As the community health LPN, you have received a referral for a 39-year old Indonesian lady for staple removal, post-op emergency cholecystectomy. Upon arrival to the home, you observe broken glass around the entrance of the basement apartment and note it is in desperate need of repairs. One of the windows has been boarded up and the step has a board missing and the wood looks rotten. The client answers the door, carrying a 2-year child on her hip and 2 older siblings, ages 5 and 7 are standing behind her. The children are all noted to be dressed in several layers of clothing. Upon entering the home, you note the home feels quite cold and damp. The only furniture you can see is a small table, two chairs and a mattress on the floor of the only bedroom. There is no visible toys, books, or TV. In communicating with the client, you detect a thick accent and she speaks in broken English. She informs you that she is doing ok; however, the family is struggling financially since they arrived in NL from Indonesia 1 year ago. Her husband is working at the local gas bar part time. The client states "I try get groceries cheap but that hard". " I like NL but miss my home country. (I talk to my family every month". I get job but need more education. My son he needs medicine but we no money. My husband has bad cough, he always tired and no taste no more." I attend my church online and meet 2 ladies from my home country. One lady wants to teach me how make masks. She tells me I think take English course by our church.

. • What are the clients and family needs?

• What role does the social determinants of health play in this situation?

• What are the risk factors for this family?

• What are the protective factors?

You have a busy family physician within your healthcare facility, and one day a nursing staff member hands you a phone message in the middles of your busy day. The spouse of one of a patient that has had care in your facility has called to discuss concerns about the health of her husband, Sam. She informed a nurse that she thinks that her husband is addicted to prescription pain medications and would like to know if anyone else has observed any signs of addiction during his last visit. You spoke to the physician who saw Sam 2 weeks ago, and he advised that he did think that Sam was behaving strangely. The physician noted that Sam seemed very preoccupied and disengaged. In addition, he seemed sad, and both the physician and nurse inquired with family members about his emotional health because he was very out of character. Sam denied any depression. You and your administrative team have to discuss the ramifications of discussing Sam’s care with his wife and also the following issues.

You should discuss this case as if you are in a committee meeting. Think about all the different stakeholders and their perspectives on the case. Be prepared to think of both sides of the discussion. There should be 1 document written up to address the Summary of your thoughts of this case that also should include answers to the following questions.

There are a number of considerations here. You should write up your class case that specifically addresses the following:

What are the ramifications of discussing Sam’s case with his wife?

How does confidentiality impact EACH stakeholder in this case?

Is there a US federal regulation/legal considerations with regard to patient confidentiality? If so, explain how it impacts this case.

What are the ethical considerations regarding the theories that are applicable to this case? Identify the theory, define it and explain how it relates to this case. You should have at least 2 theories.

Case Study #1 Mr. S is a 79-year-old with multiple medical problems, but primarily suffering from heart disease. He is retaining fluid in his legs and feet, sometimes limiting his mobility. Mr. S has difficulty keeping his multiple medications organized and taking them as prescribed. He lives with his daughter, who is balancing the needs of her young family with her aging father. Mr. S hates burdening his daughter with his medical problems and tries to help by assisting with some of the daily house chores. He seldom leaves the house, as most of his friends have either moved away or have died. Most of the time he stays in his room to not get in the way of his daughter. Case Study #2 Mrs. M is a 90-year-old woman and has been a resident of a long-term care community since her husband died 8 years ago. Her health status is fair. She has DM2 (controlled by oral medication) and rheumatoid arthritis. At the community center, she has her own apartment, which she maintains with minimal assistance, receives one hot meal each day in a common dining room, and has access to a full range of services, such as a beauty shop, recreational facilities, and a chapel. She is generally happy in this setting. She has no immediate family nearby, and the cost of the facility was covered by a large, one-time gift from her now deceased husband. Recently, she has become weaker and has had difficulty walking, attending activities including meals, and doing some of her ADLs due to her RA.

Questions: As the NP and primary care provider (PCP) for these two individuals, compare your delivery of care for these two situations. Select a nursing theory or model for each case study, and apply their principles to these case studies.

Richard and Monica had a disagreement between the two concerning educational planning. Richard believed that education was a cost that could be financed from current savings when the kids entered college. Monica said they should begin right now even though no children were planned for at least three years.

Stacy, Monica and Richard’s daughter, was already separated from her husband. She had decided to seek a divorce. Her husband Frank was a corporate executive with a salary of $200,000 a year. They had about $1 million in assets, including a home. All assets were in Frank’s name.

Monica had a brother, Jim, a corporate manager who had $3.2 million in his company’s stock. His job was a little precarious now and the stock formed 90 percent of his marketable assets and 80 percent of his total assets.

Monica’s mother, a widow, had Alzheimer’s and was increasingly unable to remember and operate on her own. She had about $200,000 in her name, which might have to be used to place her in a nursing home. Her doctor said she had no more than three years to live.

Case Application Questions:

What information would you need to answer the couple’s dispute?

Provide an estimated yearly college savings needed assuming that the two wanted to fund for a four-year private school education. Assume a 3 percent college inflation and a 5 percent investment return with annual savings beginning currently and their child being born in three years with college starting at age 18. Make other assumptions as needed. Four-year private institutions: $35,260 a year

What divorce planning recommendations do you have for Stacy? Justify them.

What advice do you have for Jim in both financial planning and investing?

What advice would you give Monica for her mother?

Ms. T, a 28 year old runway model has just been admitted to the rehab unit following an extensive stay at the burn unit in a local hospital. She was set on fire by her vengeful estranged husband 8 months ago and has spent many of those months in the hospital. She was burned about 54% of her body, including part of her face; the burn ranged from partial tissue loss to deep tissue loss. She also had contractures of her elbows, hands, and knees, which is why she was admitted to the rehab today. Some skin grafting has been done to part of her body. During admission data gathering, Ms. T. admitted to feeling worthless, guilty because she had been cheating on her husband before they broke up and he'd heard her tell her boyfriend on the phone that she'd married him for his money. She stated that she feels responsible for him killing himself after he burned her, that she should have done things differently. She stated that her famous "so-called friends" have abandoned her, that they don't even pick up her calls anymore. She said she'd heard that some people blame her for everything that happened. She expressed sadness that she'd lost her beauty, her friends, her job, her popularity, her good reputation, money, and even some of her family members. She says she doesn't see any point in continuing to live, that the health care professionals have done their best for her, but she'll still continue to look like a monster.

1. Write a SOAPIE note for this patient; 2 nursing diagnosis needed & address them separately, 1 goal, at least 6 interventions, evaluation.

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.

What I need is for you diagnose, Tell me why you chose that diagnosis. Signs, Symptoms, Age, lifestyle, any other factors to lead you to your conclusion. Give some diagnostic tests to confirm your Dx. Then a treatment plan.

Case 1

Bella is a 31 year old nervous young lady who came to see me because she and her husband have been trying to get pregnant, but have not been successful. She has been so afraid that she will never have kids that she started to cry in my office. Her husband has another child from a previous relationship, so she worried that there is “something wrong” with her.

Problems conceiving are actually quite common. It’s not always as easy to get pregnant as television makes it seem. In fact, it takes the average healthy couple an average of one year to get pregnant. Yep, that’s right--that means some get pregnant before one year, and some take a tad longer than one year.

Bella told me that she had been off birth control and trying for about two years, so I knew it was possible that there was more going on.

Once I dug a little deeper, I learned that Bella’s periods have “always” been irregular since the very beginning. She does get her periods, but perhaps once every one to three months; and during a time when she gained 10 pounds, she went as long as six months without a period.

1. Hirsutism:
2. Acanthosis Nigracans:
3. Being overweight: She is about five feet tall and 20 pounds overweight, and she carries most of her weight in the mid section. She admits that she has a tough time losing weight, no matter how hard she tries.
4. Acne: She suffers from a mild case of acne on her face and upper back.

You are the Partner in Charge of a large metropolitan office of a regional public accounting firm. Two members of your professional staff have come to you to discuss problems that may affect the firm’s independence. Neither of these situations has been specifically answered by the AICPA Processional Ethics Division. Therefore, you must reach our own conclusions as to what to advise your staff members, and what actions, if any, are to be taken by the firm.

CASE 1: Don Moore, a partner in the firm, as recently moved into a condominium which he shares with his girlfriend, Joan Scott. Moore owns the condominium and pays all the expenses relating to its maintenance. Otherwise, the two are self-supporting. Scott is a stockbroker, and recently she has started acquiring shares in one of the audit clients of tis office of the public accounting firm. The shares are held in Scot’s name. At present, the shares are not material in relation to her net worth.

CASE 2: Mary Reed, a new staff auditor with the firm, has recently separated from her husband. Mary has filed for divorce, but the divorce cannot become final for at least five mots. The property settlement is being bitterly contested. Mary’s husband has always resented her professional career and has just used community property to acquire one share of common stock in each of the publicly owned companies audited by the office in Mary works.

For one case, you are to (Students with last names beginning A-L CASE 1, M-Z CASE 2, your reply should be on the opposing case):

1. Set forth arguments indicating that the firm’s independence has NOT been impaired.
2. Set forth arguments indicating that the firm’s independence HAS been impaired.
3. Express your personal opinion. Identify those arguments from pat (a) and (b) that you found most persuasive. If you believe that the firm’s independence has been impaired, make suggestion about how the problem might be resolved.

Scenario 2:

Murphy Jones and his wife Lorreta Jones were the two directors of BEST Equipments Pty Ltd. Murphy managed all the affairs of the company and Loretta was just a housewife and had no business experience and knowledge, due to her busy schedule she had most willingly left the management of the business to her husband.

BEST Equipments Pty Ltd had been facing liquidity problems and Murphy was well aware of this fact and yet continued to operate the business, took additional financial loans and made purchases on credit. Lorreta would often sign the business documents as and when requested by her husband.

BEST Equipments Pty Ltd was unable to pay the loan instalments on due dates and some of the cheques issued by the business were not cleared due to shortage of funds. The business could not withstand the financial pressures for long and received court orders to wind up and the court appointed an official liquidator for settling the liabilities and payments to creditors.

Lorreta in her defence said that she signed the documents as she had always been doing so, as and when requested, and the documents were never explained to her and neither did she feel the need for it as she totally trusted her husband’s business skills.

You are now required to read the above case scenario and answer the following questions:

1. Define insolvency as mentioned in s95A of the Corporations Act?
2. As per s588G of the Corporations Act, which statutory duty of the director has been breached by Murphy and Lorreta? What fact mentioned in the related case indicates application of liability of s588G.
3. For the purposes of deciding the liability of Lorreta, was it a “good reason” for her not to take part in the management, is it a sufficient defence available for breach.

HINT: Response must be based on Director’s duty to prevent insolvent trading, and defences available for breach of the same (s588G and s588H). Facts mentioned in   Deputy Commissioner of Taxation v Clark