Case Review

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Review Case 4: Costco Wholesale in 2016: Mission, Business Model, and Strategy Case Study in your textbook and the following videos: Jim Cramer Discusses Why Costco Is King & Nightly Business Report: Costco strikes a new deal

Answer the following in APA Format 4-5 Pages ( Must include abstract)

Answer the following:

1. What is Costcos business model? Is the companys business model appealing? Why or why not?

2. What are the chief elements of Costcos strategy? How good is the strategy?

3. Do you think Jim Sinegal was an effective CEO? What grades would you give him in leading the process of crafting and executing Costcos strategy? What support can you offer for these grades? How well is Craig Jelinek performing as Sinegals successor? Refer to Figure 2.1 in Chapter 2 in developing your answers.

4. What core values or business principles did Jim Sinegal stress at Costco?

5. (In the event you have covered Chapter 3) What is competition like in the North American wholesale club industry? Which of the five competitive forces is strongest and why? Use the information in Figures 3.4, 3.5, 3.6, 3.7, and 3.8 (and the related discussions in Chapter 3) to do a complete five-forces analysis of

competition in the North American wholesale club industry.

6. How well is Costco performing from a financial perspective? Do some number-crunching using the data in case Exhibit 1 to support your answer. Use the financial ratios presented in Table 4.1 of Chapter 4 (pages 66-68) to help you diagnose Costcos financial performance.

7. Based on the data in case Exhibits 1 and 4, is Costcos financial performance superior to that at Sams Club and BJs Wholesale?

8. Does the data in case Exhibit 2 indicate that Costcos expansion outside the U.S. is financially successful?

Why or why not?

9. How well is Costco performing from a strategic perspective? Does Costco enjoy a competitive advantage over Sams Club? Over BJs Wholesale? If so, what is the nature of its competitive advantage? Does Costco

have a winning strategy? Why or why not?

10. Are Costcos prices too low? Why or why not?

11. What do you think of Costcos compensation practices? Does it surprise you that Costco employees apparently are rather well-compensated?

12. What recommendations would you make to Costco top management regarding how best to sustain the companys growth and improve its financial performance?

Part 2:

Using the financial ratios provided in Table 4.1 and the financial statement information presented below for Costco Wholesale Corporation.

Calculate the following ratios for Costco for both 2013 and 2014:

a. Gross profit margin
b. Operating profit margin
c. Net profit margin.
d. Times interest earned coverage
e. Return on shareholders equity
f. Return on assets
g. Debt-to-equity ratio
h. Days of inventory
i. Inventory turnover ratio
j. Average collection period

Urinary Obstruction Case Studies

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1. Does BPH predispose this patient to cancer? 

2. Why are patients with BPH at increased risk for urinary tract infections?

 3. What would you expect the patients PSA level to be after surgery? 

4. What is the recommended screening guidelines and treatment for BPH?

 5. What are some alternative treatments / natural homeopathic options for treatment?  

Discussion Peer Replay, APA 6, Similarities Less 5%, At Least 2 Evidenced-Based, References No Older Than 5 Years

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Polypharmacy is a common issue that NPs and any prescriber should keep in mind. That is because a common risk factor for polypharmacy is elderly patients. After living for many years, it is common to have multiple comorbidities. Multiple comorbidities represent different treatment which most of the time includes 6 to 7 pills taken daily. Another risk factor for this includes obesity. Obesity rates continue to rise in the US and with that many other diseases. Obese patients usually suffer from cardiovascular, respiratory, gastrointestinal, and neurological problems at the same time (Ersoy & Engin, 2018). All of these combined also lead to them needing multiple drugs to be taken as treatment daily.

            As an NP, it is our duty to make sure we look out for the safety of the public specially when it comes to polypharmacy. One intervention we can apply in our plan of care for patients at risk of polypharmacy is providing education in regard to the side effects and information regarding the drug. Another intervention we can apply is finding medications that can be taken once a day and recommending using a pill dispenser (Dagli & Sharma, 2014). Another intervention that could be applied is eliminating one of the multiple drugs if possible or if the medication is unnecessary. Polypharmacy is an issue for many of our patients thats why it is our job to manage it and prevent adverse effects from it.

References

Dagli, R. J., & Sharma, A. (2014). Polypharmacy: a global risk factor for elderly people. Journal of international oral health : JIOH, 6(6), iii.

Ersoy, S., & Engin, V. S. (2018). Risk factors for polypharmacy in older adults in a primary care setting: a cross-sectional study. Clinical interventions in aging, 13, 20032011. doi:10.2147/CIA.S176329

Discussion Peer replay, APA 6, similarities less 5%, at least 2 evidenced-based, references no older than 5 yearsg

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DQ1

Aging comes in with multiple health conditions such as obesity, diabetes, heart diseases, and arthritis conditions. Compared to the younger population, elderly people are more likely to suffer from multiple diseases. Polypharmacy is a sector of concerning for specifically elder people compared to the younger population (Salvi, Rossi, Lattanzio, & Cherubini, 2017). Elderly population is at the highest risk of adverse drug reaction as a result of metabolic changes as well as reduced drug clearance related to the ageing. Additionally, the risk factor accelerated with the increasing number of drug being used. The potentiality of drug to drug interaction is further increased by application of varied or multiple drugs.

An intervention is use of non-pharmacological interventions including non-modification strategies. Therapeutic activities including art, music, pets and aromatherapy which helps in reducing the demand for psychoactive medication so as to modify behavioral episodes. Old age comes with a lot of chronic condition whereby some could be managed minus medication.

Polypharmacy is associated with incidence of frailty over the eight years follow up period. Frailty is referred to as the state of increased vulnerability to the stressor resulting from decrease in the physiological reserves in the multiple organ system leading to the limited capacity to maintain to manage or maintain homeostasis (Lim et al. 2017). Those people who are using multiple drugs happen to be less health compared these taking fewer drugs. Individual who takes multiple drugs have double incidents of frailty. Moreover, frailty is linked to the polypharmacy because it contribute to development of frailty as a result of negative influence on the factors related to frailty including commodities or weight loss.

The intervention is to identify the indicator for every medication. All the medication should include indication or diagnosis for which the drug has been prescribed. This practice will encourage safe prescribing. Deprescribing is also important as the risk versus the benefit of medication or the drugs is examined to reduce the chances of polypharmacy complications (Lim et al. 2017).

References

Lim, L. M., McStea, M., Chung, W. W., Azmi, N. N., Aziz, S. A. A., Alwi, S., … & Rajasuriar, R. (2017). Prevalence, risk factors g health outcomes associated with polypharmacy among urban community-dwelling older adults in multi-ethnic Malaysia. PLoS One, 12(3).

Salvi, F., Rossi, L., Lattanzio, F., & Cherubini, A. (2017). Is polypharmacy an independent risk factor for adverse outcomes after an emergency department visit?. Internal and emergency medicine, 12(2), 213-220.