Bonny Doon Vineyards, a successful winery business based in Santa Cruz, California, has grown from selling 5,000 cases of wine a year in 1981 to 200,000 cases a year in 1999. To keep growing and be more profitable, the business must choose amongst three possible strategic directions. The first strategy is to start importing wines from Europe into the United States. The second alternative is branching into a retail outlet for unusual wines of great value, accompanied by a high level of service. Lastly, the business’ D.E.W.N could be expanded to include wines not made by the company itself but by other wineries that follow the same values and philosophy.…
The reporting party (RP) stated her 94 year old mother Connie Pineira DOB: 1/20/22 is a resident of the facility. Subsequently the resident in independent requires little or no assistance. The resident resides in her own room and uses a walker for mobility. According to the RP the resident is able to keep and self-administer her medications. Consequently the resident's medication Lorazepam (Ativan) is constantly being stolen. The RP disclosed the medication is prescribed for agitation and anxiety. On one occasion the medication went missing and the RP and 2 other friends searched the entire room and were unable to locate the medication. Walking into the front office the RP informed the administrator she was going to contact the local Police…
B) was brought into the emergency room for pain to left leg and left hip. The injury occurred when the patient had a fall due to him losing his balance after tripping over his dog. The hospital is a 60 bed rural hospital located in Mr. B’s hometown. Mr. B was brought in by his son and neighbor. Upon triage Mr. B was complaining of pain 10/10 on the numerical pain scale and his vitals were found to be stable. Mr. B has a history of impaired glucose tolerance, prostate cancer, and chronic pain which he is on oxycodone. The Patient states he had no known allergies or previous falls. Upon the nursing assessment Nurse J. has noticed that the patient has limited range in motion, his left leg has swelling and appears shortened in comparison to the right. Nurse J. has informed the ED physician which he came to his bedside for…
During a regular board meeting on December 14, 2015 the Lake County School District #7 board of directors unanimously voted to name Will Cahill, the current interim superintendent, as the permanent superintendent for the district.…
Detailed description of event including timeline: Thursday 3:30 pm Mr. B a 67 year old patient was admitted to the ER after a tripping and falling over his dog at his home by nurse J. He was complaining of 10/10 pain to his left leg and hip region but appears to be in only moderate distress. Mr. B’s vital signs were stable at time of admit with a blood pressure of 120/80, heart rate of 88 and increased respirations of 32. Left leg is shortened, swollen in the calf, bruising present and limited range of motion to left leg. Dr. T looked over data and ordered Mr. B to have medications for pain control and sedation in order to perform a manual manipulation in realigning Mr. B’s dislocated hip. 4:05 nurse J administered IV Diazepam per Dr. T’s orders. With no affect Dr. T. orders Nurse J to give 2mg IVP Dilaudid at 4:15. 4:20 Dr. T. orders nurse J to give 2mg IVP Dilaudid for muscular skeletal relaxation. Dr. T. notes that per patient’s weight and regular usage of Oxycodone, it was making it more difficult to achieve the level of sedation required for manual manipulation. 4:25 Mr. B appears sedated and comfortable and procedure of manual manipulating the dislocated hip back in place goes successfully and concludes at 4:30 with the patient resting and no signs of distress. Nurse J. places Mr. B on an automatic blood pressure machine and oxygen saturation to go off every five minutes and leaves to take care of another patient, with Mr. B’s son at the bedside. 4:35 Mr. B’s blood pressure is 110/62 and saturation of 92% on room air. The LPN hears a “low saturation O2” alarm and notes Mr. B’s saturation is 85% room air and repeats the blood pressure setting and resets the alarm. 4:43…
The client is a 70 year old, Caucasian male who is a retired siding salesman from Riverside, IA, who has an extensive history with Paralysis agitans (Parkinson’s disease). The client was first admitted to the long term care facility in December 2012. The client explained that he came to be at this facility after “already being in two places like this”. He was removed/discharged from the last long-term care facility for being what he called “disruptive”. The client described the staff at the last facility as not very kind to the residents. There was an incident where the drugs that were prescribed to the client made him hallucinate and he became unruly with the staff and was restrained and…
Recently, an interesting case of murder involving a young married woman was unravelled by the crime scene team. The collection of evidence and laboratory examination of exhibits provided the corroborative evidence necessary to prove the victim’s in-laws were trying to mislead the Investigating Officer by fabricating a story of looting and murder…
Admitted to the medical-surgical unit with a chief complaint of “breathing problems”. She speaks broken English & requests that her daughter be allowed to stay with her. She is on nasal cannula oxygen & sitting up in bed. At this time, she seems slightly short of breath, but is not in acute distress. You note that she is pale & has a petite frame. Her ankles are swollen. Her daughter tells you that she has been complaining of feeling more tired in the evenings & “unable to catch her breath”. While at home, she has been sitting up either in an easy chair or in bed with three pillows. Her daughter states that Mrs. Lee has not had to urinate as much in the last 2 days, but she gets up twice each night to use the bathroom.…
In this scenario the patient is a 72 year old retired rabbi with mild dementia who is admitted to the hospital for a broken right hip due to a fall at home and is receiving pain medication. After a week of being admitted the patients daughter visits her father and finds him restrained. She also notices a red depressed area over her fathers’ lower back when her father is being assisted to the bathroom and was later informed by the dietary worker about her father receiving a pork cutlet on his dinner tray. The daughter was upset with the care being provided and complained to the physician.…
History of Chief Complaint: Ms. K has reported having mood swings at an early age. She has attempted suicide at the age of 14 by ingesting codeine pills. The day after the incidence she would be back to a stable state. Parents sent her to boarding school since they were moving around very often, after attending 11 different schools in 12 years. After school, she moved to different places to pursue her acting career. During this time, the patient got married for her first time and shortly after had her daughter and was divorced. She stayed at home taking care of her daughter for three years before she went back to acting. She was then married and divorced two more times that both also only lasted less than one year. The patient was then in a severe car accident that left her out of work causing financial problems and eventually bankruptcy. During the time she was not working from her injury, she worked on her autobiography for three years. When she would write her autobiography, she would sometimes write for 10 to 12 hours at a time while chain smoking, drinking excessive amounts of coffee, and barely eating or sleeping. The patient then reported getting a virus of some sort on her computer that deleted all of her work that she has done on her book. She reported being paranoid believing that her ex-husband had connections with the government that put the virus on her computer, and believing that he wanted to kill her. The patient began taking prescription pills and drinking when she was having these episodes. She was reported missing for four days after filing bankruptcy and selling…
Mrs B is 76 years old and has been a widow for 8 years, she has four children and 5 grandchildren who visit her most days, she also has a small dog. Mrs B told me she was a waitress and continued to work up until she took retirement. Before being admitted into hospital she was very much an independent, active lady, she likes going for walks with her dog three times daily, and also likes to going shopping. Mrs B was putting rubbish into her outside bin but lost her footing, tripped and fell, this caused her to have severe pain and her neighbour called for an ambulance. She was admitted into accident and emergency at hospital where they done xrays of her head and body and found out that she had broken her hip, she underwent a hip replacement operation. Mrs B was admitted to the orthopaedic ward and is now mobilising with a zimmer frame and assistance of one nurse on the recommendation from the physiotherapists, it is important that all members of the multi-disciplinary team work together in harmony to promote a better quality of life for the patient.…
This article was about a case implicates the Georgia Regional Hospital, Atlanta. In January of 2009, a patient, Na Young, this patient has a history of psychotic episodes. This patient was released form the psychiatric hospital. On a Friday evening in January at the Regional Hospital in Atlanta, Na Yong, refused to sign the release paper. The patient go valance with the nurse and told her that she will now longer take the antipsychotic medication. The patient family pleaded the doctors and nurses to reconsider discharging her from the hospital. The patient prior to been admitted into the hospital had physically abused her mother on several occasion. Na Yong told physician and nurses that if she were discharge from the hospital she would kill her mother, which was the target of her schizophrenia-fueled rage. The hospital staff still…
On Thursday September 14th at around 12:30 pm the hospital had a sentinel event which involved a missing child. The event details are as follows: Tina was scheduled for same day surgery and was brought to the hospital by her Mother. Her Mother was informed that the surgery would take approximately 45 minutes and that Tina would be in recovery at least 1 hour. Tina’s Mother informed the pre-op nurse that she had an errand to run involving Tina’s older sibling. Tina’s mother left the pre-op nurse her cell phone number with instructions to call her if Tina got out of surgery and was ready to go before she returned. Prior to Tina’s mother returning Tina’s father showed up to check on her, and finding that she was ready to go he took her to his house until the mother could pick her up. When Tina’s mother returned 2 ½ hours later she found Tina missing and the staff did not know that her father took her. The hospital activated a Code Pink and notified the local police department. When the hospital security interview the mother they learned the parents were divorced and that she had full custody of Tina and her other siblings. The local police found Tina at her father’s home within 30 minutes of Tina’s mother returning to the hospital. No charges were filed against the father.…
I was on my third day of residential care placement; the staff had just started to take turns for their morning tea break so I took the time to catch up on my case study patient’s medical history in the nurses’ station. Within a few minutes the Manager of the rest home ran in to gather the blood pressure machine and bandages. She informed another student nurse and myself to “take these to Max’s (pseudonym) room NOW, while I call an ambulance”.…
the shift before did things that jeopardized my life. First she failed to give me report that this patient…