Pathophysiology template Complete a pathophysiology template for an ischaemic stroke that affects the dominant left cerebral hemisphere

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3.3 Assessment details

Assessment 1: Case Study

Weighting: 40% Word count: 1250 words Due date: Friday 30th August, 2013 at 5pm Submission details: Refer to Submission Requirements (p.16) Marking
criteria and standards: See pages 12 – 14. Aim of assessment The purpose of this assessment is for the student, by analysing information from a case study,
demonstrate knowledge of the pathophysiological processes involved in health breakdown affecting alterations in work/leisure specifically resulting from a
stroke. The student will also discuss pharmacological concepts related to the case study. Details Review the case study: Mr Black (detailed below) Complete
the pathophysiological template (Part 1) for an ischaemic stroke that has affected the left dominant cerebral hemisphere and answer three questions. To
complete the template you must summarise the relevant information for each component. This summary may consist of a combination of sentences, flow diagrams
and dot points where relevant. The information in the template must be accurately referenced using the APA referencing style.

Part 2. Three questions are to be answered using correct sentence structure, paragraphs, grammar and spelling. Your answers must be accurately referenced
using the APA referencing style

Length: Pathophysiology template 400 words Answers to questions 850 words Date due: Friday 30th August, 2013 at 5pm

CASE STUDY Mr Black, a 61 year old businessman was watching the 7pm television news when he developed sudden onset of difficulty in speaking and drooping
of the right side of his mouth. He was not able to lift his right arm or stand up. His wife immediately called the ambulance. The paramedics, using the
FAST protocol assessed Mr Black as having had a stroke and transported him to a hospital with an acute stroke thrombolysis centre. He was admitted to the
Emergency Department at 8pm.

History obtained from wife. Mr Black was diagnosed with hypertension 10 years ago for which he takes Metopropol daily. He smokes about one packet of
cigarettes/day and drinks alcohol socially. There is no history of serious illnesses or allergies. His father died of a heart attack at the age of 60.

400815 ? Alterations in Breathing, Work/Leisure and Mobility Learning Guide ? Spring 2013

?School of Nursing and Midwifery Page 10 of 22 University of Western Sydney

Vital signs BP 150/80 mmHg Pulse 90bpm and regular Respirations 20 breaths/minute Temperature 36.5? C SaO2 95%

Neurological examination Pupils equal – 2mm and reactive to light Right facial droop Paralysis of right arm and weakness of the right leg Normal strength
in the left arm and leg Decreased sensation on right side of the body Right knee and ankle reflexes moderately brisk compared with those on the left
Plantar response is extensor on the right and flexor on the left Difficulty with speech ? repeats yes to all questions

Laboratory tests Full blood count ? all values within normal range Blood glucose level ? 6.5 mmol/L Electrolytes, urea and creatinine ? all values within
normal range ECG ? normal sinus rhythm

CT brain scan (2hours from symptom onset) No intracranial haemorrhage or mass lesions. Suggestion of early ischaemic changes in left hemisphere.

Diagnosis Mr Black is diagnosed with a left middle cerebral artery distribution stroke. He is assessed as being eligible for thrombolytic therapy.

Management IV Alteplase (8.1mL bolus over minute; 72.9 mL added to 50mL sodium chloride infused over 60 minutes via a volumetric control pump). Continue
antihypertensive medication 24 hours after completion of alteplase follow-up CT brain scan ? if bleeding excluded commence Assasantin? SR capsule twice a
day.

400815 ? Alterations in Breathing, Work/Leisure and Mobility Learning Guide ? Spring 2013

?School of Nursing and Midwifery Page 11 of 22 University of Western Sydney

PART 1 ? Pathophysiology template Complete a pathophysiology template for an ischaemic stroke that affects the dominant left cerebral hemisphere (400
words).

PART 2- Questions related to the case study Question 1 (450 words) Explain the pathogenesis that leads to the structural and functional changes resulting
from Mr Black?s stroke. Question 2 (150 words) Explain how two of Mr Black?s clinical manifestations are related to the structural and functional changes
caused by the stroke. Question 3 (250 words) Relating your discussion to the pathogenesis of Mr Black?s condition, explain the mode of action of Alteplase
and Assasantin?. Resources ? Examples may be available on the vUWS site. ? There are a number of textbooks and resources available through the UWS Library
that may assist you.

Biology and Crime

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Crime and Delinquency
Biology and Crime
There is a long tradition in criminology that there are biological roots to criminal behavior. The major issue revolves around how much of an influence biology has on crime compared to other known social factors. This issue has been revisited recently with advances in our understanding of the brain and brain chemistry. This is a politically charged issues, often related to questions of racism and gender bias.
Early Ideas:1860-1970
The book presents excellent reviews of the work of the early leaders of this field:
Lombroso
Dugdale
Goring
Lange
Hooton
Sheldon
Crime Control and Drug Therapy
The use of lobotomies as a means of making the criminally violent docile has been in decline for decades.
Since crime is so often related to psychological or emotional injuries, for example, Post-Traumatic Stress Disorder or mental illness, control of these conditions with drugs has some crime reduction effects.
Crime and Social Structure
Recall that social structure refers to all the norms, roles, statuses, institutions and values of a society.
All these factors influence crime in one way or another.
Generally speaking, research on crime and social structure centers on the criminogenic effect of economy and other social institutions, such as the neighborhood or family.
Delinquency and Juvenile Justice
Delinquency
Delinquency is a status imposed by a state juvenile court in cases where a person below a specified age, generally 16, is responsible for a criminal act.
The legal tradition of holding youth to a lower standard of criminal culpability dates back to Roman law, and has been a part of American law since 1900.
The Juvenile Court
Juvenile Court
The first juvenile courts in the US were created around 1900. The book presents a very good history of this movement and its proponents.
The contemporary juvenile court is widely viewed as dysfunctional for a wide variety of reasons.

How does the financial planning and strategic planning of the new for-profit status align with the financial and strategic plans of the existing community hospital status?

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3 to 5 pages  in APA style references and citations

Established in 1987, ABC Community Hospital not-for-profit is an acute care hospital located in an east coast Metropolitan area. With a staff of nearly 200 physicians and specialists, 800 employees and 100 volunteers, they offer a full range of healthcare services. They are accredited by the Joint Commission. The hospital has been profitable for the last 5 years with a profit margin of 3-4%.

In March 2012, XYZ Healthcare System, a private, for-profit health care chain, took over management of the 400-bed ABC Community Hospital. In May 2013, officials began to discuss a proposal to build a new wing devoted to a Cancer Center and ancillary services devoted to the treatment of Cancer.  The new wing would have 30 acute care beds, four surgical operating rooms, intensive care unit and extensive support services, including physical therapy and Hospice care. All patient rooms would be private. There are no Cancer Centers within a 200 mile radius of the hospital service area.The Board of directors is concerned with taking on the additional debt of the Cancer Center. They have tasked the CFO with developing a financial plan and strategic plan that will outline the impact of the Cancer Center. They want you to address the following areas:

  • What are the key financial policy targets for which the board is responsible for? List and explain each.
  • How does the financial planning and strategic planning of the new for-profit status align with the financial and strategic plans of the existing community hospital status?
  • Explain how management control is used in conjunction with the financial plan. With the takeover, would the ABC Community Hospital CFO need to consult with XYZ Healthcare System executives for the decision making?
  • A financial plan may be thought of as a bridge between two balance sheets. What are the major categories of assumptions that must be specified to project a future balance sheet, given the current balance sheets from the ABC Community Hospital and now XYZ Healthcare System?

Determine this disturbance’s “Effect on the Environment”, and re-run the rest of the model to see how your output could likely be affected.

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Determine this disturbance’s “Effect on the Environment”, and re-run the rest of the model to see how your output could likely be affected.

  • Next, instead of using a Goal as a “Reference Value”, now substitute this “Threat: you have determined that to avoid any contact with a car, it is best to cross a street when vehicles are at least 100 feet away from you. “ What would be the result of the comparator function? What would be a possible output?
  • Hints to Guide Your Reading
  • Questions for Reflection:
  • What kind of affect occurs when a goal is going well? What type of behavior is likely produced?
  • What kind of emotion occurs when a goal is going poorly? What type of behavior is likely produced?
  • What kind of affect occurs when a threat is going well (is being avoided)? What type of behavior is likely produced?
  • What kind of affect occurs when a threat is going poorly (you are getting closer to the threat value)? What type of behavior is likely produced?
  • In which type of behavior feedback loop are you trying to produce an output that moves you closer to the ideal?
  • In which behavior feedback loop are you trying to produce an output that moves you away from the ideal?
  • How do these cybernetic models indicate when you could or should shift from one reference situation to another. For example, how do you know, according to these models, when to shift from the reference of “spending time with my significant other” to the reference of “earning a 90% on my chemistry exam”?
  • Discussion Group Case Study
  • The goal of this case study is to get you to consider why or how failures in self regulation could occur.
  • Janie, a person with an avoidant temperament approaches you, a clinical psychologist, and indicates that she is having an anxiety problem. Specifically, she suffers from “generalized anxiety” which means that she is chronically anxious and really doesn’t know why. In other words, nothing in her environment triggers anxiety, per se, she just feels anxious all the time.
  • Why should this make sense to you, knowing that she has an avoidant, rather than an approach temperament?
  • You decide to use a cognitive therapy strategy to assist her in alleviating her anxiety. In preparation for your first counseling session, you create a cybernetic behavioral and affective feedback loop that would indicate how an anxiety disorder would occur (NOTE: the KIND of behavior feedback loop you use is critical to understanding this task)
  • So, pick you behavior loop. Next indicate how a malfunction in the components would likely create chronic anxiety that would lead to her anxiety disorder. Look at each component, consider how it should function for a person to have a normal affective life, and then consider how that specific component could work improperly, thereby causing an erroneous affective output.
  • After identifying all of the possible malfunctions, focus in on one and formulate a strategy to help her regain adaptive self regulation that would decrease her anxiety disorder.
  • Discuss your thoughts with your group, then post your collective feedback loop and explanation of the malfunction within the class discussion.