Mrs. Ross is a 63-year-old woman who has a history of hypertension, chronic heart failure, and sleep apnea. She has been smoking two packs of cigarettes a day for 40 years and has refused to quit. Three days ago, she had an onset of flu with fever, pharyngitis, and malaise. She has not taken her antihypertensive medications or her medications to control her heart failure for 4 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure.
1. Is very anxious and asks whether she is going to die.
2. Denies pain but says she feels like she cannot get enough air.
3. Says her heart feels like it is “running away.”
4. Reports that she is so exhausted she cannot eat or drink by herself.
1. Height 175 cm; Weight 95.5 kg
2. Vital signs: T 37.6 C, HR 118 and irregular, RR 34, BP 90/58
3. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint; all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation
4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%
5. Gastrointestinal: BS present: hepatomegaly 4 cm below costal margin
What nursing interventions are appropriate for Mrs. J. at the time of her admission? Drug therapy is started for Mrs. J. to control her symptoms. What is the rationale for the administration of each of the following medications?
1. IV furosemide (Lasix)
2. Enalapril (Vasotec)
3. Metoprolol (Lopressor)
4. IV morphine sulphate (Morphine)
Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide rationale for each of the interventions you recommend
Monetary Accounting Standards Board Framework Analysis Distributed: 23rd March, 2015 Last Edited: 25th April, 2018 Disclaimer: This paper has been put together by an understudy. This isn't a case of the work composed by our expert article authors. 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. Presentation The bookkeeping reasonable structure has been censured for not giving a sufficient premise to standard setting. This insufficiency is prove through the FASB's norms ending up increasingly manage based. All things considered, no observational confirmation has been accumulated to help the reactions of the theoretical system. We broke down the five subjective qualities of bookkeeping data from the applied system in conjunction with a person's aim to utilize/depend on monetary proclamations. Utilizing auxiliary condition demonstrating, we found that just a single subjective trademark, dependability, influenced a man's aim to utilize money related articulations. Moreover, it creates the impression that the best factor that impacts whether an individual depend on money related explanations is their nature with bookkeeping. In light of our discoveries, it gives the idea that not exclusively does the calculated structure should be modified, however it additionally should be changed to help make rule based bookkeeping principles that are valuable to all individuals, paying little heed to their experience. The Financial Accounting Standards Board (FASB) has been censured for not expecting firms to report data that is interpretable and helpful for money related articulations clients (CICA, 1980). The FASB's reasonable structure is the center in which all bookkeeping norms are determined. In this way, the bookkeeping applied structure must typify an arrangement of subjective attributes that guarantee monetary revealing furnishes clients of budgetary explanations with satisfactory data for basic leadership. The U.S. money related bookkeeping applied structure was built up between late 1970's and mid 1980's. Explanation of Financial Accounting Concepts (SFAC) No. 2 (1980) demonstrates that there are five principle subjective qualities of bookkeeping data; understandability, pertinence, unwavering quality, similarity, and consistency. Nature and Purpose of the Conceptual Framework The theoretical system was framed with the goal of giving the spine to guideline based bookkeeping benchmarks (Nobes, 2005). Be that as it may, the Securities and Exchange Commission (SEC) has as of late condemned the bookkeeping models setting board for winding up excessively administers based, which prepares for the organizing of exchanges in the organization's support (SEC 108(d)). Pundits of the system have focused on that the move towards control based benchmarks are a result of deficiencies in the bookkeeping applied establishment. Nobes (2005) contends that the requirement for lead based bookkeeping gauges is an immediate aftereffect of the FASB endeavoring to drive a fit amongst measures and a reasonable structure that isn't completely created. A sound and solid theoretical system is fundamental for the advancement of guideline based bookkeeping gauges and the movement towards merging in global bookkeeping norms. In any case, specialists are uninformed of any observational proof that backings the reactions of the current calculated structure. Also, none of the commentators have taken a gander at the theoretical system from the most imperative perspective, the client's point of view. Along these lines, the motivation behind this paper is to exactly break down the sufficiency of the applied system, from a client's viewpoint, in connection to a person's dependence on money related articulations for basic leadership. We built up an overview instrument to break down a person's expectation to depend on budgetary articulations utilizing Ajzen's (1991) Theory of Planned Behavior. We found that the unwavering quality normal for the theoretical system spoke to the main huge measurement of a man's disposition influencing their goal to depend on money related explanations. Be that as it may, the understandability trademark was moving toward centrality. Inside the setting of the hypothesis of arranged conduct, social weights was not huge impact on the goal to utilize/depend on monetary explanations, yet commonality with bookkeeping was found to altogether impact expectation. The applied structure and potential monetary explanation client's goals can be dissected inside the setting of Ajzen's (1991) Theory of Planned Behavior. Ajzen (1991) demonstrates that observational confirmation proposes that we can decide a person's aim to play out a conduct through examining their state of mind, subjective standards, and saw social control. Inside this viewpoint, we adjusted Ajzen's (1991) hypothesis of arranged conduct to a person's inclination to depend on bookkeeping money related proclamations. The motivation behind this examination was to give an experimental investigation to the feedback against the FASB's theoretical system. Our general outcomes recommend that the current calculated structure does not enough adjust the targets of financing answering to the clients of money related proclamations. By the by, accessible discoveries make them intrigue suggestions for the applied system and future standard setting. Dependability is the main subjective trademark that has a positive measurable critical association with goal. The bookkeeping calling is confronting a decision amongst unwavering quality and importance in budgetary announcing, as there is an inborn exchange off amongst dependability and significance (Paton and Littleton, 1940; Vatter, 1947). Dependable data has the normal for objectivity and certainty, which is related with chronicled taken a toll bookkeeping. Importance, then again, relates to any data that will impact the clients' budgetary choice. Commonly the most pertinent data is frequently present or forthcoming in nature. In this way, we can't have bookkeeping data that expands the attributes of both applicable and solid in light of the fact that important data isn't generally irrefutable. We would have anticipated that would consider pertinence to be a critical factor in clients' aim to utilize budgetary articulations since the ongoing bookkeeping models have advanced toward reasonable esteem bookkeeping measures, which are thought to be more applicable than dependable data (Ciesielski and Weirich, 2006). Be that as it may, our outcomes demonstrate that unwavering quality is a huge factor. The present bookkeeping educational modules could be the reason for our outcomes since it is established in Paton and Littleton's verifiable cost approach, which centers around unwavering quality of data. With regards to the Theory of Planned Behavior, we observed that commonality to be a factually huge factor to a person's aim to utilize money related articulations. In this way, as an individual turns out to be more acquainted with money related proclamations, he or she will probably have the expectation to utilize or depend on them when settling on choice. An ANOVA examination gives additionally support to this as it shows that goal to utilize or depend on money related explanations is fundamentally unique between bookkeeping majors and non-bookkeeping majors. This gives prove that bookkeeping could be winding up excessively troublesome for people who are not capable in bookkeeping to get it. It gives the idea that the development towards administer based bookkeeping benchmarks could be a contributing reason for this uniqueness in expectation. That is, the bookkeeping benchmarks have turned out to be so specialized upon their execution that the normal peruser of bookkeeping can never again perceive the principle target of each money related proclamation component. This finding is upsetting to bookkeeping since it repudiates the essential target of bookkeeping, which is to give helpful bookkeeping data to basic leadership. Bookkeeping data ought to be valuable for all individuals who need to utilize it as opposed to just being helpful to the individuals who comprehend it. Moreover, by no means, should bookkeeping data give leeway to people who happen to be specialists inside the field. Bookkeeping ought to be a device and not a boundary At the-display, the bookkeeping calling is thinking about an issue, which it has recognized as the requirement for a theoretical structure of bookkeeping. This structure has been carefully created over hundreds of years, and it is just the calling's assignment to tweak the current applied system as a result of the requirement for consistent improvement because of evolving conditions. This reasonable system has never been spread out in unequivocal terms; thusly, it is consistently neglected. A calculated structure has been depicted as "a constitution," an intelligent arrangement of interrelated destinations and essentials that can prompt steady norms and that endorses the nature, capacity, and cutoff points of budgetary bookkeeping and money related proclamations. For some bookkeepers, the theoretical system venture is hard to grasp in light of the fact that the topic is dynamic and bookkeepers are acquainted with managing particular issues. In settling those issues, bookkeepers may unwittingly depend individually calculated structures, however CPAs have not beforehand been approached to explain their structures in deliberate, durable form with the goal that others can comprehend and assess them. It is fundamental that a system be explicitly settled with the goal that the FASB and those assessing its guidelines are constructing their judgments in light of a similar arrangement of destinations and ideas. An explicitly settled system is additionally basic for preparers and reviewers to settle on choices about bookkeeping issues that are not particularly secured by FASB models or other legitimate writing. It is viewed as that if the applied structure bodes well and>GET ANSWER