Each of the adult children is located interstate and has young family. Klara had previously participated in many outdoor activities with her husband and her hobbies include bushwalking, cryptic crosswords and gardening. Phillip and Klara have recently separated and are living separately.
Recently, Phillip has had a number of minor mishaps at work and has been increasingly dropping things. He has been experiencing a slight right-hand tremor and his gait has become unsteady. The tremor appears to worsen at night particularly when sitting down and when resting in bed. Phillip has been increasingly fatigued and forgetful. This was becoming more noticeable and problematic as the tremor did not subside and Phillip felt he was becoming clumsier.
Phillip has been increasingly concerned that he would fall asleep at work so has tried not to sit down unless he is at lunch. It is at work that the hand tremor is particularly troublesome. Two Phillip has also had two episodes of losing his balance and once fell over. Phillip also feels as if everything is spinning around and has numbness in his hands. He was also having difficulty speaking and slurring his words. Phillip managed to call an ambulance as he didn’t know what to do. Phillip was reviewed, admitted and seen by a medical officer, and referred to a neurologist for review.
Phillip spent two weeks in hospital and a provisional diagnosis of Parkinson’s disease was made. To rule out any other neurological conditions a series of investigations was conducted including an MRI and PET scan as part of the diagnostic screening process; no abnormalities were detected. Following these investigations and a thorough neurological exam, a firm diagnosis of Idiopathic Parkinson’s disease was made.
Phillip was discharged home, being collected by Klara. Klara indicated that she would not be able to be Phillip’s carer, Phillip was adamant that he would be fine at home on his own. You have been asked to see Phillip in the community as part of his discharge plan.
Intermittent fatigue for approximately 8 months.
Bradykinesia for approximately four months. Phillip has been increasingly dropping equipment and stock at work.
He has been unable to deal with hot water at work and was not able to make tea to serve as samples.
Increasing hand tremor for 4 months, most evident at rest.
Emotional lability for 4 months with out of proportion emotional reactions to small incidents.
Unsteady gait for approximately four months including stumbling without cause
Increasing levels of confusion;
Increasing drooling; Increasingly being told he is hard to hear;
Discharge Summary Phillip Dillon is a 67-year-old male, recently separated from his wife. Admitted via A&E with a history of:
• Increasing upper limb tremor; more pronounced right side;
• Increasing global bradykinesia – shaking and slow response to requests
• C/O increasing fatigue and ‘sleepy’ episodes during the day when working; drooling;
• increasing hypophonia (hard to hear)
• Feeling ‘blue’ and sad on and off for the past 12 months.
• High cholesterol Surgical history
• L knee arthroplasty – age 44
• Tonsillectomy and adenoidectomy as a child
• Other • semi-retired; works part time in Tea shop;
Recent admission to hospital for investigation of altered mobility;
• Neurological, musculoskeletal, cardiovascular assessment – no abnormalities detected
• Excluded neuro pathology – CT and PET scan – no abnormalities detected;
• Provisional diagnosis: Parkinson’s disease Discharged – yesterday Primary diagnosis of Parkinson’s disease
• Lipitor 25mg mane
• Dopamine releaser-Amantadine HCL – 100 mg daily
• Dopamine agonists – Carbergoline – 0.25mg BD
• Dopamine replacement – Levodopa 10mg TDS
• MAO-B inhibitors – Selegiline -25mg patch changed daily
• Maxolon for nausea 10mg prior to meals
• Paracetamol PRN
identify and discuss two PRIORITIES OF CARE and apply the clinical reasoning cycle to these as a means of justification
Presentation The Enterprise Networking task depends on the electronic stock control framework. This task is about how to execute another online book organization called "Astonishing Books". "Astonishing Books" organization is another online book organization that will offer books by means of a site. The site speaks to the books that are in the organization's stockroom. It additionally contains the data of the books and the data gave to the clients to arrange the books they need. It is connecting with organization's stock control framework. The stock will be routinely recorded and refreshed in view of the business record. At the point when a client takes care of a request shape, he or she needs to pick the things and the conveyance data. At the point when the organization gets the request, it conveyed the bundled books to the neighborhood warehouse of a messenger organization. The online book organization likewise executes its electronic stock control framework in the stockroom. This framework incorporates arrange preparing, recording new passage of books, despatching books to the dispatch firm, and hailing stock reorder step up. Along these lines, the organization will examine the sites of stock control framework as test and execute its own one. Additionally, the organization will make a neighborhood (LAN) for in the stockroom by utilizing proper media and topology to complete its procedures well. The organization likewise has an arrangement to convey the requested stock things from the stockroom to the conveyance organization effectively by utilizing appropriate vehicles which contains equipment and programming for security administration. The last arrangement is to deal with a security control framework so as to keep the robbery of staff themselves and to direct the stock reorder level when burglary happens. The system director or administrator of the "Stunning Books" online book organization will explore the book sites and electronic stock control framework sites of different organizations. He or she is likewise anticipating finding the conveyance administration framework and security administration framework on the web. At that point he or she will compose a report (with suggestions) how to execute theirs organization so as to effectively set up. Errand 1 Astounding Books Company is one that needs to oversee themselves as an online book deals organization. They will offer their books by means of the web. Thus, they need to build up a site which will show data about their books. Before it is created, they look at three sites of the online book organizations that offer theirs by means of the web. The principal researched site is www.bookshopofindia.com. In landing page, the photos of a few books are introduced. At the point when the photos are multiplied clicked, the outlines of each book are shown. It contains other data, for example, creators' names, ISBN number, cost and quantities of pages. On the left-hand side of the landing page, the subjects of the books that are sold in this site are recorded. The subjects contain religions, expressions, business, PC innovation, youngsters books et cetera. To arrange the books, clients can send messages, however they can just influence installment by utilizing bank to record of Corporation bank and Punjab bank. The second analyzed site is www.boomerangbooks.com. In landing page, a few pictures of ordinary books are set on the correct side. In the best, some uncommon ones, for example, books for Mother's day are put. Amidst the page, some are promoted by indicating pictures, creators' names, and short portrayals of them. On the off chance that the photos are double tapped to examine, the photos of the books' spreads and rundowns of them with writers' names show up. ISBN, arrange, number of pages, distributers, distribute date and dialects are likewise appeared. On the correct side, ordinary cost and markdown cost are thought about. On the left half of the landing page, the site orchestrates a few classifications to peruse for books as per book classes, smash hits, books from motion pictures, and book grants, and so forth. It additionally puts book substance. In landing page, it goes a menu called "Boomerang Books Bulletin". On the off chance that a client joins in this shape, he or she can get a $5 book voucher and 20% markdown when rebates days are on. To arrange the books, the site shows its telephone number, email address, and fax number. Along these lines, clients can arrange by telephone, email or fax yet they can pay just Australian dollars. The third one that is seen to get showing books data is www.cherrythitsar.org . This site is where clients can get ebooks. On the landing page, there is a rundown that portrays the classifications that clients can download. These classes contain Myanmar free ebooks, Myanmar books, Myanmar daily papers et cetera. On the off chance that a client needs to get them, he or she needs to influence a record by entering client to name and watchword. At that point he or she can get them. In the wake of examining these sites that give data to online book offering, "Stunning Books", the online book organization, is executing their site. On the highest point of the landing page, the photographs of the books that are sold for the remembrance days will be displayed. They will be sold by gifting reasonable rebates. On the left-hand side of the landing page, the lists of the books will be displayed with a specific end goal to seek books by the classes the clients need. The inventories will line the arrangements of the books as indicated by book classes, smash hits, books from motion pictures, and book grants, and so on. On the off chance that the photographs of the books in landing page are double tapped, the outlines of the books with books' titles, sorts of books, ISBNs, writers' names, distributers, distributing date, number of versions, and number of pages, and so forth will be appeared. Under the each page of site, there will be organization's address and requesting data will arrange. Requesting data will incorporate telephone numbers, fax numbers and friends' email address. Along these lines, clients can arrange books by ringing a telephone call, or making request by fax, or sending an email. To arrange by email clients must fill picked things into the shopping container that is on the correct side of the landing page. At that point they need to enter their telephone numbers and addresses (counting postal code). They can enter their financial balances or charge card records to arrange. Errand 2 There are numerous stock things that are put away in the distribution center of the "Astonishing Books" online book shop. The stock control framework in distribution center is connected with the organization's site so clients can see the books that are in stockroom by means of the site. On the off chance that they need to arrange books, the will their own data including conveyance addresses, postal codes and bank or credit accounts. At the point when clients influence books to arrange by means of site, the organization will advise the staff of the stockroom. The distribution center staff checks the level of stock things and answer to the fundamental server. Furthermore, the server keeps the data refresh and let the clients know data to the site. At that point the organization will convey the books to a conveyance group. And after that the messenger organization will convey books as indicated by the clients' locations and postal codes. To do these procedures effectively, the book shop needs an appropriate stock control framework. Along these lines, they assemble data for stock control framework by investigating the sites which speak to their electronic stock control frameworks. Required data for proposals The first and second researched sites demonstrate their online stock control frameworks. They demonstrate their item data and other related one. Clients can inquiry and peruse they need and they can arrange them by messages. The organization that makes the primary site is utilizing RFID (Radio Frequency Identification) perusers for recording the new things for the stock. The organization likewise clarifies its conveyance benefit for requested things. The second site utilizes standardized identification peruser. It portrays their control arrangement of adjust levels of the stock and cautioning the hailing up reorder framework by utilizing the stock control administration programming. The third and the fourth one are the sites that offer programming applications for electronic stock control administration framework. They give the point by point data of how to utilize their product. Them two are created to run the elements of recording clients' request, acquiring, things section, evaluating, getting, shipping, exchanging, revealing and security administration, and so forth. Among them, the previous one is utilized with standardized tag peruser and the last one with RFID for recording new stock things for the framework. Clients can purchase their product by entering their email locations, and bank or credit account numbers in these sites Techniques and equipment for recording stock section which are in distribution center In the wake of researching four sites, "Stunning Books" executes its electronic stock control framework. As a matter of first importance, they make buying books from numerous different sources. At that point the books are placed in holders which contain RFID (Radio Frequency Identification) labels and the compartments are conveyed by reasonable vehicles. When they touched base to the distribution center of the organization, the RFID labels are checked by RFID perusers which transmit the arrangement of advanced personalities of the books remotely. The label perusers identify the bundles or holders which contains a few book things. The RFID perusers can check every whole holder all the while and enter information into the server PC utilizing exceptional stock control administration programming for stock control. Thus, the correct information in database of the server can continue refreshing. Being connected the server with the site of the organization, the data of the books in website pages is consequently refreshed. (c) Methods and equipment for arrange preparing To arrange the book things, the clients need to take care of the request shape. In this frame, the clients must fill their data that contains their addresses and postal codes and conveyance charges (which value ranges rely upon nations) by methods for bank or credit account numbers. From that point onward, they can ord>GET ANSWER