A nurse at the local Senior Center made the following notation about a client: A 74-year-old female client wearing eyeglasses with bifocal lenses and hearing aid in her left ear. Walks with a shuffling gait, using a cane for support. Wearing house slippers and housedress. States, "My other doctor says I should have my eyes looked at by an expert. It's been a while, and my eyes seem to be acting up lately. I can't see so good anymore." The client states that she takes medication for "sugar" and her blood pressure and has worn glasses for years with the last prescription changed about 3 years ago. "I was a seamstress for many years and quit when I couldn't see to thread the needles anymore-just in time too. These new materials are too hard to work with!" Denies using any eye drops. Describes vision changes as difficulty seeing well at night, especially if trying to read. Uses a magnifying glass to help when reading. No eye pain or discharge, although eyes sometimes feel "dry and scratchy," with the left eye being worse than the right. Admits to rubbing eyes but without relief.

Develop a Plan of Care for this patient that includes:

2 Nursing Diagnosis

2 goals for each Nursing Diagnosis

Interventions with rationales

F. E. is a 74-year-old woman who comes to the medical clinic with concerns related to various “spots” on

her face. She says they have been there for a while and she thought they were just “age spots” but got

concerned after her friend was diagnosed with a malignant melanoma

Nursing Care Plan

Provide a nursing care plan for F.E. Provide a two nursing diagnosis.

Nursing Care Plan 1 and 2.

1.Assessment

2.Diagnosis

3.Goals/Plan Nursing

Interventions

4.Rationale for

the Nursing

Intervention

5. Evaluation

Please cite the reference. Thanks

or the link of reference

D. E. is a 74-year-old woman who comes to the medical clinic with concerns related to various “spots” on

her face. She says they have been there for a while and she thought they were just “age spots” but got

concerned after her friend was diagnosed with malignant melanoma.

Please provide 2 nursing care plans related to this case. Thanks

Nursing Care Plan

Problem 2

A person with mass m1 = 74 kg person climbs a distance d from the base of a uniform ladder before the ladder starts to slip. The ladder has a mass m2 = 30 kg and length L = 7.0 m and rests against a smooth vertical wall at an angle θ = 65° with the floor. The coefficient of static friction between the floor and the ladder is 0.40. Use the symbolic notations given before using numerical substitutions.

A) Find the normal force N from the floor and the force of the wall Fw on the ladder when the man is on the ladder.

B) Find the distance d that the person climbs on the ladder before the ladder starts to slip.

74. A particular brand of tires claims that its deluxe tire averages at least 50,000 miles before it needs to be replaced. From past studies of this tire, the standard deviation is known to be 8,000. A survey of owners of that tire design is conducted. From the 28 tires surveyed, the mean lifespan was 46,500 miles with a standard deviation of 9,800 miles.

Using alpha = 0.05, is the data highly inconsistent with the claim?

In other words, is there convincing evidence (at the 5% significance level) that the deluxe tires actually average less than 50,000 miles before needing to be replaced?

Mr. Jones who is 74 years of age, is being discharged home after having a right knee replacement. the discharged orders from the orthopedic surgeon include: continous passive motion at the current setting 0-degree extension worn when wolking with crutches (nonweight bearing postdischarge day 1, and may begin weight bearing postdischarge day 2); and home nurse visits, as needed, physical therapy should begin the day after discharge at an orthopic center. the orders will be faxed to the center. The following medication with prescription attached include: lovenox (enoxaparin) 70 mg subcutanously onces daily for seven days, vicodin (hydrocodone bitartrate) 10mg every 4 hours PRN, and colace (docusate sodium) 100mg every day. The patient is to fellow up with the orthopedic surgeon in 3 weeks. His daughter plan to stay with him for several weeks to assist him with meal and other house hold chores. and take him to physical therapy and the orthopedic surgeon for follow up. Mr Jones has three other children who live in other states. he is a widower and attends a local church. (learning object 4)

what preparation should the nurse make in advance before attainingnecessary communuity resources and referrals before the patient is discharged.

what necessary community resources and referals will the patient need

1. Mr. Jones, who is 74 years of age, is being discharged home after having a right knee replacement. The discharge orders from the orthopedic surgeon include: continuous passive motion (CPM) at the current setting of 0-degrees extension worn when walking with crutches (nonweight-bearing postdischarge day 1, and may begin weight-bearing postdischarge day 2); and home nurse visits, as needed. Physical therapy should begin the day after discharge at an orthopedic center. The orders will be faxed to the center. The following medications with prescriptions attached include: Lovenox (enoxaparin) 70 mg subcutaneously once daily for 7 days, Vicodin (hydrocodone bitartrate) 10 mg every 4 hours PRN, and Colace (docusate sodium) 100 mg every day. The patient is to follow up with the orthopedic surgeon in 3 weeks. His daughter plans to stay with him for several weeks to assist him with meals and household chores, and take him to physical therapy and the orthopedic surgeon for follow-up. Mr. Jones has three other children who live in other states. He is a widower and attends a local church. (Learning Objective 4)

What preparations should the nurse make in advance before attaining necessary community resources and referrals before the patient is discharged?

What necessary community resources and referrals will the patient need

DDA Cardiac Module

CC: Shortness of breath, cough and fatigue

HPI: Mrs. Short is a 74 year old Caucasian female with h/o of HTN and RA. She is very active at the senior center with group activities and exercise class. She presents today because she feels “her energy is drained” and she cannot get over a cough. She has been seen in the clinic 3 times over the past year for the cough. She was treated each time with antibiotics but has not gotten much better.

ROS: denies fever or night sweats, +fatigue, appetite ok, denies HA or vertigo, denies syncope or presyncope, +SOB on exertion, denies orthopnea, +palpitations, denies chest pain, denies any GI/GU complaints, +edema, +joint pain in hands that is chronic due to RA

PMH: HTN, RA – last visit with rheumatologist was “years ago” because she did not want to take DMARDs, GERD, osteopenia, menopause

Diagnostic testing: EKG 2015 that showed LVH with normal rhythm, ECHO 2012 with normal LV function, DEXA 2010 TScore -1.9

Labs: she had “complete workup” for PE 2 years ago but doesn't know the results

SH: married for 45 years with 4 adult children who live in area, never smoked, +ETOH 2-3 glass of wine daily, no illicit drug use, works part time in real estate. Fully independent in all ADLs, IADLs.

FH: Father side of family with T2DM and HTN.

Meds: metoprolol XL 50mg qd, ASA 1mg qd, Calcium 1000mg daily, Pepcid 20mg qd, Tylenol as needed for pain

Allergies: NKDA

Physical Exam:

VS: BP 142/90, P90, R18, SPO2 98% on RA, height 60in, weight 150lbs, BMI 29.3 (up 7lbs in 6 mos)

General: slightly obese female in NAD, appears well groomed and well nourished.

HEENT: normocephalic, PERRL, teeth in good repair, buccal mucosa moist

Neck: No JVD, No bruits, No thyromegaly

CV: S1S2, RRR, II/VI SEM, +S3

Lungs: CTA A/P, no wheezing

Ext: 1+ BLE edema, pedal pulses 2+ bil, no calf tenderness,

Abd: soft, nontender, BS+, no heptamegaly or splenomegaly

Skin: no lesions or rashes

Neuro: nonfocal, CN 2-12 grossly intact

MS: small joint deformities and synovitis present in bil hands. Slight tenderness in joints of fingers, strength 5/5 in bil hands, ROM slightly limited in fingers.

What are her medical diagnoses?

What are her differential diagnoses, with rule outs?

What diagnostics are needed?

What prescriptions does she need?

What education does she need?

CASE STUDY PARKINSON’S DISEASE Miss Rose is a 74 year old female, who is a retired widow and lives with her son for the past five years. Both enjoy planting seedlings and own a community agriculture store. She does not suffer with hypertension or diabetes and has an active lifestyle. She is also not known to have any psychiatric illnesses. Over the past six months Miss Rose’s son and herself noticed physical changes and decided to visit her General Practitioner. At her visit she mentioned to the doctor that she was having difficulty rising up from a sitting position after grooming her plants or turning from one table to another when she has customers. Documentation on her clinic file noted that she previously complained of difficulty walking and falling when coming out of bed. She was sent for an X-ray but there were no clinical findings. The physician asked her to describe what happened when she fell. Miss Rose verbalized that when she got up from bed and starting walking she started moving forward and backward then stooped forward with small fast steps and then she fell. Her son mentioned to the doctor that he has noticed that when she is pruning her plants she has abnormal rhythmic movement of the upper and lower limbs. She occasionally has a slight limp and her handwriting has become smaller over the past months. This has stopped her from doing her daily yoga exercises and she has been very disturbed about it. Miss Rose then further explained that the movement started on the distal part of both upper limbs at the same time. She also expressed that during rest she noticed the movement in her limbs and as she started her tasks the movements became more aggravated. Urinary incontinence is also a problem for Miss Rose and she is having difficulty in her swift movements to her bathroom. The patient was later diagnosed with Parkinson’s disease. After the assessment and interview of Miss Rose the Physician documented the following: Physical Assessment Vital Signs: BP- 130/74 mmHg Temperature - 36.7 C, Pulse- 78 bpm regular and bounding Respiration- 20 bpm Height- 5ft 7 in Weight- 70 kg Facial expression- Masklike Gait- Shuffling gait with tendency to fall forward and backward CNS Examination Alert and oriented to time, person and place Level of consciousness GCS- 15/15 Sleeping patterns- normal Swallowing gag reflex- normal Cogwheel rigidity present Tremor present Bradykinesia present Dysphonia present

Instructions:Answer the question below.

a) Discuss the nursing management of the patient using a care plan. Three actual and two (2) potential problems.

Sherrod, Inc., reported pretax accounting income of $74 million for 2021. The following information relates to differences between pretax accounting income and taxable income:

1. Income from installment sales of properties included in pretax accounting income in 2021 exceeded that reported for tax purposes by $7 million. The installment receivable account at year-end 2021 had a balance of $8 million (representing portions of 2020 and 2021 installment sales), expected to be collected equally in 2022 and 2023.
2. Sherrod was assessed a penalty of $3 million by the Environmental Protection Agency for violation of a federal law in 2021. The fine is to be paid in equal amounts in 2021 and 2022.
3. Sherrod rents its operating facilities but owns one asset acquired in 2020 at a cost of $68 million. Depreciation is reported by the straight-line method, assuming a four-year useful life. On the tax return, deductions for depreciation will be more than straight-line depreciation the first two years but less than straight-line depreciation the next two years ($ in millions):

4. For tax purposes, warranty expense is deducted when costs are incurred. The balance of the warranty liability was $1 million at the end of 2020. Warranty expense of $3 million is recognized in the income statement in 2021. $2 million of cost is incurred in 2021, and another $3 million of cost anticipated in 2022. At December 31, 2021, the warranty liability is $2 million (after adjusting entries).
5. In 2021, Sherrod accrued an expense and related liability for estimated paid future absences of $14 million relating to the company’s new paid vacation program. Future compensation will be deductible on the tax return when actually paid during the next two years ($8 million in 2022; $6 million in 2023).
6. During 2020, accounting income included an estimated loss of $2 million from having accrued a loss contingency. The loss is paid in 2021, at which time it is tax deductible.

Balances in the deferred tax asset and deferred tax liability accounts at January 1, 2021, were $0.8 million and $1.5 million, respectively. The enacted tax rate is 25% each year.

1. Determine the amounts necessary to record income taxes for 2021, and prepare the appropriate journal entry. (If no entry is required for a transaction/event, select "No journal entry required" in the first account field. Enter your answers in millions rounded to 2 decimal places (i.e., 5,500,000 should be entered as 5.50).)

Journal entry worksheet

2. What is the 2021 net income? (Enter your answer in millions rounded to 2 decimal places (i.e., 5,500,000 should be entered as 5.50)

3.Show how any deferred tax amounts should be classified and reported in the 2021 balance sheet. (Enter your answer in millions rounded to 2 decimal places (i.e., 5,500,000 should be entered as 5.50