Discuss the key areas of hospital management of the patient in the case study

Case Study on Heart Failure
Paper , Order, or Assignment Requirements

2,000 words essay based on a case study given below.
All references should be peer-reviewed, no websites to be referenced at all. 1 reference per 100 words.

Activity 1 – Essay (worth 35% of total marks):
The essay will allow students to apply clinical reasoning to patient care. You are asked to write an essay based upon any one (1) of the four (4) case studies that will be distributed in class. The case studies will focus upon those diseases listed in the teaching timetable.
You must include the following information in the essay:
1. A brief overview of the epidemiology of the disease
2. Discuss the key areas of your pre-hospital management of the patient, using a collection of local, national and international guidelines (select 1 other Australian states guidelines and 1 other international ambulance service)
3. Discuss the key areas of hospital management of the patient in the case study
4. Outline and justify the importance of communication during the patient contact

• You must provide an evidence-based discussion by using peer-reviewed journal articles to support the discussion.

Additional comments:
• Maximum of 2,000 words (allowance of 10% either side)
• Referencing style should be APA

PMC2110 Paramedicine Principles 1
Case Study 2
Heart failure

An ambulance is responding to a 000 call for a female complaining of shortness of breath. On arrival at the address the patient, a 50-year-old female reports the following signs, symptoms and history:
Shortness of breath and associated symptoms:
O – Started while watching TV 3 days prior
P – Constant, made worse with exertion and when laying down
Q – N/A
R – N/A
S – Given a score of 8 out of 10
T – Getting gradually worse over the past 3 days
A (associated symptoms) – shortness of breath, fatigue, coughing white sputum, swollen abdomen, sudden weight gain.
Table 1: Physical observations





Pale, diaphoretic




37 degrees celsius
Breath sounds

Fine crackles in bronchial areas bilaterally

Past medical history (PMHx)
Mrs. A had an anterior MI in 2004 which is well controlled.
Medication history
Daily doses of Atenolol, aspirin, GTN
Social history (SHx)
Mrs A. lives with her husband, has 3 cats and used to go horse riding prior to her MI in 2004, but now does no active sports.
Family history (FHx)
History of cardiovascular disease in the family and her grandfather had NIIDM.

Explain how each of these measures relates to one of more of the IOM’s six aims.

Quality management
Paper , Order, or Assignment Requirements

Question 1 4 pts
Read the Health Affairs article titled, “The Quality Tower of Babel”, which is provided in a pdf file in Canvas. (Be sure to look under the “Modules” section to find it).
The article points out the plethora of “quality” measures that are being reported by organizations. Explore the following websites: Consumer Reports, US News and World Report, Leapfrog, Health Grades, and Hospital Compare. Based on your exploration of these websites, answer the following questions:

What organization is developing each website? Who is the target audience? What level/ type of data is provided and on which organizations/ individuals? For how many years have they been reporting these measures? Is this data reliable (support your answer)? Is it valid for decision making (explain)?

For each of the websites, list 5-10 individual data measures (be specific) and explain if these are outcome, process or balancing measures. Try to find some measures from each website that represent each type (outcome, process, balancing).

Question 2 1 pts
Pick three related measures from any of the websites in which the organization appears to show an opportunity for improvement. Using these three measures answer the following question:

Explain how each of these measures relates to one of more of the IOM’s six aims.
Explore CMS’s Measure Inventory, specifically those measures in the pipeline. Answer the following questions:

1. How do the pipeline measures complement, expand, or improve the current publicly reported measures?

2. If you were a new patient looking for a provider in your area, which SINGLE of the pipeline measure would be most important to you and why ?

3. If you were a new geriatric internal medicine physician looking to be employed by a hospital in your area, which SINGLE of the pipeline measure would be most important to you and why (choose one)?

4. If you were a new hospital administrator who had recently been hired at a hospital in your area, which SINGLE of the pipeline measure would be most important to you and why (choose three)?

Question 4

Access the County Health Rankings & Roadmaps website.

1. Compare Harris County, TX to Bexar County, TX on 3 Measures for each of 4 different Health Factors including Health Behaviors (12 measures total).

2. Discuss how these two counties compare on Health Outcomes.

3. Select one measure to improve. Access the “What Works for Health” section of the website. Identify two interventions (policy, programs and/or systems change) that could be implemented to improve the measure. One intervention should be targeted to individual-level impact and the other to population-level impact. Comment on evidence rating of the intervention you selected.

What are some potential barriers that you anticipate related to change in the workplace related to your practicum project?

Questions for Week 5
Paper , Order, or Assignment Requirements

Question 1
Change Theory (Chapter 11)
What are some potential barriers that you anticipate related to change in the workplace related to your practicum project? What are some components of Change Theory that could be used to facilitate and manage anticipated barriers?

Question 2
Conflict Resolution
Identify an issue of conflict that you have witnessed or you have seen present in the workplace. Which conflict resolution style was used to handle the situation? Was it effective? Which conflict resolution style would you use, how, and why?

Question 3
Motivated Employees (Chapter 5)
Intrinsic motivation has been found to be a source of long term motivation in the workplace. Explain your view of intrinsic motivation and how this is a factor in motivating employees in the workplace? How will you identify and use intrinsic motivation as a nurse administrator?

Question 4
Change Process (Chapter 5)
Think about your organization. Determine one thing that needs to be changed. What is that process? How would you initiate this change including presenting it for approval? What is the nurse administrator role in this process?
Question 5
Learning Organizations (Chapter 2)
Does your organization fit the characteristics of a Learning Organization? How does a Learning Organization better meet the needed changes identified by the Institute of Medicine for health care production and delivery of services? How would your organization benefit from a Learning Organization model?
Question 6
Culture In Organization (Chapter 2)
How do you see the role of culture in your organization as a factor in creating needed changes? Would the Mayo Model be effective in your institution in its current culture?

Question 7
External Factors (Chapter 3)
How might external environment factors shape a consensus or create conflict among an organization’s departmental missions, objectives, and goals? How do conflicting departmental goals and competing budgetary interests affect a business plan?
Question 8
Leadership Teams (Chapter 3)
Do you see the three types of leadership evidenced in your organization? If not, what elements are missing and how would your organization be influenced by the presence of all three in a Leadership Team? How do you see your personal leadership style fitting into this model?

Have you ever been in an elevator with someone who asks you a question and you try to respond before the person reaches his/her floor and gets off the elevator?

U7D1 – Reflective Practitioner
Paper , Order, or Assignment Requirements

Have you ever been in an elevator with someone who asks you a question and you try to respond before the person reaches his/her floor and gets off the elevator? You only have a very short time to communicate the information.
Your task for this discussion is to present you elevator response to one of the following:
Joe, who has worked at the hospital on the business side for years says “I don’t understand why this accreditation business is so important, we have been in the healthcare business for years, we know what we are doing”.
Ann, a worker in the cafeteria says “the money that the facility is paying to remain accredited would be better spent on raises for the lower paid workers”.
Dr. Jones, an old school doctor who has been in medicine for years says “We have accreditors here all the time, I don’t think we need to do anything special to get ready for a site visit, we have always gotten our accreditation”.
What would you say to one of these people? Remember you only have a short time to make your point – figure about one minute before they are off the elevator.

Prepare all journal entries, consistent with GAAP, including budgetary and encumbrance entries that the department should make in 2015.

Government and Not-For-Profit Accounting Portfolio #1
Paper , Order, or Assignment Requirements

Your portfolio project will provide specific answers to questions that follow. Apply what you have learned in this course to your answers to these questions.

2-6: The nature of a transaction gives a clue as to the type of fund in which it should be recorded. (80 points)

Scenario 1:

Kendal County engaged in the following transactions:

It levied and collected $1million in taxes dedicated to the repayment of outstanding general obligation bonds.
It billed sponsors of a charity bicycle ride $5,000 for providing police patrols during the ride.
It recognized $60,000 of cash dividends on investments dedicated to the support of a county arts center.
It recognized $70,000 of cash dividends on investments dedicated to scholarships for needy county residents.
It incurred $6 million in construction costs to complete a new county jail. The new jail was funded entirely with the proceeds of long-term bonds.
It transferred $400,000 of unrestricted funds to an appropriate fund to be invested and eventually used to repay the principal on the long-term jail bonds (entries in two funds required).
It recognized depreciation of $100,000 on equipment in a vehicle repair center that services all county departments that have motor vehicles.
It collected $30,000 in parking fees at the county-owned garage.
It issued $8 million in bonds to improve the city-owned electric utility.
It distributed $3 million in taxes collected on behalf of school districts located within the country.


1.Prepare appropriate journal entries.

2.Indicate the type of funds in which these transactions would most likely be recorded.

5-4: Generally accepted modified accrual accounting practices pertaining to inventories may not fulfill the objectives of financial reporting. (80 points)

Scenario 2:

The following is an excerpt from a note to the financial statements of the city of Dallas (dates changed):

The city prepares its annual appropriated general fund, debt service fund, and proprietary operating funds budgets on a basis (budget basis) which differs from generally accepted accounting principles (GAAP basis). The major differences between the budget and GAAP bases are that encumbrances are recorded as the equivalent of expenditures (budget) rather than a commitment of fund balance (GAAP) in the governmental funds.

The city accounts for inventories on the purchases basis. One of the city’s departments, which is accounted for in the general fund, budgeted $195,000 in supplies expenditures for fiscal 2015. It began the 2015 fiscal year with $30,000 of supplies on hand. It also had $12,000 of supplies on order. During the year it ordered an additional $180,000 of supplies, received (and paid for in cash) $185,000 of supplies, and consumed $178,000 of supplies.


1.Prepare all journal entries, consistent with GAAP, including budgetary and encumbrance entries that the department should make in 2015.

2.Indicate the accounts and amounts related to supplies that the city would report on its year-end statement of revenues, expenditures, and changes in fund balance and balance sheet.

3.By how much did the department over- or under-spend its supplies budget (on a budget basis)?

4.Comment on the extent to which the city’s statement provides a basis to:1.Assess the ‘‘true’’ economic costs associated with supplies

2.Determine whether the city adhered to budgetary spending mandates

5.Suppose that in the last quarter of the year, department officials realized that the department was about to overspend its supplies budget. They therefore ceased placing new orders for supplies. However, they imposed no restrictions on the use of supplies and thereby allowed the supplies inventory to decline to near zero.1.What impact would these cost-cutting measures have on supplies expenditures as reported in an actual-to budget comparison (on a budget basis)?

2.What impact would the year-end measures have on reported supplies expenditures (per GAAP)? Would your response be different if the city accounted for supplies on the consumption basis?

10-4: Investment gains and losses may have to be accounted for differently in nonexpendable than in expendable funds. (70 points)

Scenario 3:

The McCracken County Humane Society (MCHS), which is part of a county’s reporting entity, established a permanent fund to provide support for its pet neutering program. As of the start of the year, the fund had a balance of $600,000, composed of both cash and marketable securities.

The program itself, which is accounted for in a special revenue fund, is funded by both direct contributions and the income from the permanent fund. At the start of the year, the special revenue fund had assets (all investments) of $26,000.

The following transactions and events occurred in a recent year.

The MCHS conducted a Walk Your Pet Day fundraising drive. The event raised $120,000, of which $20,000 was in pledges expected to be collected shortly after year-end.
The society acquired food and medicine at a cost of $60,000 (cash). During the year, it used $30,000 of these supplies. The society accounts for supplies on a consumption basis. It incurred other operating costs (all paid in cash) of $85,000.
The society earned interest of $45,000 on investments accounted for in the permanent fund.
During the year, the market value of the investments held by the permanent fund increased by $30,000. Per the terms of the agreement establishing the endowment, all capital gains, both realized and unrealized, must be added to principal.
During the year, the value of investments held by the special revenue fund increased by $3,000.
The society transferred cash to the special revenue fund in the amount of the earnings of the permanent fund.


1.Prepare journal entries to record the events and transactions. Be sure you indicate the fund in which they would be recorded.

2.In your opinion, should the unrealized gains on the investments held in the special revenue fund be considered expendable or nonexpendable? Explain.

3.How would the transfer from the permanent fund to the special revenue fund be reported in the government-wide statements?


Include a cover page denoting the paper title, your name, the course number and name, your instructor’s name, and the date you are making the submission.
Use APA citations where appropriate, and include an APA- formatted reference page at the end.

Identify which countries have a centrally organized and controlled healthcare system.

Critique the Differences of National Health Service Countries
Paper , Order, or Assignment Requirements

Identify which countries have a centrally organized and controlled healthcare system.
Identify which countries have a central policymaking function with delivery delegated to regional, state, or local institutions.
Explain how comprehensive the coverage is in each of the countries with a national health service.
Determine how rural/urban disparities in healthcare distribution influence access under national health services.
Interpret how the utilization of traditional medicine is incorporated into national healthcare delivery systems.
Determine the role of the private sector in the delivery of healthcare services.
Compare observable disease patterns among the varying national healthcare systems.

Do you think that such improvements mean that gender inequality will soon be a problem of the past?

Womens Liberation?
Paper , Order, or Assignment Requirements

Gradual improvements in the economic, occupational and political circumstances of women in the United
States may challenge the argument that the condition of women is still fundamentally characterized by
gender inequality. Do you think that such improvements mean that gender inequality will soon be a
problem of the past?
Part One: Summarize the Changes in Womens Status (two or three paragraphs)
Which changes in the status of women in the last generation or two have been the most
significant in eroding gender inequality? Consider the various arenas in which womens status
has improved. For example, how has the status of women improved in the economy (jobs,
income), education, politics, or in interpersonal relations? Hint: focus on only one or two of
these changes
In which ways (and to what extent) are women still subject to gender inequality and
discrimination? Again, consider the various arenas above and narrow your focus.
Part Two: Evaluate Whether Womens Status Is Still Basically Characterized by Gender Inequality
(about a paragraph)
Based on the evidence you presented above, do you think that it makes sense to focus on
inequality and discrimination in order to understand the status of women in the contemporary
United States? Is seeing women as a minority group (as sociologists use that term) useful or
Is gender equality even possible (or desirable) given the biological differences between men and
How to answer this question effectively:
Although this is asking your opinion, you should present specific, measurable evidence, not
anecdotes, stories and personal examples. This is especially important for part one.
The kinds of evidence which might be relevant include items listed below. Do not try to discuss
all of these. Focus on the two or three you consider to be the most important.
o proportions of women in positions of power (e.g. Congress, corporate boardrooms)
o changes in the occupations of women, particularly higher status occupations (e.g. law,
o changes in income and poverty over time (particularly relative to men)
o college admission and completion rates over time
o incidences of domestic abuse and other violence against women
o incidences of hate crimes directed against women
o surveys of (changing) gender attitudes
o cultural (media) depictions and expectations of women
o gender scripts and the social construction of gender
Assignment Details
Your essay should be about 500 words in total (about two pages typed). Your grade will be based on
how well you apply the concepts discussed in the text to the broader question and on the external
evidence you bring to bear on your argument. Thus, you should demonstrate understanding of the
concepts themselves and how they apply to the question, and also find and apply relevant, objective
evidence to back up your argument.

Discuss treatment for this patient. Would you treat her dyslipidemia? Why or why not?

Homework 1unit 1
Paper , Order, or Assignment Requirements

Discussion Topic 1: You are seeing a 68 year old female to discuss recent routine lab results. She has a history of hypertension for the past 10 years, well-controlled on current medicine regimen. Her father had a MI at age 50 (evidence of premature CAD). She tells you she feels great and denies any symptoms. Her labs: Total cholesterol = 277, HDL = 90, LDL = 164, Triglycerides = 114. She is not currently taking any medication for dyslipidemia. Her ankle-brachial index test was normal at > 1.0 (no evidence of peripheral vascular disease). You calculate her 10-year risk for having a cardiac event to be 5.5%.

Initial Post: Discuss treatment for this patient. Would you treat her dyslipidemia? Why or why not? Provide rationale for your answer, including current evidence from the literature to support your position.

Subsequent posts: Comment on a colleague’s decision that differs from yours. Cite current research findings, national guidelines, and expert opinions and controversies found in the medical and nursing literature to support your position.

Students are expected to:

Post an initial substantive response of 200-250 words to each question.
Read postings and engage in the discussion boards 4-5 days per week.
Respond to at least two other student’s postings with substantive comments.
Substantive comments add to the discussion and provide your fellow students with information that will enhance the learning environment.

The postings should be at least one paragraph (approximately 100 words) and include references as indicated by the instructor.

References and citations should be no more than 5 years old and should conform to the APA 6th edition.

Based on the MEDEX mission statement, tell us how your values and experience make you a good fit for MEDEX.

Based on the MEDEX mission statement, tell us how your values and experience make you a good fit for MEDEX.
Paper , Order, or Assignment Requirements

Applying to a Physician’s Assistant Program

Sorry about the long description, they have several questions to answer.

– Medic in the Army

– Wanted to include my respond to house fires while in the Red Cross as a story that inspires my vounteerism

Describe how your experiences working with, talking to, or observing physicians, PA’s or NP’s have convinced you that the PA profession is the right health care role for you.
Worked with several PA’s with strong background in volunteering, showing passion for helping the underserved communities. Compassion for their patients and liked working under multiple specialities during their career (one worked under as Emergency Medicine then switched to orthopedics)

What are the biggest challenges you face in returning to school, and what will you contribute to your MEDEX classmates?
Biggest challenge and excitement includes coming back to structured learning environment, I have been taking independent learning courses and learning through the clinic for several years.

My contributions to MEDEX include my vast military experience, volunteer experience with the Red Cross, and having be able to act at the level of an independent medical provider in austere environments that may provide some insight

Do you believe your academic history accurately reflects your ability to successfully complete PA school? Please explain.