frame for these goals?

Who will you identify as a mentor or accountability partner, and how will you ensure that you are meeting your career goals?

What words of wisdom would you give someone who is newly entering the profession in a manager/leadership role?

Are you a member of any national professional associations? Which ones

Reference

Anthony R. K., Ann S. M., Duncan N. Health Services Management: Cases, Readings

         and Commentary (10th ed.). Health Administration Press

Question 3

A) Please define real versus nominal interest rates. Do we using see figures in the press stated in nominal or real terms? When expected inflation is positive, is nominal inflation greater than or less than real? What if expected inflation is negative, what happens to the relationship?

B) The relationship between nominal and real interest rates continues to hold when there is deflation rather than inflation, except the overall change in prices is now negative. For example, take the case where the desired real interest rate is 3%., the expected deflation rate is -2%, and the actual deflation rate is -3%. What is the nominal interest rate? The actual real interest rate? If the reduction in prices is greater than expected, do borrowers or lenders benefit? Explain.

Analyzing and Determining the Amount of a Liability

For each of the following situations, indicate the liability amount, if any, which is reported on the balance sheet of Hirst, Inc., at December 31, 2018.

Subject: Financial Accounting