Critical Thinking Case Four-DKA

Mrs. S is a 28-year-old patient, with a 12-year history of type I diabetes mellitus. Her husband states that she has had a “bad cold” for several days. Yesterday she stayed in bed and slept all day. She was “too ill” to check her blood sugar, and since she was not really eating, she did not take her insulin. This morning, she was not able to stand up and vomited twice. A Gram stain of Mrs. S’s blood contains gram-positive cocci in clusters. Her admission vital signs are: BP = 90/60; HR = 118 bpm (sinus tachycardia); RR = 32/min; T = 102.3° F; O₂ sat via pulse oximetry = 96%. Her serum glucose is 398 mg/dl, and she is positive for serum ketones. She is admitted with a diagnosis of DKA.

Her baseline ABGs on 2 L of oxygen are: pH = 7.25; PCO₂ = 28; HCO₃ = 14; PaO_{2 =} 92; O₂ sat = 96%. Her respirations are deep, rapid, and labored. She has bronchial breath sounds in the right axillary area. There is bilateral chest expansion and no evidence of cyanosis.

A regular insulin bolus is given and a regular insulin drip is initiated. Mrs. S’s IV fluids are infusing at 800 ml/hr. Her vital signs after 2 hours in the unit are: BP = 120/70; HR = 78 bpm (normal sinus rhythm); RR = 22/min; O₂ sat = 100%. Her serum glucose is 250 mg/dl and serum potassium is 4.0 mEq/L. She is more alert and is feeling hungry.

What is insulin’s function in the body? What is the most significant basic defect in the development of DKA?

What is the cause of Ms. S experiencing DKA? Describe the pathophysiologic rationale for your answer.

List the classic signs and symptoms of DKA. Which signs and symptoms did Ms. S experience? What are the pathophysiologic causes of these signs and symptoms?

What is an anion gap? Why is the anion gap important to follow in the treatment of DKA?

What acid base disturbance is Ms. S experiencing? What compensatory mechanisms are in effect at this time?

What is the primary nursing diagnosis for Ms. S.? What are the goals for treatment (both independent and collaborative)? What interventions are imperative to initiate immediately? What interventions are important within the next 12-24 hours?

What are potential lab abnormalities for a patient in DKA?

What nursing considerations are important in planning Ms. S’s discharge? What I need is each question answered with resource Please Lori

calculate using a financial calculator

Last year Clark Company issued a 10-year, 12% semiannual coupon bond at its par value of $1,000. Currently, the bond can be called in 4 years at a price of $1,060 and it sells for $1,100.

What are the bond’s nominal yield to maturity and its nominal yield to call? Would an investor be more likely to earn the YTM or the YTC?

What is the current yield? Is this yield affected by whether the bond is likely to be called? (Hint: Refer to Footnote 8 for the definition of the current yield and to Table 7-1.)

What is the expected capital gains (or loss) yield for the coming year? Is this yield dependent on whether the bond is expected to be called?

Landcaster Inc. sells its products with a 2-year service-type warranty. On January 1, Year 1, Landcaster sells 60 machines for $2,500 each, on account. Landcaster determines that the machines normally sell for $2,275 each and the service-type warranty could be purchased for $225 per machine. In Year 1, Landcaster pays $5,000 for warranty costs.

Required:

GENERAL JOURNAL

On January 1, Year 1, Bryson Company obtained a $71,000, four-year, 11% installment note from Campbell Bank. The note requires annual payments of $22,885, beginning on December 31, Year 1.

a. Prepare an amortization table for this installment note, similar to the one presented in Exhibit 4.

Note: Round the computation of the interest expense to the nearest whole dollar. Enter all amounts as positive numbers. In Year 4, round the amount in the Decrease in Notes Payable column either up or down to ensure that the Carrying Amount zeroes out.

b. Journalize the entries for the issuance of the note and the four annual note payments.

Note: For a compound transaction, if an amount box does not require an entry, leave it blank. For the Year 4 entry (due to rounding), adjust Notes Payable up or down to ensure that debits equal credits.

I don’t understand this. Last year [year 1], we decided to drop our highest-end Red model and only produce the Yellow and Green models, because the cost system indicated we were losing money on Red. Now, looking at the preliminary numbers, our profit is actually lower than last year and it looks like Yellow has become a money loser, even though our prices, volumes, and direct costs are the same. Can someone please explain this to me and maybe help me decide what to do next year?

Robert Dolan

President & CEO

Dolan Products

Dolan Products is a small, family-owned audio component manufacturer. Several years ago, the company decided to concentrate on only three models, which were sold under many brand names to electronic retailers and mass-market discount stores. For internal purposes, the company uses the product names Red, Yellow, and Green to refer to the three components.

Data on the three models and selected costs follow.

This year (year 2), the company only produced the Yellow and Green models. Total overhead was $650,000. All other volumes, unit prices, costs, and direct labor usage were the same as in year 1. The product cost system at Dolan Products allocates manufacturing overhead based on direct labor-hours.

Required:

a. Compute the product costs and gross margins (revenue less cost of goods sold) for the three products and total gross profit (loss) for year 1.

b. Compute the product costs and gross margins (revenue less cost of goods sold) for the two remaining products and total gross profit (loss) for year 2.

c. Should Dolan Products drop Yellow for year 3?

Note that Initial Cost is present value. You may convert into annual cost over 30 years at a specific rate.

Based on B/C Ratio analysis, should the city construct the by-pass? The rate that the city uses for its economic analysis is 5%.

Please use excel to solve this question

Case study:

Miranda Miles is a 35-year-old white female. She has a 10-year history of cigarette smoking and refuses to quit after several educational teachings from health care providers and family members. There is no history of alcohol consumption. She has been married for five years and lives with her husband and son. Miranda works at a factory and her husband is a truck driver. She was admitted on August 7th, 2020 at 1700 with complaints of joint and back pain, difficulty performing ADL’s especially in the mornings, difficulty falling asleep due to chest pain, and a fever. Upon admission, the patient’s vitals were taken and blood was drawn. Diagnostic and laboratory testing resulted in a medical diagnosis of rheumatoid arthritis exacerbation.

Lab/Diagnostic Testing

Upon admission, the patient's joints were inspected and palpated to find any swelling. Findings in this patient’s case, spongy swelling has been found in knees and ankles and deformities in both hands and feet. Also, a complete blood count (CBC) was taken and white blood cells were found to be mildly elevated in response to inflammation. A synovial fluid culture will be taken as well. The synovial fluid was cloudy with elevated white blood cells. A rheumatoid factor test was also taken and results were positive. An MRI on her knee was ordered and findings include erosion of bone and destruction of cartilage which results in the patient's problem with limited range of motion and pain in knee.

Medication:

QUESTION: Come up with a......

-psychosocial Nursing diagnosis,

-Short term goal,

-Long term goal

-5 nursing interventions,

-5 Evaluated statement

-Patient education teaching

please add references.

11. Last year Clark Company issued 10-year, 12% semiannual coupon bond at its pair value of $1,000. Currently, the bond can be called in 4 years at a price of $1,060 and it sells for $1,100. a. What are the bond’s nominal yield to maturity and its nominal yield to call? Would an investor be more likely to earn the YTM or the YTC? b. What is the current yield? Is this yield affected by whether the bond is likely to be called? (Hint: : Refer to footnote 7 for the definitions of the current yield and to table 7.1.) c. What is the expected capital gains (or loss) yield for the coming year? Is this yield dependent on whether the bond is expected to be called? *****PLEASE DO NOT COPY OTHER'S WORK AND NOT USE EXCEL, THANK YOU********

Quantitative Problem 2: Hadley Inc. forecasts the year-end free cash flows (in millions) shown below. Year 1 2 3 4 5 FCF -$22.89 $37.4 $43.9 $52.2 $55.6 The weighted average cost of capital is 9%, and the FCFs are expected to continue growing at a 4% rate after Year 5. The firm has $25 million of market-value debt, but it has no preferred stock or any other outstanding claims. There are 18 million shares outstanding. Also, the firm has zero non-operating assets. What is the value of the stock price today (Year 0)? Round your answer to the nearest cent. Do not round intermediate calculations. $ per share

I don’t understand this. Last year [year 1], we decided to drop our highest-end Red model and only produce the Yellow and Green models, because the cost system indicated we were losing money on Red. Now, looking at the preliminary numbers, our profit is actually lower than last year and it looks like Yellow has become a money loser, even though our prices, volumes, and direct costs are the same. Can someone please explain this to me and maybe help me decide what to do next year?

Robert Dolan

President & CEO

Dolan Products

Dolan Products is a small, family-owned audio component manufacturer. Several years ago, the company decided to concentrate on only three models, which were sold under many brand names to electronic retailers and mass-market discount stores. For internal purposes, the company uses the product names Red, Yellow, and Green to refer to the three components.

Data on the three models and selected costs follow:

This year (year 2), the company only produced the Yellow and Green models. Total overhead was $764,100. All other volumes, unit prices, costs, and direct labor usage were the same as in year 1. The product cost system at Dolan Products allocates manufacturing overhead based on direct labor hours.

Required:

a. Compute the product costs and gross margins (revenue less cost of goods sold) for the three products and total gross profit for year 1. (Do not round intermediate calculations. Negative amounts should be indicated by a minus sign. Round your answers to 2 decimal places.)

b. Compute the product costs and gross margins (revenue less cost of goods sold) for the two remaining products and total gross profit for year 2. (Do not round intermediate calculations. Negative amounts should be indicated by a minus sign. Round your answers to 2 decimal places.)
     

c. Should Dolan Products drop Yellow for year 3?