Palliative Care Case Study Example | Topics and Well Written Essays - 2000 words

Palliative Care - Case Study Example The report then discusses the case in light of current medical practice in the field of palliative care and applies the ACE model in the design and implementation of the palliative care plan of the patient. Palliative care for the elderly is a critical healthcare service whose objective is to improve the quality of life of the elderly. Although a lot has been done in terms of research initiatives, and education of healthcare providers, the quality of healthcare is yet to reach the desired standards (Jerant, Azari, Nesbitt, & Meyers, 2004). In many instances, design of care provision often overlooks the elderly who in fact have the greatest need for the care due to the complex nature of their needs. Despite this, palliative care is progressively being incorporating the elderly in the design of care and has played a major role in alleviating pain and distressing symptoms thereby gaining wide acceptance as a recognized specialty of nursing (Becker, 2009). Palliative care and nursing are also closely intertwined and the knowledge and skills required are applicable across the nursing profession. It is therefore critical that nurses acquire critical skills and knowledge that would enable them to conduct research and apply current evidence based practice guidelines in palliative care delivery. This report will be based on a case study of a 78 year old man brought into the ER after being found down and altered by a friend.... On physical examination, the heart rate was in the 110’s and improved to 130 and then to 140’s systolic with fluid resuscitation. On further examination; the patient is noted to be cachetic, and malnourished. He was alert, oriented, awake and talking. The mucous membranes were very dry. He had tachycardia with inspiratory rales on the right upper lobe of the lung. The abdomen was non distended and non tender. His laboratory results revealed a white blood cell count 16.1 with a left shift, the sodium concentration was 128, the creatinine level was 2.0, and lactate at 5.1. His chest x ray was clear and the head CT scan of the head revealed moderate hypoattenuation of the white matter. The patient has evidence of having an acute kidney injury and hyponatremia. The patient displays evidence of failure to thrive. The initial diagnosis made included altered mental status, acute kidney injury, failure to thrive, malnourishment, starvation, weight loss, history of alcohol abuse , severe chronic obstructive pulmonary disease, dehydration, and hyponatemia, The condition of the patient was determined to be critical and he was admitted into the medical intensive care unit. While in the MICU, the patient complained of increasing cough, difficulty swallowing and abdominal pain. On auscultation of the lungs, there were scattered rhonchi across the lung fields both posterior and anterior. The patient grimaced on palpation of the abdomen and had a productive cough. The bowel sounds were hyperactive and the abdominal x-ray revealed a large amount of stool within the rectosigmoid colon. There were also several air filled loops in the mid to upper abdomen. The mucosal lining appeared thickened and distorted. The x-ray of the chest

Amazon.Com in Business Plan Research Paper Example | Topics and Well Written Essays - 1000 words

Amazon.Com in Business Plan - Research Paper Example To sustain this new venture, Amazon Inc. has a good start off, as its traffic is attractive to buyers and sellers into Amazon market place. Firms likely to be acquired in this endeavor include Diapers.com, Zappos and Soap.com. Amazon intends to buy Quaidis, the parent company to Soap.co and Diapers.com for $540 million. The capital that was collected to fund this acquisition amounts to $78 million. In another strategy for up its competition with CPG companies, Amazon Inc. intends to acquire Zappos at a projected price of $1.1 billion. To compete with Google and Apple, Amazon Inc. intends to upgrade its Kindle to support mobile phone applications and functions. This will enable the incorporation expand from just providing physical goods to digital goods. The low margins strategy has been employed by Amazon regardless it is downcast by other companies. Amazon is offering its products and services at low prices as a strategy to attract more customers and increase its market share. This is a strategy aimed at increasing value to customers rather than increasing its value through high prices and high profits. Increased market share will see Amazon reduce its costs through economies of scale, as the costs will b e spread through many customers. For instance in 2011, Amazon had operating expenses of 91% expressed as a fraction of revenues. This demonstrated its big market share compared to Walmart. Amazon had revenue streams of up to $48 billion. Most of this is attributed to online retail store where it has managed to attract millions of shoppers and sellers to its website. This has led to a cost advantage for Amazon in relation to Walmart and Costcos. Amazon has grown from just a book retailer to be the largest online retail shopping for physical and digital goods and services. This has not stopped the company from further growth and development. The company is seeking to contract Google, which will see it use the Android technology. Although Amazon and Google are market rivals, Amzon seeks to cross the gap between the two and build its new devices on the Android operating system. 8. Implementation strategy: From a range of reasonable options (build or â€Å"go it alone† strategy, p artner via a joint venture or less formal business alliance, license, minority investment, and acquisition), indicate which option would enable the acquiring firm to best implement its chosen business strategy. Because of the nature of the course, you must indicate that an implementation strategy involving an acquisition is preferred to the other options and why. An acquisition is the best strategy for implementation. The acquiring firm’s stands an advantage of running a business that is well established compared to building up a new business. With an established business, the acquiring firm can use the existing financial records to forecast future performance to determine if the new firm to be acquired is profitable. This is not the case with a new firm being set up. Setting up a new firm may require more capital and time. The business’ future performance may not be correctly forecasted because there are many unseen occurrences, as the business has no experience. Part nerships on the other had result in legal disputes, as the partners are likely to disagree on decisions and business issues. Acquisition remains the