Pt-1 Jennifer Hoffman is a 33-year-old female brought to the Emergency Department by her neighbor. She has a history of asthma since childhood with multiple emergency visits within the last year. She appears to be in respiratory distress, struggling to breathe. She is unable to speak other than simple one-word statements. An infusion of normal saline has been started at a keep-open rate.

PT-2 A 52-year-old patient has just arrived in the Emergency Department with complaints of severe abdominal pain, nausea, and vomiting over the last few days. His abdomen is distended. He has poor skin turgor and dry mucous membranes. He has not urinated since yesterday. He has felt "dizzy" and "weak" all evening. He thought it might be the flu, but decided to come in because the stomach pains were getting worse. He has signed informed consent for treatment and labs have been drawn.

PT 3-Situation: Mrs. Morrow is an obese, 80-year-old white female who developed a venous stasis ulcer on her right medial malleolus while still living at home. She moved into our skilled nursing home care facility 3 days ago. The current plan of care is focused on promoting wound healing, improving venous return, and preventing skin breakdown.

Background: Mrs. Morrow has a past medical history of chronic obstructive pulmonary disease (COPD), chronic venous insufficiency, and deep vein thrombosis (DVT). Peripheral arterial disease is ruled out by duplex ultrasound. Her daughter had her admitted to this skilled nursing home care facility due to concern for her safety with impaired mobility, an unhealthy diet, and inability to adequately care for herself at home.

Assessment: Mrs. Morrow is alert and oriented, but sometimes forgetful of recent events. Vital signs have been within normal limits and are performed weekly. Results from yesterday's labs are in the chart. She is on a regular diet with nutritional supplement and has been eating the majority of her meals since admission. She requires assistance with positioning in bed and assistance times 1 to get out of bed to the chair or ambulate. Her gait is unsteady, and she is easily fatigued. Her Braden Scale score is 16, and her skin is intact except for the venous stasis ulcer on the right medial malleolus. She has brown hyperpigmentation on both lower legs with +2 edema. The venous stasis ulcer is covered with a hydrocolloid dressing, which is due to be changed. In preparation for her dressing change, she was medicated for pain half an hour ago.

1.   In what ways are the patients similar?

2.    In

what ways would their nursing care be similar?

3.    In

what ways are the 3 patients different?

4.    How

would their care be different? Why?

Scenario Summary

You are the new director of risk management at Little Falls Hospital, which is a 450-bed tertiary care facility in a major urban area in the Northeast. The hospital is an integrated health system that provides the full array of inpatient and outpatient services. The hospital enjoys a reputation for quality care in the area.

As the new risk manager, you have been briefed about a patient care case that needs your attention.

·         The patient is a 45-year-old woman, Lydia, who is currently paralyzed and can only communicate through head nods as a result of a car accident over 6 months ago.

·         The patient is currently on a ventilator for respiratory assistance and receives tube feedings.

·         The professionals in the hospital are uncertain as to whether the patient is capable of understanding information and making her own decisions.

·         It is reported that the patient has an advance directive, but no one has been able to secure a copy of the document.

Your Assignment

You have been asked by Felicia Larue, the hospital CEO, to give a briefing on the patient situation and alternative actions that may be taken by the hospital to ensure that the rights of the patients are preserved and the risks to the hospital are minimized. Prepare a 500-word summary of the important components of this case, the laws that may have an impact on this case, and alternative courses of action that the hospital may pursue to satisfy the parties that are involved with the scenario. The strategies and recommendations should be as specific as possible and include the resources needed for implementation. Your primary text and journal and website research must be used as a reference to support your analysis.

Key Players

Mr. Bevins—Patient's Spouse

Lydia and I have been married for 4 years, and I know that she would not want to be kept alive in this fashion. She and I have had many conversations and discussions about end-of-life decisions, and living like this would not be her choice. I do not know the whereabouts of the advance directive, because she did this prior to our marriage, and my attempts to obtain a copy have failed. I am her guardian, and therefore the decision should be mine.

Eileen Redfield—Patient's Mother

I am Lydia's mother and it hurts me to see my daughter laying there so incapacitated. Ending her life is not the answer. A couple of the physicians have implied that she might get better and live a better life, although others have given me little hope for recovery. A miracle is always possible, and I want to give my child every chance she can to live.

Dr. Bob Pritchard—Patient's Physician

I have been taking care of Lydia for the past 90 days. Although she does demonstrate progress in very small increments, her level of functioning has not significantly improved. This is compounded by the fact that Lydia also suffers from breast cancer—a condition diagnosed and treated successfully before the accident. I am not sure what advice to give the family about the patient's long-term survival.

It's common for the planning system to put financial executives in uncomfortable ethical positions. Plans are vehicles for communications to outsiders and they are usually put together by the finance department. But outside communications are ultimately the responsibility of the chief executive officer (CEO). That means that a CEO who doesn't like what a plan says can apply his or her “judgment” and tell outsiders something else.

Problems arise when CEOs use judgment to further their personal ends or just refuse to accept unpleasant realities. Chief financial officers (CFOs) get caught in the middle, because although they work for CEOs, they're supposed to have an overriding responsibility for truth and fairness in financial representations. They also have to stand up next to the CEO when the message is delivered and at least act as if they support every word.

Here's an illustration. Suppose the planning process at a division of a large corporation reveals that it's likely to lose market share and a great deal of money in the future. If the information is revealed to parent company executives in an upcoming meeting, they're likely to replace the division's president whose strategy is probably responsible for the poor performance. On the other hand, if a falsely optimistic plan is presented, the current president and his policies will continue in place, but the eventual loss is likely to be much larger.

The president plans to present the optimistic version of the plan. The division CFO feels this constitutes misleading corporate management. What is her ethical responsibility?

To appreciate this dilemma, it's crucial to understand that all plans are to some extent matters of opinion. No one can say with certainty that the division president is proposing to lie. He's just supporting a planning position that most people would find unrealistic if they knew all the details. The fact that it serves his own personal ends makes him suspect, but it doesn't prove he doesn't believe in the better plan. Optimistic people tend to believe what they want to in spite of overwhelming evidence to the contrary all the time!

If the CFO refuses to go along and insists on presenting the more likely plan herself, she'll be setting up a confrontation with her boss in front of senior management. That will probably destroy her relationship with the president forever. And she may not win. Remember that the corporate managers put the president in charge because they valued his judgment above that of others. They may still do that in spite of strong evidence that he's wrong. The fact that the CFO may eventually be proven right doesn't help because the damage will be done, and she'll be long gone by then.

On the other hand, if the CFO doesn't stand up and give her opinion, there's no doubt the unduly optimistic plan will be accepted. That will probably mean deeper losses for the company, which might lead to closing the division and laying off its employees. At that time, the corporate people will probably want to know why the division's management team didn't see the problem coming.

What are the CFO's options? What would you do?

Consider the following scenario:

XYZ Health Organization has a division that currently uses zero debt financing. Assume that the operating income (EBIT) is 1,000,000 SAR. Assume that the firm has 5,000,000 SAR in Assets with an equal amount in equity (because it currently has no debt). The firm wants to expand its product offerings and is considering replacing half of its equity financing with debt financing at an interest rate of 8%. The corporate tax rate is 20%. Assume that you are the Chief Financial Officer of the organization.

1. Determine how the new capital structure would impact the firm’s net income, total dollar return to investors, and ROE?
2. Conduct the analysis again but assume that the cost of debt has risen to 15%?
3. Then using the original 8% interest rate, assume that annual EBIT has dropped to 500,000 SAR or could go as high as 1.5 million SAR (both with a probability of 20%). While there is a 60% chance that EBIT will remain 1,000,000 SAR. Redo the analysis for each level of EBIT and determine the expected values for the division’s net income, total dollar return to investors, and ROE.

After you have conducted all the calculations, make recommendations to the company as to which avenue the company should take. Consider what you have learned about the healthcare needs under SV2030 as well as your knowledge of the healthcare industry.

Discuss the considerations for risk and return for western investors who will be entering into Islamic financing arrangements. How will those investors consider the risk of this business endeavor?

1. Issue sukuk for the debt financing (make calculation in accordance with the principles of debt financing so that you may conduct the financial analysis).
2. Using equity for financing and some borrowing (your project would be financed in accordance with Murabaha principles but for the convenience of calculations, you will use the processes of a conventional loan and/or issuing equity in the organization).

Make recommendations to the organization as to the course of action that they should follow considering all risk factors. Please make certain that you show your calculations. Submit your findings in a proposal to the hospital.

• You must show all your calculations for credit. Your calculations for this assignment must be submitted as an Excel file, identified as Appendix A, and included as part of the Word document submission.

Your paper should meet the following structural requirements:

• The paper should be 4–5 pages in length, not including the cover sheet and reference page.
• The paper should be formatted according to APA writing standards.
• Provide support for your financial statements with in–text citations from a minimum of four scholarly articles.
• Two of these sources may be from the class readings or textbook, but the others must be external and come from peer–reviewed journals.
• The Saudi Digital Library is a good place to find these references.

I need this reviewed, reworded and shorten please?!

Reading the letter above my initial response would be that the language and attitude shown in the letter is very rude and impolite. It focuses more on blaming the customer for the damage than providing with any materialistic solution. Customer satisfaction might drop after receiving such a response from the dealer for her claim. The negative review about the company can spread adversely by word of mouth and diminish the company's image. Refusal should be done in a polite and positive manner rather than being rude and offensive. In this case though the clauses the employer has put are right but the way they are put is offensive and rude hence it can put a negative impact.

The weaknesses that this letter shows are:

Being personally offensive - the technician states that he has not seen such a gunky phone interior' This statement is not professional and does not specify the fault in the phone that the customer is specifying but talking about how the phone has been handled generally. It is an offensive attitude towards the customer.

Being rude - did not bother to arrange a backup' this is a rude statement and could be put up in a much polite manner.

Negative marketing strategy - suggesting buying a new phone where the customer wants to replace this one at zero cost is a wrong strategy to sell the product for which the customer will never agree.

Too much of blaming - the phone is damaged due to some careless mistake of the customer. Instead of blaming the customer all through for their fault and making them feel even worse about the damage, polite ways can be used to pacify the customer and provide alternative ways.

Unprofessional and callous - giving less and unfavorable options employer is directly asking to let them know what the customer wants to do. This may result in negative results only as customer will get an impression of unprofessionalism from the employer.

Sounding only business minded and selfish- the employer has given only options that are favorable for the employer rather than putting up a win situation for both the parties. The customer will not want to take up any of the options in this way and might even not want to deal with the employer in future seeing their selfish intentions.

If I was the customer, even though initially it would be my fault in damaging the phone but with the attitude and rude response of the employer I would be severely offended and livid. I might take the matter up to the higher management of the company putting up my issue and the way it was handled and responded. I might even lose the trust in the company for any further dealing and leave the same impression on my social network for the rudeness and unprofessionalism I received from them. Even if buying a new phone was the option I was left with, I would not be buying it from the employer due to their negative attitude.

Bob is a new RN on the 7p to 7 a shift. He has 5 patients to provide care for this shift.

I) Mrs. Smith, 58 year old, POD 3, s/p colectomy. She is scheduled for colostomy training and then discharge.

Vs wnl, is accepting and beginning to assist with colostomy care.

II) Mr. Jones, 68 year old POD 1, s/p ruptured appendix.

Vs wnl, cbc pending, remains NPO. Dressing RLQ clean, dry, intact. IV, 0.9% at 75 ml/hr. Foley drained 200 ml total day shift. Drain, RLQ drained 75 ml total day shift.

III) Mr. Word, 52 year old, s/p cardiac cath this morning.

Vs wnl, dressing to right groin dry, intact. To be d/c this evening.

IV) Mrs. Roberts, 60 year old s/p laparoscopic cholecystectomy, POD 1.

Vs wnl, c/o nausea and pain; medicated with relief at 5pm. To be d/c in the morning.

V) Mr. Humble, 56 year old, scheduled for inguinal hernia repair for tomorrow morning, if his INR is within normal limits

PMHx includes mitral valve repair, on Coumadin 5 mg at home. Coag panel pending.

All patients are seemingly at baseline at shift change. Bob delegates vital signs to the NA’s as he prepares to administer medications.

Midnight assessment, Bob observes Mr. Jones, and documents:

Restless, BP 140/80, HR 102. (Previous BP was 120/80, HR 82). Bob medicates Mr. Jones with 1 mg Dilaudid.

0200: Mr. Jones RR is 32 breaths per minute, an increase from his previous 20. Bob continues to observe Mr. Jones, frequently checking in on him. During this time, Mr. Jones continues to sleep on and off.

0400: Mr. Jones is very difficult to arouse. Bob calls a rapid response and Mike and the team arrive. Mikes assessment of Mr. Jones:

Pale, diaphoretic, cold to touch. BP 68/30. Last documented BP was at midnight, 140/80.

Patient transferred to ICU with diagnosis of septic shock. He was intubated, CVL placed, vasopressors and antibiotics.

1. Using your clinical reasoning, identify what should Bob have anticipated / done/ assessed while caring for Mr. Jones?

2. At 0000, which additional assessments should Bob have performed? And why are these assessments pertinent?

3. What does Mr. Jones admitting diagnosis mean to the nurse? What would you, the D’Youville nurse be “watching” for while caring for Mr. Jones?

Learning Outcomes:

1. Demonstrate a solid understanding of overall marketing concepts, goals and strategies within the context of organizations goals and strategies (Lo 1.1).
2. Explain issues pertaining to marketing environment both internally and externally (Lo 1.2)
3. Build a strong understanding of the social, economic, ethical and technological challenges facing marketers (Lo 1.3 & 3.4).
4. Utilize strong analytical skills and tools to develop objective and effective marketing plan (Lo 4.3 & 4.5).
5. Demonstrate ability to think independently and systematically on the subject of developing the business feasibility assessment of marketing plan development. (LO.3.7)

Marketing Plan

From the real international market, select a company of your choice wishing to start its activities in Saudi Arabia. The Company hired you as Marketing Manager of Saudi Arabian Region. You have to establish a marketing department starting from the Analysis of the market, formulate overall marketing goals, objectives, strategies, and tactics within the context of an organization's business, mission, and goals designing and planning the entire function.

Write a Marketing Plan considering the following points (2x5=10 Marks)

1. Introduction, Goals and Objectives

To introduce this section you should include the "mission statement" of the business; an idea of what its goals are for customers, clients, employees and the consumer.

a. Introduction about the business.

b. Business vision and mission

c. Business objective.

d. Products and services offered

---------------------------------------------------

2. Environmental Analysis

Conduct an environmental analysis that looks at and comments on your local area and your network of business contacts, competitors and customers.

3. Target Market Analysis

Identify the target market, describing how the company will meet the needs of the consumer better than the competition does.

4. SWOT Analysis

Conduct a SWOT analysis for your chosen company based on your research.

Strengths: List the strengths of the business approach;

Weaknesses: Describe the areas of weakness in the company's operations;

Opportunities: Examine factors that may improve the business's chances of success;

Threats: List the external threats to the business' success.

5. Marketing Mix (4 P’s ) Analysis

Describe each of the 4Ps of your chosen company.

Product or Service

Identify the product or service by what it is, who will buy it, how much they will pay for it and how much it will cost for the company to produce it, why a consumer demand exists for your product, and where the product sits in comparison to similar products/services now available.

Place

Identify the location of the business, why it is located there (strategic, competitive, economic objectives), the expected methods of distribution, and timing objectives.

Promotion

Describe the type of promotional methods that will be used. Identify techniques such as word of mouth, personal selling, direct marketing, sales promotion etc. television, radio, social media and newspaper ads.

Price

The prices of the products or services that reflects the overall company strategy. Should be competitive as well as a reflection of the quality, costs and profit margin.

Please, Full explain

2. Probability (30%). Figure out the probability in the following scenarios.

(a) A number generator is able to generate an integer in the range of [1, 100], where each number has equal chances to be generated. What is the probability that a randomly generated number x is divisible by either 2 or 3, i.e., P(2 | x or 3 | x)? (5%)

(b) In a course exam, there are 10 single-choice questions, each worthing 10 points and having 4 choices (A, B, C, and D, with only one correct). There is one student, denoted as s, who has learned nothing from the course and hence has to randomly guess the answers. That means for any question, each one of the four choices has equal chances to be picked up by s. What is the probability that s passes the exam (earning a total of ≥ 60 points)? (5%)

(c) Consider three positive integers, x1, x2, x3, which satisfy the inequality below: x1 + x2 + x3 = 17. (1) Let’s assume each element in the sample space (consisting of solution vectors (x1, x2, x3) satisfying the above conditions) is equally likely to occur. For example, we have equal chances to have (x1, x2, x3) = (1, 1, 15) or (x1, x2, x3) = (1, 2, 14). What is the probability the events x1 + x2 ≤ 8 occurs, i.e., P(x1 + x2 ≤ 8 | x1 + x2 + x3 = 17 and x1, x2, x3 ∈ Z+) (Z+ is the set containing all the possible positive integers)? (5%)

(d) There are unlimited fake coins and only one real coin. The fake coins and the real coin are almost the same and can only be detected by a special machine. At the very beginning, there are two coins in a bag, one fake and the other real (but we don’t know which one is real). We continue the following process till the real coin is found: At the each step, we randomly sample one coin from the bag and examine whether it is fake. If yes, we put the coin back to the bag, additionally put in another fake coin, and randomly draw a coin for examination. The sampling process won’t stop until we find the real coin. Assuming that each coin (either fake or real) has equal chances to be selected, what is the probability that we sample 9 times but still cannot find the real coin (and hence has to continue the sampling process)? (5%)

(e) From a random sports news, the probability of observing the word “ball” and “player” is 0.8 and 0.7, respectively. For a non-sports news, the probability to observe “ball” is 0.1, so does that to observe “player”. Let’s assume that in any article, the appearance of any two words (including “ball” and “player”) are independent with each other. Also, the probability of sports news’ occurrences is 0.2. Given a news report x containing both “ball” and “player”, what is the probability that x is a sports news. (10%)

Fibre2Fashion Ltd. is the country’s largest manufacturer of spun yarn with well-established market. Fibre2Fashion Ltd. has good reputation for quality and service. Their marketing department identified that the potential for global market is expanding rapidly and hence the company undertook exercise for expansion of the capacity for export market. The company formed team of Marketing and Materials department to study

the global logistics possibilities. After extensive study, the team came up with a report on global logistics and submitted that global logistics is essentially same as domestic due to following similarities: • The conceptual logistics framework of linking supply sources, plants, warehouses and customers is the same. • Both systems involve managing the movement and storage of products. • Information is critical to effective provision of customer service, management of inventory, vendor product and cost control. • The functional processes of inventory management, warehousing, order processing, carrier selection, procurement, and vendor payment are required for both. • Economic and safety regulations exist for transportation. The company had very economical and reliable transportation system in existence. For exports as well they decided to evaluate capabilities of their existing transporter and entrusted them with the job of transport till port. For customs formalities they engaged a good CHA after proper cost evaluation and entered into contract for freight with shipping company agent. The response for company’s export was very good and the company could get as manyas 15 customers within first two months and reached to a level of USD 250,000 per month by the end of first half of the year. Based on this response the export volumes were expected to grow to a level of USD 400,000 per month by the end of the year. When the review was made at the end of the year, company found that export volumes had in fact come down to the level of USD 120,000 which was much lower than it had reached in the first half of the year. The managing committee had an emergency meeting to discuss this and the export manager was entrusted with the task of identifying the reasons for this decline. Mr. Ganesh decided to visit the customers for getting the first-hand information. When he discussed the matter with the customers, the feedback on the quality and price were good but the customers were very upset on the logistic services due to delayed shipments, frequent changes in shipping schedules, improper documentation, improper identifications, package sizes, losses due to transit damages etc.

After coming back, the export manager checked the dispatch schedules and found that production and ex- works schedules were all proper. Then he studied the logistics systems and found that the logistics cost was very high and all the logistics people were de motivated due to overwork and were complaining of total lack of co-ordination and the system had become totally disorganized.

Questions

1. Explain the problems experienced by Fibre2Fashion Ltd. What is the main cause of these problems?

(15Marks)

2. What logistics model should the company go for to ensure proper operations of the company?

(10Marks).

Note : Answers should be in word format and in details . ( you can copy and paste from the net )

1.) Each of the following actions would be considered a "ministerial act," EXCEPT:

a.) calling the client to obtain some information necessary for a contract

b.) Making arrangments for a home inspector to access the property

c.) answering a question about the definition of a particular word in a contract

d.) setting the listing price

2.) When proposing a brokerage relationship with a prospective client, the licensee must advise the client of each of the following issues, EXCEPT:

a.) the type of brokerage relationship proposed

b.) the nature of the fiduciary relationship created

c.) the broker's compensation

d.) whether the compensation can be shared with other brokers

3.) If a brokerage agreement does not include a termination date, it will automatically terminate after:

a.) 90 days

b.) 6 months

c.) 9 months

d.) 12 months

4.) A brokerage agreement would be terminated upon each of the following circumstances, EXCEPT:

a.) The expiration date is reached

b.) default by either party to the agreement

c.) the presentation of an offer to the client

d.) the client's refusal to consent to a disclosed dual agency relationship

5.) Under what circumstances could a licensee reveal a client's confidential information?

a.) Under no circumstances

b.) when required by law or authorized by the client

c.) only when required by law

d.) only when authorized by the client

6.) In order to receive compensation form the seller, whether directly or indirectly, a licensee:

a.) must be an agent or representative of the seller

b.) need not be an agent or representative of the seller

c.) must have written agreement with the seller

d.) must be a standard agent

7.) A licensee who is acting as agent of the seller makes an intentional misrepresentation of a material fact to a buer.The seller was unaware of the misrepresentation. Who would be liable for any losses incurred by the buyer due to this misrepresentation:

a.) only the licensee

b.) only the seller

c.) both the seller and the licensee

d.) neither the seller nor the licensee

8.) Broker Betty has a listing on a home and is acting as agent of the seller. Broker Bob is acting as agent of the buyer. If broker Bob makes an intentional misrepresentation to the buyer, without Betty's knowledge, who would be liable for losses incurred by the buyer:

a.) Broker Betty only

b.) Broker Bob only

c.) Both Broker Bob and Broker Betty

d.) Broker Bob, Broker Betty and the seller

9.) Clients and licensees can be held responsible for:

a.) imputed knowledge only

b.) actual knowledge only

c.) both actual and imputed knowledge

d.) neither actual now imputed knowledge

10.) A seller is represented by one broker and a buyer is represented by another broker (with a different firm). If the buyer's agent is grossly negligent in the performance of his duties, who can be held liable for this negligence?

a.) only the buyer's agent

b.) only the seller's agent

c.) Both the buyer's agent and the seller's agent

d.) Neither the buyer's agent nor the seller's agent