Analyzing an Aspect of Nursing Care Based on a Provided Profile of a Essay

Analyzing an Aspect of Nursing Care Based on a Provided Profile of a Patient - Essay Example Although, the patient has multiple system involvement, given the recent history of myocardial infarction and resulting LVF, heart failure is likely to be the leading cause of hospital readmission in this case. LVF, when coexisting with COPD, makes pharmacological treatment challenging (Padeletti, Jelic and LeJemtel, 2008). This disease is likely to impact and overshadow the management and prognosis of all other associated conditions. Limitation of functional capacity due to LVF is a serious hindrance for the patient to seek treatment for other associated conditions and participate in a rehabilitation program for stroke, peripheral vascular disease and COPD. Acute decompensation of LVF can occur because of treatment non-compliance, infection or poor nutritional status and can be fatal. Thus, nurses play an important role in preventing acute decompensation and rehospitalisation. Heart failure patients generally have a poor prognosis and a reduced quality of life (Gould, 2002). However, because of advances in treatment and dedicated heart failure programs, the prognosis of the condition has improved with the 6 month mortality rate declining from 26% in 1995 to 14% in 2005(Mehta, et al., 2009). Concurrently, hospitalization rates are increasing. An elderly patient with multiple comorbidities, multiple medications and reduced quality of life is the typical profile of a patient with heart failure. In this patient, MI, LVF, COPD, peripheral vascular disease as well as duodenal ulcer have common risk factors of age, smoking and atherosclerosis. Pathophysiology of left ventricular failure Left ventricular failure may be defined as the inability of left side of the heart to pump enough blood to meet the metabolic needs of the body. Coronary artery disease leading to myocardial infarction is the most common cause of left sided heart failure (NICE, 2010, Gould 2002). MI impairs myocardial contraction and hence, reduces its efficiency to pump blood. Severity of the infarcti on is proportional to the severity of LVF. Other common causes of left ventricular failure include hypertension, cardiomyopathy and valvular heart disease. Positive history of smoking, peripheral vascular disease and age, point towards atherosclerosis and resulting MI as the cause of LVF in this patient. COPD also causes heart failure which is mainly right sided. However, it can also precipitate LVF (Paudel, et al., 2008). LVF, in turn, can cause right heart failure by increasing pulmonary vascular resistance (pulmonary hypertension). Signs and symptoms As the ability of the left ventricle to pump blood in the forward direction is impaired, symptoms result from pulmonary vascular congestion and inadequate cardiac output. Pulmonary congestion affects gas exchange in the alveoli and causes dyspnea, orthopnoea, cough, dizziness, confusion, syncope, fatigue, and decreased functional capacity and exercise tolerance (Buckler, 2009). New York Heart Association (NYHA) grading is a useful to ol for grading the severity of LVF that should be used. Physical examination reveals tachypnea, gallop rhythm and features of pulmonary oedema, such as crepitations over lung fields, predominantly at the base. Respiratory distress and production of pink frothy sputum is present in decompensated cases,

Ombine the processes of consultancy and project management with people Essay

Ombine the processes of consultancy and project management with people management - Essay Example In order to understand the financial as well as human resource aspects, work breakdown structure will be drawn and budget will be analyzed for the overall project. Time constraint is the most important factor for the success of the project. Failure to deliver the project in time may have an adverse affect on the expected benefit of the project. Hence, the project has taken into consideration the time schedule and network diagram has been developed so as to analyze it. It is also important to determine the risk of the project as risk management is the significant consideration of the project. Therefore, the project will also throw light onto the risk that is associated with the project. Emperor Capital Group Limited was established in the year 1993 and is a Hong Kong based investment holding company. It has been providing various ranges of financial services to the customers. It has been facilitating the brokerage services for various products like securities, future, options, bonds that are traded on the exchanges in Hong Kong, Japan and in the US (Emperor Group, 2010). The company also provides Margin and IPO financing, as well as it has been pioneer in providing loans and other related services to its clients. It is to be noted that the brokerage business of the company has been running since last 12 years along with stable business development. In the year 1994, headquarter was moved to a newly made Emperor Group Center that was located in Wanchai, Hong Kong. Emperor Futures Limited was also established in the same year that provided investors the financial services like securities and future trading. The year 2007 was marked as the most remarkable year as Emperor Capital Group Limited got listed on the main board under the stock exchanges of Hong Kong (Corporate Information, 2010). The company maintains corporate governance and is also committed for effective accountability mechanism in every part of