Ms. M is a 66 year old Hispanic female with limited English comes in to the emergency room with a history of hypertension, hyperlipidemia, lumbago, gastroesophageal reflux, and diabetes type II.
Medications: Patient is currently taking Zestril (lisinopril) 20 mg PO daily, Zocor (simvastatin) 10 mg PO q pm, Vicodin (hydrocodone/acetaminophen) 5/500 1 tablet q 6-8 hrs prn lumbago, Prilosec (omeprazole) 20 mg PO daily, and Glucophage (metformin) 850 mg PO bid.
Lab: Patient reports she has been getting a FSBS around 180-210 when taking blood sugar every third day. Sometimes she does not take her blood sugar because the supplies are expensive. HgA1c results of 9.2.
Signs and Symptoms: Patient admits she is not taking metformin as prescribed because it cost too much money and she needs to buy food. Patient also reports when she goes shopping she will check her blood pressure. Patient reports she gets readings in the 140-160/88-100 range, but she really does not understand what that means. Patient reports she is well-controlled with her reflux. She lives alone in an apartment and drives a car. She does receive Medicare and social security, but often gives her money to her son to help him with child support so he will not go back to jail. Today she came to the clinic for headaches and feeling tired all the time.
Describe what you would tell the patient for education regarding her medications and health conditions to improve her outcomes. Take into account she is on a limited budget and will need cost effective care.
Examine how the safety, quality and cost effectiveness of health care can be improved through the active involvement of patients and families. Consider other health professionals and/or community resources that may help.
Examine common barriers (to include cultural aspects) to active involvement of patients in their own health care processes.
Describe strategies to empower patients or families in all aspects of the health care process.
Adjusted Budget Amendment 1997 Analysis Distributed: sixteenth October, 2017 Last Edited: sixteenth October, 2017 Disclaimer: This exposition has been presented by an understudy. This isn't a case of the work composed by our expert exposition 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. Adjusted Budget Amendment Vu Luu Presentation In March 4, 1997, the adjusted spending change was vanquished in the United States Senate by only one vote. Quick forward to the present, the United States is confronting a $17 trillion shortage versus the $5 trillion out of 1997. The inquiry that remaining parts to be asked is had the adjusted spending revision passed the United States Senate and affirmed by Congress in 1997, would we confront the obligation emergency that we are confronting today? In view of my decision, the appropriate response that I accept is no, the obligation emergency would not have been as serious as it is today. In this paper I will contend why the United States require a national adjusted spending correction in the constitution. Specifically, I will examine the accompanying focuses to go down my claim; future ramifications if no adjustments in approaches and fathoming government spending. As the United States' government shortage keeps on developing, numerous are requesting an adjusted spending alteration to be added to the constitution. An adjusted spending correction would require the government not to spend more than it gets in income. This implies it would be unlawful and illegal for the government to collect spending deficiencies. THE NATIONAL DEBT ISN'T GOING TO GO AWAY As per the 2012 Congressional Budget Office report, our present arrangements will in the long run prompt a government obligation that would in the end achieve a 90% GDP by 2022, 109% by 2026, and 200% by 2037 (CBO 11). These appraisals depend on the suspicion that our present laws remain by and large unaltered and that our spending approaches which is the reason for the aggregation of spending deficiencies continue as before. The CBO spending gauges are additionally in light of conjectures of financial state, statistic patterns, and past experience. The other fascinating appraisal that the CBO detailed was that regardless of whether there were general changes in our present laws, they evaluate that the spending shortage would reach around 60% of GDP by 2020 which is just 10% lower than our present circumstance (CBO 7). http://www.heritage.org/~/media/pictures/reports/2011/01/wm3121_chart2.ashx?w=400&h=571&as=1 As demonstrated by the diagram over, our yearly deficiency through 2021 could never dip under $1 trillion dollars under current approaches. In spite of the fact that the primary driver of the spike in deficiency spending from 2008-2011 was predominantly because of the subsidence, the Congressional Budget Office doesn't trust the United States would recoup under momentum laws. The adjust spending change allows special case, which for this situation is the subsidence. In the event that the national adjust spending correction was set up then after 2011, the yearly shortfall would just go down in view of the radical spending changes in programs. It's truly evident that the cash we are acquiring is expanding to an ever increasing extent, however what will happen when it achieves that moment that we need to begin reimbursing these advances? The administration reading material gives us an extraordinary case of the end result for Greece when they couldn't pay off the entirety of their credits. The financing costs on Greek government went far up and by 2011, they needed to pay 25% to get a two-year advance from private segment (Sidlow 6). Contrasted with the United States, we are paying an insignificant 0.44% contrasted with the 25% Greece needed to pay. The closure brings about the Greek government close out of private acquiring and needed to rely upon other European nations. The Greece case and the CBO's appraisals are colossal future ramifications and inclination for immense changes in our strategies which I accept is the government adjusted spending alteration. CALIFORNIA BALANCED BUDGET AND FEDERAL BALANCED BUDGET Albeit most states in the United States have an adjusted spending alteration, the government does not and as a rule work with a shortfall. California has battled with the state shortfall as far back as the 2002 retreat. They were in a shortage of more than $20 billion out of 2003 and needed to drive intense slices to meet their financial plan (Gerston 104). In 2011, the state was in a $26 billion deficiency and Jerry Brown needed to take extraordinary measures and power more cuts in programs. This outlines to a certain something and that is they dealt with their issues with insignificant help. The present government under the Obama organization doesn't appear to take extreme measures to cut elected shortage. Rather, it appears the government is spending like never before. One case of inefficient spending that I found is the working of an unused $75.5 million air terminal and a $29 million harbor without any streets in Alaska in 2012 (Yahoo). It's extremely faulty for them to utilize boost cash for these tasks. The working of the unused airplane terminal and harbor is a pointer that not all government officials share a similar view. The ones that run the nation and the ones that run a state may have contradicting sees and that could raise distinctive needs. As indicated by the Government Accountability Office, the United States is on an unsustainable way in light of the accentuation on Medicare and Social Security spending (Wikipedia). President Obama is known for his accentuation on Medicare and that could be infectious to different government officials. What I am endeavoring to draw from this is if President Clinton, who had a surplus amid his organization, was as yet the president then I don't figure we would have an overspending issue. President Clinton assaulted the shortage by adjusting the financial plan through conventional monetary strategy and raising expenses (Wikipedia), while President Obama doesn't appear to be radically cutting spending or raising assessments. WHY THE NATIONAL DEBT IS ONLY GROWING The United States could never recoup from this shortfall except if they settle one issue and that is overspending. The income people in general produces is fine, with the goal that isn't the issue. The issue lies with the administration and the over the top spending. Congress has three alternatives concerning spending which are 1) they can cut it, 2)raise duty rates, or 3) pass it to the confined government. From my point of view, it appears as they did none of these and burned through cash that isn't planned which basically just adds more to the shortfall. http://www.heritage.org/~/media/pictures/reports/2011/01/wm3121_chart1_600.ashx?w=600&h=419&as=1 The chart above demonstrates the normal spending from 1960-2009 which is 20.3%. Notice how when spending increment, income likewise increment. Tragically, this isn't the situation for the circumstance we are in. We are presently sitting at an untouched high spending of 24.7% though our income is at a record-breaking low of 14.8% (The Heritage Foundation). The sensible move to be made in this circumstance is to diminish spending, which we clearly haven't. In the event that Congress is commanded to adjust the financial plan, it would figure out which programs are wasteful and would burn through cash all the more soundly. On the off chance that the adjusted spending alteration passes, I trust it would diminish overspending in light of the fact that it would require the president to submit to Congress an adjusted government spending plan every year. As per Steven Calabresi, an educator at Northwestern University and fellow benefactor of the Federalist Society, Congress ought to be unavoidably required to hold a vote with the president's anticipated spending plan in 3 months and with the president and Congress having an era of up to a half year to acknowledge a last spending plan (The American Spectator). On the off chance that they neglect to receive a last spending plan amid the allotted measure of time, all government spending with the exception of installments on the obligation ought to be solidified. Taking everything into account, on the off chance that we are to settle are national shortfall then we should begin concentrating on the national adjusted spending revision. The adjust spending correction will constrain the president to submit and an adjusted government spending plan every year with the president and Congress both concurring on the last spending plan. In general, this will diminish overspending which is the primary driver of our undeniably deficiency.>GET ANSWER