Describe the types of corporate shares and compare the use of shares to bonds and debentures in financing a corporation
Order Instructions:
describe the types of corporates shares and compare the use of shares to bonds and debentures in financing a corporation
SAMPLE ANSWER
Types of corporate shares
Introduction
Shares represent ownership rights to a company while debentures and bonds refer to long term debt instruments that are used by a company to borrow money from the public or private firms mostly at a certain interest rate which is fixed. There are two main types of shares, ordinary shares and preferential shares. Ordinary shares have voting rights and they participate on the sharing of profits in a company. However, they have no guarantee on the profits of the company. Preferred stock has a guarantee on profits and the shares are redeemable at the option of the holder. They have the first right to the assets of the company in case the company goes bankrupt before the ordinary shareholders are paid however they have no voting rights (Chandra, 2007)
Debentures and bonds have no voting rights in the company’s general meetings and they are freely transferable. They are entitled to a fixed rate of interest that is guaranteed.
There are certain types of bonds that can be converted to equity shares. Convertible bonds or debentures can be converted to equity shares at the option of the holders after the lapsed of a stated period of time. The feature of Convertibility in bonds is a way that’s meant to attract the customers to the product by promising ownership rights to the company in future. The other ordinary bonds or debentures are non-convertible debentures or bonds and they cannot be converted to equity shares but they mostly carry higher rates of interest than the convertible ones.
Ordinary shares can be issued according to different classes. Some classes can have different number of voting rights per share. For example class A ordinary shares can have one vote per share while class B have two votes per share.
References
Chandra, G. (2007) Company Law, 3rd Edition; McGraw-Hill Education
We can write this or a similar paper for you! Simply fill the order form!
A sole proprietorship a partnership and a corporation
Distinguish among a sole proprietorship a partnership and a corporation delineate the advantages and disadvantage of each describes how the revenues profits liabilities and assets are shared
Order Instructions:
distinguish among a sole proprietorship a partnership and a corporation delineate the advantages and disadvantage of each describes how the revenues profits liabilities and assets are shared
SAMPLE ANSWER
Distinguish between a sole proprietorship a partnership and a corporation
Introduction
Sole proprietor engages in a business enterprise mostly as a single director as well as the owner. There are many advantages related with this kind of arrangement. The owner can make quick decisions without consulting anyone. He also shares his profits with no one and he can dissolve the business without consulting anyone. The major disadvantage is that there is no continuity in case of death and the business is not limited. The business cannot be sued or sue in its own name and the owner is personally liable for the debts of the company. The owner cannot also borrow money from the public (Chandra, 2007).
A partnership is also not limited and it can be formed by two or more persons but they should be less than fifty members or as stipulated by law. The partners share all the profits according to their own agreements. Partnerships are simple to create and manage. Partnership also has continuity as in the case of the death of a member the rest of the members can continue with the business. General partnerships have partners who are personally liable for any debts incurred from the business. Limited partnerships have limited liability to its members however it’s more expensive to create.
Corporations have legal personality and they can sue or be sued in their own names. They can also raise money from the public and they have limited liability. They are formed by two or more directors.
The major disadvantage is that they are taxed highly and the process of registering the corporation is longer and requires more money. The company must also publish its accounts annually. Companies declare dividends to the shareholders as profits from the company and which is distributed according to each shareholding. All dividends payable to the shareholders are also taxed.
References
Chandra, G. (2007) Company Law, 3rd Edition; McGraw-Hill Education
We can write this or a similar paper for you! Simply fill the order form!
Corporations shareholder rights and distinguished between derivative action dissents and oppression remedies
Order Instructions:
discuss broadly held corporations shareholder rights and distinguished between derivative action dissents and oppression remedies
SAMPLE ANSWER
Corporations shareholder rights
Introduction
Shareholders have the right to vote during the annual general meeting and participate in the election of the company officials and directors of the company. The shareholders also have the right to receive any dividends that have been awarded or to receive any bonus issues made. The ordinary shareholders are like the owners of the company and they have the right to be informed on the progress of the company (Chandra, 2007).
However, preferential shareholders only have the right to dividends. There powers are limited to the amount of interest that their rights have against the company.
A derivative action arises where individual shareholders maintain their rights to sue the directors for breaches regarding the corporation as in the case of Donahue v Rodd Elctrotype Co (1975) of New England 367 Mass 578.
The majority shareholders cannot be allowed to oppress the minority shareholders as all the shareholders enjoy equal rights and are allowed to vote fairly as per their shareholdings.
The remedies may involve the court decision to lift the veil incorporation that protects the directors to be sued on their names. They are also allowed to maintain a collection action problem or to derive a claim on behalf of the corporation to sue for breach of duty but the parties must seek the court’s consent before bringing such an action.
Oppression remedies are provided by the court where the directors or the majority shareholders have been oppressive in their actions or inactions against mostly the minority shareholders as in the case of Donahue v Rodd Elctrotype Co above.
References
Chandra, G. (2007) Company Law, 3rd Edition; McGraw-Hill Education
Explain the duties of directors of a corporation we else owes similar duties? what remedies area available for the breaches of duties
SAMPLE ANSWER
The directors of a company are the key personnel that are responsible for the management of the company. In most cases, the directors of the company work collectively as a board in order to the chant the way forward as one sole entity. The articles of association give the board of directors to delegate authority to individual directors as considered appropriate by the company. The duties and responsibilities of directors are statutory duties with their legal capacities in order to drive the company forward. The operations of the directors are closely guarded by the company constitution to ensure that all their work is reasonable and has no conflict of interest. In their duties, the directors exercise independent judgment and are not obliged to accept benefits from third parties. The directors are responsible for drawing policy initiatives for the company in accordance with the scope operations of the company.
In some instances, one or more directors can breach their duties as far as company operations are concerned. However, the law provides for a variety of remedies in the event a director breaches his duties by contravening his moral and legal authority. The remedies for breach of duties include a court injunction or declaration and compensation where appropriate. In the case where the company property is lost, the director can be ordered to restore the company property or account for profits. In case of contract breach, rescission of the relevant contract can be ordered to act as a remedy for the breach of duty. In extreme cases where the director portrays gross violation of the company rules, the director can be dismissed and be replaced with other responsible persons who can act with due diligence.
Reference
Cheeseman, H.R. (2012). Business Law 8th Edition. Prentice Hall
We can write this or a similar paper for you! Simply fill the order form!
explain the significance of the memorandum of association articles of incorporation and articles of association
Roles and Responsibilities of Company Directors Sample Answer
Memorandum of Association and the Articles of Association are some of the important legal documents that are critical in the formation and running of companies. These important legal documents are drafted by experts at the time of incorporation of the company and they are useful throughout the existence of the company. Whereas the memorandum of association is a legal document that governs the relationships of a company with the outside parties, the articles of association governs the internal relationships of a company. The contents in the memorandum of the association include name clause, registered office clause, objects clause, limitation of liability clause, capital clause, association clause (Cheeseman, 2012). The memorandum of association is the basic document needed for the formation of a joint stock company, thus, is known as the charter of the company. The significance of this document is that it sets the limits by which the company operates, thus it becomes unlawful for the company to operate beyond its scope. In this regard, it enables the stakeholders and others who deal with the company to ascertain the permitted range of the company to avoid coming in conflict with the law. On the other hand, the articles of association are a company formation document that specifies the regulations of the company operations. The document helps to define the company’s purpose and lays how the tasks are to be accomplished within the organization such as handling of finances and appointment of various directors and managers. In addition, the article of association defines the roles and responsibilities of the company directors and the means by which the company shareholders exert control over the board of directors.
Roles and Responsibilities of Company Directors Reference
Cheeseman, H.R. (2012). Business Law 8th Edition. Prentice Hall
The ways stigma can influence health care delivery
The ways stigma can influence health care delivery for marginalised people and groups in Australian society
Order Instructions:
Discuss the ways stigma can influence health care delivery for marginalised people and groups in Australian society? People from the following groups may be stigmatized.
Explore this question from one of the following marginalised groups: refugees, Indigenous Australians, mentally ill or homeless people, older adults or the disabled.
Students will learn to reflect on sociological topics related to society, culture and health and apply the Sociological Imagination Template to their chosen topic. Using the Reflective Learning and Writing Proforma on LEO respond to one of the two topics provided below for the reflective assessment task. Use the proforma steps as headings and write in paragraphs below the headings. Ensure that you use all the factors from the SI template in completing this reflective writing task. It is not necessary to use all four factors in every Step of the proforma. All sources should be referenced using APA style.
SAMPLE ANSWER
The ways stigma can influence health care delivery
Step 1:
Carefully choose one question from the Reflective Learning and Writing Assessment section of the unit outline to guide your reflection. Write the question here:
How does stigma prevent the delivery of healthcare to mentally ill patients in Australia?
Step 2:
Reflect upon and analyse your experiences and observations in relation to your chosen question from Step 1, using the four factors from Willis’ (2004, as cited in Germov, 2014, p. 7-8) sociological imagination template (SI template):
Whereas the treatment of mental illness in Australia is embedded on technological advances and medical research that is informed by not only scientific inquiry but also evidence based results, stigma tends to impact the quality of care patients receive. While dealing with mentally ill patients at my former place of work, I would notice stigma as the most terrifying barrier to quality mental healthcare. One of my patients, who traced her roots in South Asia, recounted just cultural issues impede members of this community from seeking mental healthcare owing to negative thoughts and ethos that encourage the community to pinpoint persons with mental illness. Moreover, an aboriginal patient with a poor self-mage indicated that members of his community tend to repress symptoms to an extent that they fear seeking medical attention after internalizing the community mindset. By and large, this is evident of cultural stigma, which is anything but a cultural mindset unconsciously perpetuated by members of the community Willis’ (2010, as cited in Germov, 2014). Additionally, stigma hinders their access to services and contributes to low self-worth and greater seclusion and despair. A shocking revelation of how stigma impacts on the delivery of healthcare was evident when mentally ill patient indicated how medical practitioners would treat them as non-entities. As a team leader, I made a follow to determine if the allegations were founded or malicious. Going through the patient’s medical record I was able to identify the care giver that had attended to the patient. After a close examination I noticed that both the caregiver and the patient shared the same cultural background. With this revelation I was quick to learn that caregivers with a certain cultural orientation irrespective of their medical background tend to hold with high esteem issues of stigma and the society’s mindset. This is demonstrated by the highest level of discrimination against persons with mental illness when it comes to the delivery of quality healthcare Willis’ (2010, as cited in Germov, 2014).
With this backdrop from a clinical setting, I learnt that a genuine interaction from the community through to medical facilities in the absence of a pre-determined mindset can help curtail stigma. Essentially, these experiences demonstrate that minority groups have similar views concerning the stigma that persons with mental illness are subjected to wherever they go (Bradby, 2012). An elder brother to one of my patients’ told me just how stigma had crushed the self-esteem of not only the patient but also the entire family on allegations that that could imply a family spell that sweeps across blood of generations. It becomes common sense that stigmatization is literally what hinders the minority group from seeking medical attention (Hampton and Toombs, 2013).
Step 3:
Next, identify and cite one of the readings, articles or videos from eModule 1 or 2 and discuss how this resource helps you to expand and deepen your original reflections on this topic. Remember to relate the information from this resource back to the factors from the sociological imagination template. (400 words; use two academic sources – one from your textbook Second Opinion by Germov (2014))
The article’s commitment in highlighting stigma as a deterrent to quality mental health care helped me to understand the need for advocacy to de-stigmatize the people. In addition, I learnt new discoveries, techniques and knowledge synthesis. Past studies have main concentrated on descriptive, for instance number of individual that stigmatize depression. The articles adequately evaluate theoretical approaches of stigma. Furthermore, I learnt how stigma operates from a social perspective because the author would conceptualize stigma as a series of mind set and stereotypes about groups. For instance, the mental ill have been considered by the society to be dangerous which is not the case (Germov, 2014). Besides, I learnt that sociologists consider stigma as a structural aspect. This is based on the political as well as economic reasons, particular institutions have been set in the society which promote stigma or lead to discrimination of people with mental illness. For example, for mental illness one of the structural forms is the law which undermines their ability to vote, have a family among others. The article also exposed the fact that people with psychiatric problems do not get the medical attention compared to other people. This implies that medical facilities discriminate against people with mental illness. Another thing would emerge from the article is the labeling theory. The term stigma would suggest that mental ill persons are socially unkempt. So the article helped me to understand that just because someone has to check with psychiatrist does not mean that they are mentally ill (Germov, 2014). The article demonstrates that stigmatization many interfere with treatment. These are some people with mental illness that decide not to seek for medical attention. So the article enabled me to understand that persons with mental illness want to avoid the labels by refusing to seek psychiatrist attention.
According to the article, I learnt that there different ways of combating stigma including public awareness, protest and contact. Protest is like shame on you type of statement and an appeal to the public to change their negative mindset towards people with mental illness. On the other hand, public awareness is all about transposing the myths of mental illness using facts. Much as public awareness is widely used, its impact seems to wash out in short period of time. Contact approach is involved with introducing persons with psychiatric illness to rest which decreases stigma. Much as the article exposes that structural stigma can be combated in accordance with social justice, I learnt that it has some associated implications. For instance, its injustice to leave mental issues to people with this problem, rather this is a society’s challenge which requires looking at changes in the community to provide these people with an equal chance.
Step 4:
Now, building upon your reflections using the sociological imagination template, answer the original question you identified in Step 1, using at least four academic sources (e.g. journal articles, research reports) to support your answer. Locate these academic sources through your own information search.
Stigma and discrimination continue manifesting as a part of the fabric and tradition of Australia society (Burbank, 2011). It has significantly affected minority populations, the general healthcare system, and the nursing profession. Usually, stigma is based on the differences that arise due to age, ethnicity, religion, sexual orientation, gender, race, age or any other characteristic by which people vary (Massaro, 2012). The Australian Nursing Association is determined to work towards the eradication of stigma and discrimination in the profession of nursing, in the education of nurses, in organizations where nurses work as well as well as in the practice of nursing (Barry & Yuill, 2012).
The organization is also committed to promoting egalitarianism and promoting justice in the access and delivery of quality health care to all people regardless of their differences. Stigma associated with mental illness has been attributed to unfairness when it comes to unequal treatment of persons suffering from the condition (Willis, Reynolds & Keleher, 2012). Stigma leads to individual prejudice in terms of disallowed resources, and systemic inequity such as socio-economic, legal and institution discrimination. Moreover, stigma often thwart mentally impaired persons from seeking medical attention, sticking to treatment procedures, getting employment and living harmoniously in the society.
Mindsets towards mental infirmity differ among persons, households, traditions, cultures and nations. Cultural as well as religious teachings impact beliefs concerning the origins and nature of mental sickness (Willis, Reynolds & Keleher, 2012). Besides influencing whether persons with mental illness face social embarrassment, perceptions about mental sickness can impact patients’ eagerness and motivation to look for medical treatment and stick by the guidelines. Deeply ingrained stigmatization has had a wide range of implications in Australia. Structures of discrimination continue putting a severe toll on the minorities contributing majorly to the fact that the minorities are still dying at a younger age compared to other people in the general population (Keleher & MacDougall, 2011). Here are some of the ways through which stigmatization affects health care delivery.
As such, comprehending both cultural and individual mindset about mental sickness is elementary for the execution of proficient strategies to mental health care. Studies indicate that individual experience with mental sickness is distinct. An assessment of ethno cultural value system and mental sickness conducted by Willis & Elmer, (2011) underscores a broad range of cultural beliefs concerning mental health. For example, whereas American Indian communities do not confound mental sickness, others castigate only some mental sickness, while others castigate all mental sickness.
Stigmatization puts the marginalized groups at great risk for long-term health problems. For instance, previous research has found out that refugees who are exposed to stigmatization especially during adolescence have high chances of developing stress-related health issues (Massaro, 2012). This puts them at the risk of acquiring chronic diseases later in their life. Researchers found out specifically that this group of individuals is more likely to have higher levels of hypertension, higher levels of stress related hormones once they turn 20 and a higher body mass index (Barry & Yuill, 2012). Stigmatization also exposes minority groups to high psychological toll which has been linked closely to hypertension. Just the fear of discrimination triggers stress-related responses among refugees which translate to the constant biological stressors that these individuals experience.
Nonetheless, the castigation of mental sickness can be controlled by other variables including perceived cause of the sickness. A study conducted in 2003 on Chinese Americans and European Americans were executed with a vignette in which persons with schizophrenia were diagnosed (LaNave & Navarro, 2013). Respondents were informed of the fact that individual’s sickness was somewhat hereditary in origin, as such respondents were queried to contemplate a scenario in which their children would date, marry or replicate with the subject of the vignette.
In Australia, majority of nurses harbor unconscious racial biases especially towards marginalized groups especially the Indigenous Australians. A study conducted in 2012 indicated that about two-thirds of primary care nurses discriminate against the Indigenous Australians. The research suggested that clinicians spend less time with the Natives and do not involve them in medical decisions. However, majority of the health officials are not aware that they are treating this group of people any differently (Bessant, & Watts, 2012).
Genetic ascription of mental sickness importantly abridged the reluctance to get married and procreate among Chinese Americans, while enhancing the same among the European Americans, a factor that underpinned previous findings of cultural differences. Genetic attribution of mental illness significantly reduced unwillingness to marry and reproduce among Chinese Americans, but it increased the same measures among European Americans, supporting previous findings of cultural variations in patterns of mental illness stigmatization (Bessant & Watts, 2012). This form of stigma creates an environment in which the Natives do not feel welcome in the medical system that some have started to avoid seeking medical attention. This has led to the deterioration of their health and increased number of deaths among this group. Furthermore, Indigenous Australians are more likely to lack access to health insurance and less likely to have a regular doctor for checkups. This has resulted in circumstance whereby the Natives die from preventable diseases at higher rates compared to other people in the society due to delayed treatment (Couzos & Murray, 2010).
Several studies have demonstrated other considerable attitude variations towards mental sickness among various cultures in North America. For instance a comprehensive observation ethnographic research of chronic mental ailing people, the European respondents regularly seek treatment from health care providers and seem to convey beliefs regarding mental conditions related to biomedical views on the sickness (Macionis & Plummer, 2012). On the other hand, African Americans as well as Latino respondents mostly put emphasis on non-biomedical understanding of the symptoms of mental sickness. Even though participants alleged that they face stigma as a result of their mental condition, stigma was the main aspect of African Americans’ views however it was not greatly accentuated by European of American decent (Couzos & Murray, 2010).
Step 5:
Finally, choose one of the Graduate Attributes (at the front of the Unit Outline) that is most relevant and explain how answering this eModule question has helped you to develop this Graduate Attribute.
Research and Inquiry:
The answering of this eModule has helped me to enhance my research and inquiry skills. In bid to understanding how stigma impedes healthcare especially on person with mental health, I conducted an extensive study that highlights the popular belief on persons that need mental healthcare. The review of literature from various sources gave me not only an informed position from which to argue my case, but also augmented my knowledge base in nursing. The discrimination perpetuated by healthcare facilities against persons with mental illness shaped not only my critical thinking skills in try to formulate new comprehension but also when it comes to appraising the existing body of literature on nursing and to acknowledge the drawbacks of that knowledge. Having noted that most studies had been devoted in exploring the public view of mental illness, I would therefore recommend research on community based mitigation plans or approaches through proper legislation as the best way to controlling the segregation that persons with mental illness grapple with. In the end, I have come to realize the importance of research and management care.
References
Barry, A-M., & Yuill, C. (2012). Understanding the sociology of health: An introduction (3rd ed.). London: Sage.
Bessant, J., & Watts, R. (2012). Sociology Australia (3rd ed.). Crow’s Nest, NSW: Allen Unwin.
Bradby, H. (2012). Medicine, health and society: A critical sociology. Thousand Oaks, CA:Sage.
Burbank, V. K. (2011). An ethnography of stress: The social determinants of health in Aboriginal
Couzos, S., & Murray, R. (2010). Aboriginal primary health care: An evidence-based approach (3rd ed.). South Melbourne, VIC: Oxford University Press.
Germov, J. (2014). Second Opinion: An Introduction to Health Sociology. Fifth Edition. Oxford University Press.
Hampton and Toombs (2013) Indigenous Australians and health: The wombat in the room. South Melbourne, VIC: Oxford University Press.
Keleher, H., & MacDougall, C. (Eds.). (2011). Understanding health: A determinants approach. (3rd ed.). South Melbourne, VIC.: Oxford University Press.
LaNave, K., & Navarro, C.S. (2008). Teaching manual for living justice and peace: Catholic social teaching in practice. Winona, MN: Saint Mary’s Press.
Macionis, J.J., & Plummer, K. (2012). Sociology: A global introduction (5th ed.). Harlow, UK: Pearson/Prentice Hall
Massaro, T. (2012). Living justice: Catholic social teaching in action (2nd Classroom ed.). Lanham, MD: Rowman & Littlefield.
Willis, E., Reynolds, L., & Keleher, H. (Eds.). (2012). Understanding the Australian health care system (2 nd ed.) Chatswood, NSW: Elsevier.
What is bonding? distinguished between bonding and insurance coverage
SAMPLE ANSWER
According to Cheeseman (2012), bonding and insurance are forms of protection that guards against financial loss, but work in different forms. Bonding is a specific protection by providing coverage when the specified job is not complete to the client’s satisfaction, such that a claim can be made for compensation purposes. The bond differs from commercial liability insurance since the bond only covers the specific obligation and not broader coverage like insurance claims. In other words, the insurance protects the business owners, while the bond protects the client and this makes the tow work concurrently without any conflict of law.
Whereas an insurance coverage is a form of risk management in a two party contract between the insured and the insurance company, a bond is a contract between three parties, namely the surety, the principal, and the obligee. In this regard, the surety is issued by one party on behalf of the second party to guarantee that the second party will complete the obligation to a third party. Whereas the bond provides legal protection to the obligee, the insurance coverage protects the insured against a risk (Cheeseman, 2012). Another difference is that the premium paid for the bond is for the guarantee that the principal fulfills his obligations, while the premiums paid is for insurance coverage is designed to cover for potential losses. For insurance coverage, losses are expected and the insurance rates are adjusted to cover losses depending on many factors, however, losses are least expected for bonds since contracts are awarded to qualified persons. Bonding is a form of credit such that the principals are to pay for the claims, however, the insurance coverage claim is paid and the insurance company doesn’t expect to be repaid by the insured.
Reference
Cheeseman, H.R. (2012). Business Law 8th Edition. Prentice Hall
We can write this or a similar paper for you! Simply fill the order form!
explain what is meant by the right of subrogation. how may subrogation affect not only the insured but also the person who has caused the injured or damaged? indicate other means by which the insurance company may keep damages as low as possible
SAMPLE ANSWER
Subrogation is the right of the insurer to assume the rights of the insured that arise automatically as a matter of law or by the agreement as part of the contract (Cheeseman, 2012). Subrogation by contract is common and arises in insurance contracts, especially in accidents and injuries that require monetary compensation. Therefore, it is the act of insurance companies seeking the reimbursement from the person or legal entity responsible for the injury or the accident after realizing that they have paid money that ought to have been paid by another party. In other words, it is the substitution of one person or groups by another in respect to a debt or insurance claim after realizing that the other party is responsible for such claims.
According to Cheeseman (2012), subrogation can affect both the insured and the person who has caused the injuries or the damage in various ways. If the accident or the damage was caused by the insured, the insured is thus responsible for the damage caused and the insurance company is likely to subrogate against the insured. For the person who has caused the damage, the subrogation can be applied against his company so that the insurance company gets a refund for their expenses used to bail out their client.
There are other ways by which insurance companies are likely to keep their damages as low as possible in order to improve on their profitability. The insurance companies keep their damages as low as possible to carefully examining all the conditions surrounding the accident to check is the possibility of transferring the liability to other third parties. In addition, the insurance companies’ only pay for what they think is reasonable concerning the nature of the industries or the damage to their client.
Students are to choose one (1) of the case studies available (see LEO) and answer the associated questions. The assignment is to be presented in a question/answer format, and not as an essay (i.e. no introduction or conclusion). Each answer has a word limit; each answer must be supported with citations. Students should follow the recommended formatting for academic papers http://students.acu.edu.au/308971 Students must provide in-text referencing and a reference list must be provided at the end of the assignment.
SAMPLE ANSWER
1 In relation to your chosen patient, discuss the pathophysiology of their condition and using evidence based practice explore current treatment options for your patient’s condition, include any pharmacological and non-pharmacological considerations.
This is a common operation procedure performed in the U.S. Though practiced for along period of time, the procedure faces numerous controversies especially on post-surgery complications. Tonsillectomy refers to the surgical removal of palatine tonsils. It is among the most common surgical procedures performed (McCance Et al., 2014)
Pathophysiology of the disease; tonsils are 3 tissue masses namely the lingual tonsil, pharyngeal tonsil and the palatine tonsil. These tonsils ate lymphoid tissues which are covered by cryptic invagination respiratory epithelium. Tonsils play an important role in immunity process. They produce lymphocytes and synthesize immune-globins. However, diseased tonsils are usually less effective because they are associated with reduced transportation of antigen, reduced production of the antibody and recurrent bacterial infection. This normally causes the tonsils to enlarge resulting to systems complication such as Difficulty in breathing, difficulty swallowing and disrupted breathing especially when the patient is sleeping. In some cases, there could be cancerous tissue on one or all tonsils. This could lead to recurrent bleeding from the blood vessels neighboring the tonsils surface (Tollefson, 2012).
Tonsillectomy is normally recommended especially if there are frequent episodes of tonsillitis such as more than seven episodes per year, or more than three episodes per year. It is also recommended if the bacterial infection does not improve with antibiotic therapy. However the process is not usually smooth sailing but also associated with risks and complications like other surgeries. For instance, some patients may react to anesthetics. Anesthesia is used to make the patient relax during the surgery, but some studies have reported minor complications such as headache, nausea and soreness of the muscle. Swelling of the tongue and the soft palate could cause breathing difficulty. Bleeding may occur during the process and may also occur during healing processes. This implies that further treatment is required and the patient longer hospital stays (McCance Et al., 2014).
For patients presenting airway obstruction or hemolytic anemia, they are treated using corticosteroids. This pharmacological therapy has been indicated to be effective in reducing fever, pharyngitis and mononucleosis (MN) which could be infectious. Antibiotic treatments are normally used for secondary bacterial infection. Ampicillin and related compounds should be avoided where MN is suspected because it causes generalized popular rash. Cephalexin reacts similarly. The evidence based recommended antibiotic is the antistreptococcal antibiotics e.g. erythromycin. Antibiotics should only be administered is there is an indication of bacterial etiology. The etiology is presented by presence of tonsillar exudates, fever, leukocytosis and GABHS. The bacterial infections are indistinguishable and may require culturing of the bacteria. Administering of penicillin for 10 days is recommended (Martini, Nath & Bartholomew, 2014).
The non-pharmacological therapy entails patient education; patient is requested to complete medications even where the symptoms have been relieved. It is also important for the patient to take a lot of fluids, particularly water and ice pops. Patient is advised to take foods which are easy to swallow. The patient should avoid crunchy and over spiced food. The patient is also required to take ample rest. They should avoid strenuous activity until one is able to resumes normal diet and pain is relieved (Jarvis, Forbes & Watt, 2012).
Q. 2 Critically discuss four (4) components of the PACU discharge criteria outlined in the Aldrete Scale. Utilize the scale provided on LEO as a resource in your case study.
The main goal for postoperative care is to mitigate complications and to promote rapid healing for surgical incision. The care involves assessment, diagnosis of the post-surgery events, intervention and evaluation of the patient’s outcome. The extent of PACU is highly influenced by the type of surgery and the patients’ health status at that time. Where post anesthesia complications are identified, patients must be retained in the hospital until their conditions stabilizes (Smedley, 2012). After tonsillectomy and any other type of surgery, the patient is transferred to PACU where anesthesia reversal and other processes are conducted. The amount spend in this care unit depends on the length of surgery, status of the regional anesthesia and the status of the patients consciousness. In PACU, the nurse reports on the patient’s condition when performing an assessment for post-surgery complications (Tamura Et al., 2012).
The patient is only discharged from PACU after she meets the standard discaharge criteria as indicated by Aldrete Scale. This is scales provides scores on patients vital components. Muscle activity must be scored. This includes the ability for the patient to move jaws and muscle extremities with ease either on command or spontaneously. Where all muscle in question move, the item is scored as one, where none muscle extremities moves, then it is scored as 0. It is important to evaluate because nerves and blood vessels could be accidently injured during the process. The earlier the condition is identified the better. The second component is the respiration efficiency (Estes, 2013). In this case study, the patient was assessed if they could breathe deeply with ease, where a score of 2 is given. If the respiratory system is limited or cases of dyspnea are observed, then it is scored as 1, the 0 score is given if there is no spontaneous respiratory activity observed. Postoperative patients are characterized with poor ventilation. The aim is to identify airway obstruction and changes in oxygenation in order to correct it as fast as possible.
The third component is the circulation system. This entails checking the systolic and diastolic systems. This is monitored through the anesthetic state. If the systolic and diastolic pressure seems to be +/- 20% is normal, then a score of 2 is given. BP of +/- 20 % to 50%, the scoring is 1; and if there is alteration of the pressure is more than 50%, the score is zero. Some patients may experience hypoxemia and may require supplementary oxygen. This situation may alter the blood pressure which could result to stroke and ischemic heart attack. Lastly, Consciousness is the most important component of Aldrete assessment (Lopez Et al., 2013; Wilding Et al., 2010). The patient full alertness is indicated by their ability to answer give questions vividly and attentively. Where the patient is considered to be awake, then a score of two is given, if the patient are aroused only their names are called, then they get a score of 1, and score of zero where the auditory stimulation elicit reduced response. This is important to identify conscious complicated and uncomplicated conditions due to reactions to anesthesia medication which could change the patients’ blood pressure, respirations and heart rates (Atlas Et al., 2014).
3 Discharge plan
Amy is 20 year old female. She was admitted on October 23rd, 2014. She was suffering from difficulty in breathing and swallowing, fever and insomnia which was diagnosed as tonsillitis. Tonsillectomy was recommended, which she undertook three days ago. Depending with the patient’s condition and the type of surgery, the patient is discharged from PACU to in for an extended stay or to day surgery before a person is discharged to home. According to evidence based practice discharge depends on the patient’s recovery from anesthesia. Before the discharge, the patient must be conscious and mental state is fully returned. The patient should manifest stable vital symptoms including respiratory, cardiovascular system, excessive bleeding have stopped and the muscular systems. The pain should remain under control, the baseline temperature at normal level. Patient could stay longer at the PACU if there is nausea and vomiting. Additionally the patient must score nine out of possible ten PAS. If patients PAS score is below the standardized care, the chief anestheologists can be consulted. Before discharge, the RN must obtain verbal or written order from the physician; the orders must be recorded (Atlas Et al., 2014).
Preparation for discharge is an ongoing process even throughout the surgical processes. At the time of discharge, the nurse should ensure that the care providers know how to care for would sites and dressing systems including recommendations for vital daily activities during bathing. The reaction to the medication provides should be avoided and alternative drugs described or enhanced (Lewis Et al., 2013). The patient is prohibited to take physical activities such as returning to work, driving and exercises. Other important restrictions and modification should be supported. The instructions should be written instructions. Increasingly people are discharged from the ospital with many care demands, the care provider who receives the nurse should take care to protect the wounds drains, the wound dressing and other necessary traction apparatus (Tamura et al, 2011).
Social workers contact the family to inform them on discharge plan, Provides transportation to home and arranges medical supplies. Nurses ensure that patients care givers are informed on date of discharge. Provides the care giver and patient discharge list which contain treatment instructions, nutrition plan, physical activity recommended and scheduled appointment. Nurse should ask the patient care giver to verbalize the information to evaluate if they understand the instructions (Davis Et al., 2011). Documentation of the transfer is done and the patient is discharged from PACU. Sign and date the discharge form and discharge summary is documented. Pharmacist provides drug regime and the dosage. Family care giver advised on dietary modification. Family must make arrangement for care services at home. Family must ensure that the transition is smooth and peaceful. There is need to understand that the patient health is still undergoing recovery and thus need massive support (Atlas Et al., 2014).
References
Atlas, S., Matthews, J. R., Fritsvold, E., & Vinall, P. E. (2014). Social implications of chronic illness & disability. San Diego, CA: Bridgepoint Education, Inc.
Estes, M.E.Z. (2013). Health assessment & physical examination (5th ed.). Clifton Park, NY: Delmar.
Davis, G., Cox, E., Wolfe, R., & Becker, C. (2011). Cutaneous Capnography in the PACU: Immediate Assessment of Respiratory Status Emerging From Anesthesia. Journal Of Vascular Nursing, 29(2), 93. doi:10.1016/j.jvn.2011.04.009
Jarvis, C., Forbes, H., & Watt, E. (2012). Jarvis’s Physical Examination & Health Assessment (Australian and New Zealand ed.).St. Louis, Missouri: Elsevier Saunders.
Lewis, E., Craig, M., & Johnson, L. (2013). Use of the Pain Assessment Behavioral Scale (PABS) in PACU. Journal Of Perianesthesia Nursing, 28(3), e47-e48. doi:10.1016/j.jopan.2013.04.137
Lopez, M., Bellarmino, G., & Viellette, E. (2014). Early Assessment and Prevention of Skin Breakdown in the Post Anesthesia Care Unit (PACU). Journal Of Perianesthesia Nursing, 29(5), e34. doi:10.1016/j.jopan.2014.08.114
Martini, F. H., Nath, J. L., & Bartholomew, E. F. (2014). Fundamentals or Anatomy & Physiology (9th ed.). California: Pearson.
McCance, K., Heuther, S., Brashers, V., & Rote, N. (Eds.). (2014). Pathophysiology: The biologic basis for disease in adults and children (7th ed.). St. Louis: Mosby Elsevier
Smedley, P. (2012). Patient Risk Assessment in the PACU: An Essential Element in Clinical Decision Making and Planning Care. British Journal Of Anaesthetic And Recovery Nursing, 13(1-2), 21-29. doi:10.1017/s1742645612000174
Tollefson, J. (2012). Clinical psychomotor skills: Assessment tools for nursing students (5th ed.). South Melbourne: Cengage Learning.
Tomura, H., Yamamoto-Mitani, N., Nagata, S., Murashima, S., & Suzuki, S. (2011). Creating an agreed discharge: Discharge planning for clients with high care needs. Journal of Clinical Nursing, 20(3/4), 444-453.
Wilding, J., Manias, E., & McCoy, D. (2010). Pain Assessment and Management in Patients After Abdominal Surgery From PACU to the Postoperative Unit. Journal Of Perianesthesia Nursing, 24(4), 233-240. doi:10.1016/j.jopan.2009.03.013
We can write this or a similar paper for you! Simply fill the order form!
Write an essay explaining this state of affairs, focusing on why it is usually so difficult to accomplish anything in American government. Discuss how the branches must usually work with each other in order to make effective public policy, and then explain why this is so often difficult — with the result being frequent gridlock. Finally, explain how parliamentary democracy in most other established democracies is quite different from American democracy. Discuss the advantages and disadvantages of the American system as compared to well-established parliamentary systems, such as those in the UK, Canada, and Australia.
SAMPLE ANSWER
Political Science
Many countries across the world have their own styles of running their government. The constitution of these countries does vary and provides the guidelines on how the government should operate. Therefore, because of these, some government experience different challenges in providing governance and leadership. This paper therefore deliberates on various aspects that manifest in governments.
Accomplishing anything in American government has been cited to be so difficult. Various reasons explain this situation. One of these problems originates from the political structures in the US. Political class has contributed to these challenges. In most of the time, there are political divisions entrenched in the society and this has contributed to change of focus on the most salient aspects of the society. Abraham Lincoln is one of the most remembered presidents and his argument that a house that is divided against itself is not able to stand hold on truth (Janda 24). These divisions affect the unity and cooperation that would have helped the people to achieve their dreams. Partisan politics is therefore one of the causes to blame for this stalemates. The other reason that has made it hard to achieve anything in the government is the increased focus on democracy. The people have a right to do whatever they want and go back to the defense of democracy. The level of unemployment has increased as people sit and wait for the government to carry out everything for them. This has therefore made it difficult for the government to expedite all the issues and therefore leaving gaps.
For the government to work effectively and achieve its goals, all the branches of the government are expected to work closely to be in a position to make effective public policy. The branches include the executive, the legislature and the judiciary. There is separation of powers and it is important that each branch respect the functions and the mandate of each other. The executive should respect the court summons and ruling as well as the decisions reached by the legislation (Janda 45). This will help to avoid stalemates in governance and when formulating policies. During a crisis or a problem, the right branches should take the matter and provide tangible solutions. In case the matter need consultation, all the branches should be consulted to provide the way forward. Such operations and arrangements will go extra miles to ensure good working relations in the government. For example, if a policy is proposed it should be taken to the parliament as a bill and discussed. The members of the house should make amendments and to the bill and if they deem it appropriate should pass and take it to the president for assent. However, in case the bill is not worthy and attracts public outcry, any party that feels offended or is against the bill should take the matter to the courts for a ruling.
Even though people expect these branches to work together, it is not always the case as these results to gridlock. The problem is because of frequent conflicts between the various arms of the government and conflicts between the government and the opposition. Impasse between branches of government such as between the president and the senate or between the courts and the parliament causes conflicts that jeopardize the operations of the government (Janda 50). Self-interest is also another problem that has contributed to increased level of disagreement and conflicts between these branches. People in power forget about their obligation in representing the masses and instead fight and agitate for their own rights. These actions brew conflicts and this affects governance.
Parliamentary democracy in most established democracies appears quite different from that of America. This situation is explained by various reasons. One of the reasons that explains these differences is that American form of government is presidential and therefore as opposed to other democracies that are lead by prime ministers. Prime ministers form governments while US president does not form government but an executive branch as he appoints the ambassadors, cabinet officials and military leaders and head of regulatory agencies. Parliaments in other democracies usually have the majority of the members and therefore are able to make decisions that the government is spearheading. Furthermore, the president comes from the same parties of the majority party members in the parliament. On the other hand, the US parliamentary democracy, the president has no powers of appointing congressional leader and the president parties may not automatically control either the house of congress or parliament. This therefore, makes it hard for the president to provide leadership, as the majority members of the party may not support him.
American systems has a number of advantages as wells as disadvantages when compared to a well established parliamentary systems in countries such as Australia, Canada and UK. America runs on a presidential system as opposed to these other countries such as Australia and UK that have a prime minister as the head of state. Some of the advantages of US system is that, the president is that there is high level of democracy. Before approving of any policy, various branches scrutinize it and this ensures that decisions reached are essential for the people. Another advantage of US system is that it is easier for the branches of government to check on the behaviors or malpractices of other branches such as congress and this ensures accountability and transparency in the government.
The disadvantages of this system are numerous. One of the drawbacks is lack of responsiveness and efficiency. In a presidential system, there is no close unity between the legislative and thee executive and this is likely to cause challenges in leadership (Hankla 200). The people have no direct influence on the person that becomes president in these parliamentary systems in countries such as Australia. The people vote the president in US system but the election collegiate has the final mandate of determining who becomes president through their voting. Therefore, this makes it difficult for a president to govern because, the number of the congress or members of the house of parliament may not be enough to provide support. This therefore, makes such a system more prone to military takeovers that occur in most cases when the civilian governments have reached impasses (Jensen and McGrath 66). For instance, in US, it is easy for a crisis to merge, if the people fail to embrace their ideological values and spirit of democracy compared to other countries such as UK where the prime minister has the full mandate to provide leadership. Ousting a prime minister is therefore difficult compared to a president in US.
In US system the president and the congress has separate powers but equal claims to legitimacy and power. Therefore, if the president of one party is divided with a congress of another party, this can lead to a conflict. There is no democratic principle currently on which such an impasse can be resolved and this therefore may affect the governance and leadership of the country.
Janda, Kennethe. The Challenge of Democracy: American Government in Global Politics, The Essentials (with Aplia Printed Access Card) / Edition 9 , US: Cengage learning, (2013). Print.
