Description
“Attachment hace explanation to all the questions “
In one page or more answer the questions included with the Discussion.
Module One Discussion
Mr. J.: Shifting from Treatment to Palliative Care
Mr. J. has been a patient in the medical intensive care unit (MICU) for the past 4 days. He is an 86 year- old male with a two-year history of dementia and newly diagnosed small cell lung cancer, with metastasis to the femur. When he came into the emergency department with shortness of breath, his respiratory status became so compromised that he required intubation and was admitted to the MICU. Although he is no longer on the ventilator, he has become increasingly confused and agitated. His non-verbal behaviors suggest he is in pain. His daughter, who is the power of attorney for health care, has requested that the goals of care shift from a plan for chemotherapy, to keeping him comfortable. The nursing staff and clinical nurse specialist in the MICU are suggesting Mr. J. be transferred to the Palliative Care Unit in the hospital.
Questions:
- What are the benefits of a transfer to the palliative care unit for this patient and his daughter?
- What are the potential barriers that may interfere with the palliative care referral for this patient?
- What strategies might be helpful to overcome those barriers?
- When is the appropriate time to introduce the concept of hospice care? How can the team explain this type of care to Ms. T.?
- Assess aspects of the quality of life (QOL) using the model of physical, psychological, social and spiritual well-being.
- What members of the interdisciplinary team might be most helpful to contact? Why?
Sample Solution
What was the European Sovereign Debt Crisis? So as to have the option to completely investigate the reasons for European Sovereign Debt Crisis its essential to comprehend what the Crisis is. The beginning of the European sovereign obligation emergency started in Greece where a higher hazard premium was alloted to the Eurozone area. By late 2009 the PIIGS nations (Greece, Spain, Ireland, Portugal and Cyprus) has conceded that their obligation was at a level where they couldn’t reimburse or renegotiate their obligation. In 2010 the International Monetary Fund and pioneers of the Eurozone consented to give a â¬750 billion salvage bundle to spare these nations from insolvency, the sum was likewise later reexamined to â¬1 trillion. Driving from this intra-eurozone capital streams at that point fell pointedly, coming about because of a solid fixing of money related conditions because of the emergency. During this emergency a significant number of these nations had their sovereign obligation brought down to garbage status by worldwide credit offices, which further intensified the circumstance. Greece’s degree of obligation being at right around multiple times the level which is ordered by the EU. With obligation levels expected to be topped at 60% Greece’s level was at 113%. Greece and the other PIIGS’s nations obligation were at a level where they required help from an outsider, for example, the (ECB) European Central Bank. In a report it was built up that the towards the finish of 2009 after a Greek difference in government coming about with new government giving a bogus spending deficiency. Which was against EU strategy set in the Maastricht settlement. Toward the start of 2010 Greece has plans to bring down its spending’s deficiency to 3% anyway later in the year Greece let the EU realize that their obligation was at such a level, that they may default. This was a consequence of reckless monetary strategies, and different components. Source: Macrobond, IMF The EU acknowledged to give a crisis bailout bundle as an end-result of Greece actualizing severity measures to manage its degree of obligation which was so crazy. The EU settled on the choice to remain behind its part and help Greece with a bailout bundle, as not rescuing would have genuine expenses to the EU all in all. The subsequent somberness estimates expected Greece to cut consumption diminishing the expenses of government community workers. Additionally managing an enormous issue in Greece which is tax avoidance. Coming about because of this a free expense authority was started to help diminish tax avoidance. “In May 2010 a â¬110 billion gave by euro region Member States and the International Monetary Fund (IMF).” (Powerpoint) These measures additionally expected Greece to auction a huge extent of its state-claimed helps, which was planned to decrease the intensity of associations and gatherings. One of the primary purposes behind Greece’s end was that the regulatory productivity inside Greece was incredibly low. Greece is viewed as a “poor understudy” in the euro zone economy, having a moderately feeble monetary base with a large portion of the populace having low expectations for everyday comforts. Joined with a the very dependence on the travel industry and assembling which was incredibly affected by the Great downturn, Greece’s economy was not fit as a fiddle going into the emergency. For the second PIIG’S nation Ireland. Irelands economy in 2007 had gotten profoundly subject to development and lodging which they utilized as the essential wellspring of monetary development. This was supported by the outside acquiring of Irish Banks as overall loaning rates at the time where generally low. Anyway late 2007 the Irish property bubble began to blast which lead to a decrease in property costs crosswise over Ireland, and lead to a stagnation in property improvement the nation over. This at that point had a move through impact causing huge misfortunes in property advancement and a nation wide breakdown in development action. This causes enormous stain on the nations Irish financial framework, and a gigantic draw again from household property speculator. These banks were regarded too huge to come up short, anyway in 2008 the first of the enormous banks petitioned for section 11 liquidation security. This prompted an arrangement which the Irish government set up to ensure the remainder of the staying national banks. Giving continued liquidity with the goal that more liquidations wouldn’t happen. Matters keeps on compounding and in 2010 the Irish government mentioned help from the EU to abstain from defaulting on its obligation. Spain was a comparative case to Ireland, with a substantial dependence in the property and development industry. The property business expanded exponentially to the point where property turned into the residents favored goal for investment funds. With the Spanish government weighted tax breaks for property which further expanded its venture prevalence. Property estimations kept on expanding, with individuals anticipated that qualities should keep on ascending, without backing off. Essentially, on account of Ireland. One of the key advantages for Spain joining the European Union, was the decrease of loan costs. This significantly expanded to accessibility and access to low financing cost credit. Which prompted a huge scale diverting of capital into the land part. Driving from this the development division turned into an enormous piece of the nations GDP. With it representing 13.3% of the nation’s absolute work. This blast didn’t last anyway prodding from the US monetary emergency, in 2008 the property bubble started to blast. Initially, sparing banks started to fall inside the nation, when markets started to crash. Chapter 11 and awful obligations began to winding out on control. Speculator certainty started to therapist, and government bailouts kept an enormous extent of banks from chapter 11. With the Spanish economy starting to give indications of disappointment, and Bankia which was the fourth biggest bank in Spain falling flat for liquidation. With a large number of the nation’s financial specialists just getting away liquidation through renegotiating there advances ordinarily. From this the pace of economy in Spain start to stagnate in 2008 and began to contract in 2009 and 2010. Once more, to a great extent because of the stockpile of liquidity evaporating globally. Which lead to a breakdown in the Property and development division. This thus at that point lead to wide scale joblessness and putting strain on the nations social security framework. This made the nations obligations get to a level wherein they were fleeing. Which at that point thus required the Spanish government requesting that the EU offer help as the nation’s obligations where at a level where the Spain could make its advantage reimbursements on its open obligation. So also, to other PIIG’S nations the main up to the European sovereign obligation emergency, Italy was at that point generously intensely obligated. To a level where the measure of government obligation surpassed the nations GDP. Which was additionally well over the 60% degree of obligation commanded by the Maastricht settlement. The administration esteemed that this was not an issue for the nation. As the administration had the option to constantly ready to renegotiate this obligation, up until 2010. With the disappointment of the US advertises, this systemically affected the Italian budgetary foundations. This caused a wide scale absence of liquidity, beginning with banks declining to take an interest in between bank loaning because of the absence of money related sufficiency. Prompting a more noteworthy constriction of liquidity. This brought about a droop in the economy’s development because of a bringing down in open utilization and speculation. Fares in the nation at that point started to decay with areas, for example, transport and assembling falling by as much as 35%. Italy’s pace of development during the emergency. Year GDP pace of development 2000 5.00% 2001 3.60% 2002 2.70% 2003 3.10% 2004 3.30% 2005 3.60% 2006 4.00% 2007 3.60% 2008 0.90% 2009 – 3.70% 2010 – 0.10% 2011 0.70% Source: Eurostat After a difference in government, Mario Monti Italy’s new executive actualized severe gravity measures. This included decreasing government organization use, raising the retirement age and lessening the degree of tax avoidance. This demonstrated compelling and in view of these measures the financial framework inside Italy just required a little bailout bundle contrasted with other EU nations. During a pressure test led by the ECB in 2011 it indicated that “⦠the Italian financial framework appears to have low introduction to government obligation; it holds under 10% of household open obligation â against over 40% on account of Spanish banks â just as low presentation to remote sovereign hazard, which speaks to just 23% of the all out government obligation Italian banks hold” (Bolton P, Jeanne O (2011)) The primary driver for Italy being affected by the European sovereign obligation emergency was there overwhelming dependence on open obligation. This turned into a huge issue for the nation in when the monetary atmosphere for the European area started to intensify in 2009. For the remainder of the PIIGS nations Portugal’s hardship began appearing in 2008 when the development of the nation’s economy eased back to a point where it indicated no development. Proceeding to fall in 2009 to a point where it contracted by 3%. During this time the Portuguese government battled to manage a quickly developing spending shortage, ascending from 2.6% to just shy of 10% in 2009. Looking further into this one of the enormous elements that principle Portugal powerless during the financial downturn was that the nations business has a solid spotlight on creating low worth products, for example, apparel. Indeed, even before the monetary emergency this industry was battling to manage developing challenge from nations, for example, the Philippines and China. Generation proficiency didn’t develop inside the area and the business was quickly losing its upper hand. In the interim the business division was acquiring intensely, which was quickly expanded the nations level of obligation. The Portuguese government kept on spending intensely depend the financial downturn, especially in foundation. At the point when the other southern European nations started to see the impacts of the sovereign obligation emergency global financial specialists>
What was the European Sovereign Debt Crisis? So as to have the option to completely investigate the reasons for European Sovereign Debt Crisis its essential to comprehend what the Crisis is. The beginning of the European sovereign obligation emergency started in Greece where a higher hazard premium was alloted to the Eurozone area. By late 2009 the PIIGS nations (Greece, Spain, Ireland, Portugal and Cyprus) has conceded that their obligation was at a level where they couldn’t reimburse or renegotiate their obligation. In 2010 the International Monetary Fund and pioneers of the Eurozone consented to give a â¬750 billion salvage bundle to spare these nations from insolvency, the sum was likewise later reexamined to â¬1 trillion. Driving from this intra-eurozone capital streams at that point fell pointedly, coming about because of a solid fixing of money related conditions because of the emergency. During this emergency a significant number of these nations had their sovereign obligation brought down to garbage status by worldwide credit offices, which further intensified the circumstance. Greece’s degree of obligation being at right around multiple times the level which is ordered by the EU. With obligation levels expected to be topped at 60% Greece’s level was at 113%. Greece and the other PIIGS’s nations obligation were at a level where they required help from an outsider, for example, the (ECB) European Central Bank. In a report it was built up that the towards the finish of 2009 after a Greek difference in government coming about with new government giving a bogus spending deficiency. Which was against EU strategy set in the Maastricht settlement. Toward the start of 2010 Greece has plans to bring down its spending’s deficiency to 3% anyway later in the year Greece let the EU realize that their obligation was at such a level, that they may default. This was a consequence of reckless monetary strategies, and different components. Source: Macrobond, IMF The EU acknowledged to give a crisis bailout bundle as an end-result of Greece actualizing severity measures to manage its degree of obligation which was so crazy. The EU settled on the choice to remain behind its part and help Greece with a bailout bundle, as not rescuing would have genuine expenses to the EU all in all. The subsequent somberness estimates expected Greece to cut consumption diminishing the expenses of government community workers. Additionally managing an enormous issue in Greece which is tax avoidance. Coming about because of this a free expense authority was started to help diminish tax avoidance. “In May 2010 a â¬110 billion gave by euro region Member States and the International Monetary Fund (IMF).” (Powerpoint) These measures additionally expected Greece to auction a huge extent of its state-claimed helps, which was planned to decrease the intensity of associations and gatherings. One of the primary purposes behind Greece’s end was that the regulatory productivity inside Greece was incredibly low. Greece is viewed as a “poor understudy” in the euro zone economy, having a moderately feeble monetary base with a large portion of the populace having low expectations for everyday comforts. Joined with a the very dependence on the travel industry and assembling which was incredibly affected by the Great downturn, Greece’s economy was not fit as a fiddle going into the emergency. For the second PIIG’S nation Ireland. Irelands economy in 2007 had gotten profoundly subject to development and lodging which they utilized as the essential wellspring of monetary development. This was supported by the outside acquiring of Irish Banks as overall loaning rates at the time where generally low. Anyway late 2007 the Irish property bubble began to blast which lead to a decrease in property costs crosswise over Ireland, and lead to a stagnation in property improvement the nation over. This at that point had a move through impact causing huge misfortunes in property advancement and a nation wide breakdown in development action. This causes enormous stain on the nations Irish financial framework, and a gigantic draw again from household property speculator. These banks were regarded too huge to come up short, anyway in 2008 the first of the enormous banks petitioned for section 11 liquidation security. This prompted an arrangement which the Irish government set up to ensure the remainder of the staying national banks. Giving continued liquidity with the goal that more liquidations wouldn’t happen. Matters keeps on compounding and in 2010 the Irish government mentioned help from the EU to abstain from defaulting on its obligation. Spain was a comparative case to Ireland, with a substantial dependence in the property and development industry. The property business expanded exponentially to the point where property turned into the residents favored goal for investment funds. With the Spanish government weighted tax breaks for property which further expanded its venture prevalence. Property estimations kept on expanding, with individuals anticipated that qualities should keep on ascending, without backing off. Essentially, on account of Ireland. One of the key advantages for Spain joining the European Union, was the decrease of loan costs. This significantly expanded to accessibility and access to low financing cost credit. Which prompted a huge scale diverting of capital into the land part. Driving from this the development division turned into an enormous piece of the nations GDP. With it representing 13.3% of the nation’s absolute work. This blast didn’t last anyway prodding from the US monetary emergency, in 2008 the property bubble started to blast. Initially, sparing banks started to fall inside the nation, when markets started to crash. Chapter 11 and awful obligations began to winding out on control. Speculator certainty started to therapist, and government bailouts kept an enormous extent of banks from chapter 11. With the Spanish economy starting to give indications of disappointment, and Bankia which was the fourth biggest bank in Spain falling flat for liquidation. With a large number of the nation’s financial specialists just getting away liquidation through renegotiating there advances ordinarily. From this the pace of economy in Spain start to stagnate in 2008 and began to contract in 2009 and 2010. Once more, to a great extent because of the stockpile of liquidity evaporating globally. Which lead to a breakdown in the Property and development division. This thus at that point lead to wide scale joblessness and putting strain on the nations social security framework. This made the nations obligations get to a level wherein they were fleeing. Which at that point thus required the Spanish government requesting that the EU offer help as the nation’s obligations where at a level where the Spain could make its advantage reimbursements on its open obligation. So also, to other PIIG’S nations the main up to the European sovereign obligation emergency, Italy was at that point generously intensely obligated. To a level where the measure of government obligation surpassed the nations GDP. Which was additionally well over the 60% degree of obligation commanded by the Maastricht settlement. The administration esteemed that this was not an issue for the nation. As the administration had the option to constantly ready to renegotiate this obligation, up until 2010. With the disappointment of the US advertises, this systemically affected the Italian budgetary foundations. This caused a wide scale absence of liquidity, beginning with banks declining to take an interest in between bank loaning because of the absence of money related sufficiency. Prompting a more noteworthy constriction of liquidity. This brought about a droop in the economy’s development because of a bringing down in open utilization and speculation. Fares in the nation at that point started to decay with areas, for example, transport and assembling falling by as much as 35%. Italy’s pace of development during the emergency. Year GDP pace of development 2000 5.00% 2001 3.60% 2002 2.70% 2003 3.10% 2004 3.30% 2005 3.60% 2006 4.00% 2007 3.60% 2008 0.90% 2009 – 3.70% 2010 – 0.10% 2011 0.70% Source: Eurostat After a difference in government, Mario Monti Italy’s new executive actualized severe gravity measures. This included decreasing government organization use, raising the retirement age and lessening the degree of tax avoidance. This demonstrated compelling and in view of these measures the financial framework inside Italy just required a little bailout bundle contrasted with other EU nations. During a pressure test led by the ECB in 2011 it indicated that “⦠the Italian financial framework appears to have low introduction to government obligation; it holds under 10% of household open obligation â against over 40% on account of Spanish banks â just as low presentation to remote sovereign hazard, which speaks to just 23% of the all out government obligation Italian banks hold” (Bolton P, Jeanne O (2011)) The primary driver for Italy being affected by the European sovereign obligation emergency was there overwhelming dependence on open obligation. This turned into a huge issue for the nation in when the monetary atmosphere for the European area started to intensify in 2009. For the remainder of the PIIGS nations Portugal’s hardship began appearing in 2008 when the development of the nation’s economy eased back to a point where it indicated no development. Proceeding to fall in 2009 to a point where it contracted by 3%. During this time the Portuguese government battled to manage a quickly developing spending shortage, ascending from 2.6% to just shy of 10% in 2009. Looking further into this one of the enormous elements that principle Portugal powerless during the financial downturn was that the nations business has a solid spotlight on creating low worth products, for example, apparel. Indeed, even before the monetary emergency this industry was battling to manage developing challenge from nations, for example, the Philippines and China. Generation proficiency didn’t develop inside the area and the business was quickly losing its upper hand. In the interim the business division was acquiring intensely, which was quickly expanded the nations level of obligation. The Portuguese government kept on spending intensely depend the financial downturn, especially in foundation. At the point when the other southern European nations started to see the impacts of the sovereign obligation emergency global financial specialists>
