Johnathan, age 7, presents to the office with symptoms of worsening cough and wheezing for the past 24 hours. He is accompanied by his mother, who is a good historian. She reports that her son started having symptoms of a viral upper respiratory infection 2 to 3 days ago, beginning with a runny nose, low-grade fever of 101.0 degrees F orally, and loose cough. Wheezing started on the day before the visit, so Johnathan ‘s mother started administering albuterol metered-dose inhaler (MDI) two puffs before bed and then two puffs at around 2 AM. The cough and wheezing appear worse today, according to the mother. He had difficulty taking deep-enough breaths to inhale this morning’s dose of albuterol, even using the spacer. Johnathan has been a patient at the clinic since birth and is up to date on his immunizations. His growth and development have been normal, and he is generally healthy except for mild intermittent asthma. This is his first asthma exacerbation of the school year, and his mother expresses a concern
about sending him to school with an inhaler. Johnathan is afebrile with a respiratory rate of 36 and a tight cough every 1 or 2 minutes. He weighs 45 pounds (20.5 kgs.). The examination is all within normal limits except for his breath sounds. He has diffused expiratory wheezes and mild retractions. Pulse oximetry readings have been 93% of oxygen saturation.
1. What is the appropriate pharmacological therapies to be prescribed for Johnathan 2. What information is necessary to provide to Johnathan and his mother regarding asthma exacerbation? 3. What is an appropriate clinical assessment tool to be use with Johnathan? 4. What are the classification of asthma? 5. How would you as the NP address his mother’s concern regarding providing an inhaler at school? 6. What is an appropriate plan of care for Johnathan?
Difficulties to the LEGO Group Distributed: 23rd March, 2015 Last Edited: eleventh December, 2017 Disclaimer: This paper has been put together by an understudy. This isn't a case of the work composed by our expert paper journalists. You can see tests of our expert work here. Any feelings, discoveries, conclusions or proposals communicated in this material are those of the writers and don't really mirror the perspectives of UK Essays. In the ongoing circumstances overall economy has turned out to be exceptionally unpredictable and was powerless against a huge number issues. One such case is the most recent monetary emergency. Such instability makes an assortment of difficulties to little and expansive ventures far and wide. One of the greatest difficulties for assembling organizations is to manage quickly expanding globalization and rivalry. The arrangements require the improvement of dexterous and quick supply organizes so as to cut expenses and take care of demand. Makers are ending up more mindful of production network administration. This mindfulness moves the concentration from inner coordinations productivity to the outer system of connections between different gatherings in the store network. The outstanding Danish toy producer LEGO has not been immune to these progressions. LEGO has confronted real difficulties, which required uncommon changes inside the association. This incorporated a change of the organization's store network administration framework. LEGO Group needed to manage presumably the most critical budgetary emergency since the organization was established in 1932. LEGO's emergency was not unmistakably noticeable all things considered. Actually LEGO had kept up mark acknowledgment. This earned them the title "Toy of the Century" from the British Association of Toy Retailers and "Fortune" magazine. LEGO was the fourth biggest toy maker in the word and had sold US$1.35 billion worth of toys in 2004. Regardless of this achievement, the organization was losing cash since 1998. LEGO had different inside operational issues. This incorporated an intricate and incapable production network, which at one phase comprised of 11,000 temporary workers. While trying to address this issue, in 2004 LEGO governing body set an objective to cut 20 percent of calculated expenses. This brought about the unsafe choice to outsource a noteworthy piece of the creation to Flextronics, a Singaporean gadgets producing administrations supplier. LEGO additionally settled a solitary dispersion focus in the Czech Republic worked by DHL. (M. M. Larsen, T. Pedersen, D. Slepniov 2010; K. Oliver, E. Samakh, P. Heckmann 2007; J. A. Cooke 2009) Such a hazardous choice included a long haul association with Flextronics that was not without challenges. In this examination paper an outline of difficulties and arrangements of the case organization LEGO Group will be displayed. The primary spotlight will be on LEGO's store network administration framework change, which was a noteworthy advance towards progress. The accompanying examination inquiries will fill in as rules for this paper: What challenges did LEGO Group confront and what choices were made to address those issues? How did Supply Chain Management change managed these issues? In this paper we will initially investigate the Supply Chain Management (SCM) ideas. Next the case organization LEGO Group will be presented. We will then present review of the difficulties that LEGO Group has confronted. The focal point of this paper will be the SCM choices that were made to manage these issues. Store network MANAGEMENT CONCEPT The globalization is expanding rivalry and shaping new conditions for directing business. This requires organizations worldwide to quickly react to their clients' requests and create items. These organizations should likewise apply data advancements in inventory network joint effort (J. S. Arlbjørn et al. 2006) Such conditions expanded the significance of coordinations and SCM part inside associations as it can turn into a noteworthy upper hand. Generally, the significant changes in strategic capacities may not be required inside the association itself. It might be more valuable to dissect the association's production network. This includes different reliant gatherings. SCM co-task is picking up in major vital significance and generally incorporates such attributes: co-working depends on end client prerequisites, long haul co-activity and high trust between performers in the supply chains or systems, shared dangers and advantages, cross coordination on different levels between organizations, shared dreams and comparable organization societies. The upside of such close co-task is a more straightforward store network. This can prompt decreased lead-time, bring down vulnerability, advancement of stocks and higher limit usage. (T. Skjoett-Larsen 2000) The idea of SCM frequently speaks to the more extensive perspective of coordinations as its primary capacity is to guarantee the smooth stream of materials from providers to association and after that out to clients through the tasks inside the association (D. Waters 2003). The motivation behind SCM can be depicted as to evacuate redundancies and correspondence hindrances through coordination, observing and control capacities (D. Power 2005). The production network typically comprises of various associations and procedures, which are intended to guarantee the smooth stream of materials from the underlying provider to the end client. By and large, producers get their materials from countless and pitch to various clients, which is the situation with LEGO Group. In figure 1, you can see a case of the production network around a producer. Materials move from a few levels of providers however association to a few levels of clients, for example, wholesalers, retailers and end clients. Figure 1: Supply chain of maker (D. Waters 2003, 9) The toy business is one of the most seasoned imaginative enterprises in the word. Be that as it may, C. Y. Wong, J. S. Arlbjørnand J. Johansen in their investigation named "Store network administration hones in toy supply chains"(2005) express that such imaginative business is exceptionally regular and unstable with emphatically fluctuating requests, short and determined undercutting windows and also item life cycles. Additionally, the toy business can be portrayed as strongly focused on evaluating and advancement, where retailers frequently begin contending with their providers. The creators infer that most retailers and makers utilize a "push" plan of action. This model incorporates low usage of innovation and data sharing and additionally moderate execution of store network activities. Prologue TO THE CASE COMPANY: LEGO GROUP LEGO can be unquestionably characterized as a standout amongst the most popular brands in the toy business. The Danish organization's toys are appreciated worldwide by kids and grown-ups alike, who utilize a large number of various pieces to develop structures, robots and other toy. In 1932, Ole Kirk Christiansen, a Danish craftsman established an organization named LEGO (Danish words "Leg" and "Godt", signifying "play well"). Initially a carpentry business for furniture, LEGO started creating kids' toys in 1934. The organization presents itself by expressing: "It is LEGO reasoning that "great play" advances a youngster's life - and its consequent adulthood. In view of this, the LEGO Group has created and showcased an extensive variety of items, all established on a similar fundamental logic of learning and creating - through play." In figure 2 the center building squares of LEGO Group are exhibited. (M. M. Larsen et al. 2010; LEGO Group, Corporate Communications 2009) Figure 2: The LEGO Company (LEGO Group 2010) Seeking after such a logic, LEGO has developed hugely since its foundation. By 2009 the organization was the world's fifth biggest toy producer regarding deal with 290 Million US Dollars in incomes and roughly 7000 representatives around the world. The LEGO block which is potentially the best known toy was first presented and protected in 1958. It has from that point forward spoke profoundly achievement and picture of this organization. With two only blocks there are 24 unique blends and with six there are 915 million potential outcomes. This empowers boundless inventiveness. As beforehand expressed, before LEGO block was named as "Toy of the century" by Fortune magazine and later by British Association of Toy Retailers also. (M. M. Larsen et al. 2010; J. Tidd, J. Bessant 2009) http://cache.lego.com/r/aboutus/ -/media/About%20Us/Media%20Assets%20Library/Logos%20Bricks%20and%20Generic%20images/ts.20120125T101709.2x4brick_red.jpg Picture 1: Lego block (source lego.com) Fragmented item classes include: Pre-school items - for the most youthful youngsters, who had not begun the school yet, incorporates LEGO DUPLO items. Inventive building - sets or cans of LEGO blocks without guidelines. Play subjects items - the items with specific stories, for example, air terminals, hustling tracks and healing centers, including LEGO City line and BIONICLE. Authorized items - identified with motion pictures and books, such Harry Potter, Star Wars and Indiana Jones. MINDSTORM NXT - programmable robot unit. LEGO instruction - items that are produced for instructive purposes. LEGO Games - new product offering began in 2009 for prepackaged games. LEGO works in more than 130 nations around the world. The organization's biggest market in the U.S., with together Australia, New Zealand and UK represented 30 percent of income in 2007. In spite of consistent difficulties and developing prevalence of shopper gadgets, LEGO is proceeding to grow. (M. M. Larsen et al. 2010) Emergency and arrangements In the late 1990's, the organization began to experience issues. This brought about a noteworthy emergency and relatively finished in chapter 11 by 2004. LEGO was losing enormous wholes of cash each day, evaluated at financial misfortunes of 375.4 thousand U.S. dollars every day since 1998. At the point when deals dropped 40 percent in 2004, obviously radical changes needed to occur. There are numerous theories, why such an outstanding and beforehand effective organization began running on tr>GET ANSWER