The Emperor of Ice Cream

Patton-Fuller Community Hospital Essays

Patton-Fuller Community Hospital Essays Patton-Fuller Community Hospital Essay Patton-Fuller Community Hospital Essay Question 1. What extra factors encountered in international as compared with domestic fiscal direction? Discuss each briefly. International fiscal direction is faced with many more concern factors than domestic fiscal direction. For case. international concerns are required to run in many different fiscal facets around the universe. International fiscal direction must cover with clients. stockholders. sellers. and other concerns across a much wider plane than domestic fiscal directors. Investing determinations sing international issues may besides be greatly affected by the exchange rate. revenue enhancements. and arbitrage. It may besides be more of a challenge to pull off fiscal records when involved in international trade. Extra differences include higher rates of return every bit good as the interest-rate para theory ( IRP ) . The IRP is the forward premium or price reduction that should be equal and opposite in size to the difference in the national involvement rates. The exposure to the diminution of foreign currency is besides a serious factor sing international fiscal direction. An extra factor is the fact that many international subordinates may take to work independently alternatively of for the multi-national company. This would in bend prove black for the full company. International companies have much more entree to financess as they can seek recognition and funding in other states besides their ain. Finally. fiscal directors have the chance to do foreign investings. 2. What different types of concerns operate in the international environment? Why are the techniques and schemes available to these houses different? There are many types of concerns that operate in the international environment. Any concern which participates in concern minutess with other states are portion of the international environment. Any organisation that is involved in imports and exports would decidedly be involved. As good. any big house that communicates daily with very important persons from other states would besides be involved in the international environment. These techniques and schemes may be different because of these businesses’ gross domestic merchandise. In add-on. these organization’s promotions in engineering. cognition. and communicating may take to higher economic development ; hence. the chance to take part in international trade and globalisation. 3. What is meant by arbitrage net incomes? Arbitrage net incomes involve investings with small to no hazard. An investor makes arbitrage net incomes by purchasing in one market with inexpensive currency. and so selling in another market. This scheme does non affect an investing of financess or any hazard bearing. However. the investor would still do a certain net income. 4. What are the markets and mechanics involved in bring forthing ( a ) simple arbitrage net incomes Simple arbitrage involves two or more markets. This type of trading does non include exchange rates across all markets with a individual currency. Alternatively. simple arbitrage is taking advantage of the differences in monetary value sing one plus. ( B ) and triangular arbitrage net incomes? Triangular arbitrage is the procedure of change overing one sort of currency to another. so change overing it to another currency. and the eventually change overing back to the original currency. Triangular arbitrage normally occurs within a short clip frame. Traders involved in triangular arbitrage would hold to hold advanced equipment and cognition in order to efficaciously and rapidly take advantage of this sort of trading. Mentions Keown. A. . Martin. J. . Petty J. . A ; Scott. D. ( 2005 ) . Fiscal Management: Principles and Applications. Prentice Hall. Inc. Patton-Fuller Community Hospital Organizations are invariably looking for new ways to turn. A portion of this includes budgeting and prediction which prepares a corporation for its hereafter enterprises. Corporations explore options for growing and Patton-Fuller Community Hospital has discovered three options for spread outing their operations. ( Apollo Group. Inc. . 2010 ) . These three options include traveling public through an Initial Public Offer. geting another organisation in the health care industry. and unifying with another organisation. This essay will supply the strengths. failings. chances. and menaces of the three options Patton-Fuller Community Hospital has. Traveling public through an Initial Public Offering ( IPO ) has its advantages. For case. creating currency that can be used to fund growing and bring forthing liquidness for laminitiss. investors and employees. among others ( Benton. 2005 ) . When an organisation goes public the largest concern is making stockholder wealth therefore. taking an IPO provides the financess necessary to increase stockholder wealth. However. geting another organisation in the health care industry may beef up Patton-Fuller to increase the firm’s assets. Harmonizing to Patton-Fuller’s 2008 fiscal statement ( Apollo Group. Inc. . 2010 ) . the current ratio is 5. 41 bespeaking that Patton-Fuller has $ 5. 41 in current assets for every $ 1 in current liabilities. The health care industry is a dearly-won concern hence this ratio could utilize betterment. Unifying Patton-Fuller with another organisation provides benefits that this infirmary lacks. Patton-Fuller is current working on reconstructing the infirmary waiting country and has late solved an issue with the nursing staff. Unifying with another organisation could supply the aid this infirmary requires in the sense of run intoing its long-run ends every bit good as increasing its operating income return on investing which is presently at 12. 3 % . We will analyze the failings of the three enlargement options. There are many disadvantages of traveling public through an IPO. The major disadvantage of traveling IPO is the cost and clip involved in the transmutation. Directors of top concern people grow exhausted from covering with lawyers. bankers. investors. comptrollers. etc. Another disadvantage is traveling public gets really expensive. Fees are paid out for assorted things and to assorted people. Losing confidentiality. flexibleness. and control is another disadvantage. The SEC requires that all public organisations let go of information about public personal businesss. net incomes. etc. Patton-Fuller has to make up ones mind if giving up their freedom is the way they want to pitch toward. Geting another organisation in the same industry can hold its disadvantages. One major disadvantage is the industry being purchased holding fiscal jobs. This sort of organisation is non worth the investing. The monetary value to buy may be a good cost for a bad ground. Cost features can be another issue. Competitive jobs are another issue. Everyone is seeking to travel after the same concern. Some organisation or cut pharynx refering competition. If Patton-Fuller takes this path. they need to do certain the industry being purchase is worth the investing. They do non necessitate their investing to work for them. Unifying with another organisation another organisation could decidedly convey on some challenges. When unifying. ballots must be approved by the shareholders. Stockholders play a large function in concerns unifying. Obtaining the ballots can be clip devouring. Trying to acquire at least two-thirds or more ballots is a undertaking. There could besides be struggle of aim between the two concerns. This could be a immense job. When the two concerns do non see oculus to oculus. this can do break within the organisation. Then there is ever the impression of a concern going excessively big. When a meeting concern becomes excessively big to quick. this leads to higher costs. When unifying. Patton-Fuller demand to make their research about the concern they want to amalgamation with. Unifying with the incorrect organisation could be a hazardous undertaking. Patton-Fuller demands to make their research and weigh their options about all three enlargement options. Patton-Fuller demand to believe long-run and what would be good to the infirmary long-run. The Patton-Fuller Community Hospital has been functioning its local community since 1975 ; nevertheless the executives at the infirmary now believe it is clip expand from being a in private and have three options for enlargement: traveling public through an IPO. geting another organisation in the health care industry or unifying with another organisation. Opportunities of each attack that could profit the Patton-Fuller Community Hospital will be determined and discussed. When a in private held coming goes public. it normally means that the company is selling portions of its stock for the first clip to the populace. This means that a one time in private held company now is owned by public shareholders. The alteration of traveling from a in private held company to a publically held company would necessitate a batch of alterations to the infirmary ; more than probably there would be a alteration in direction and a loss of flexibleness. However. traveling public through an IPO may be the lone manner the infirmary would be able to go on to turn and spread out. For any concern. traveling public requires a batch of clip and resources to guarantee that the procedure happens swimmingly. It is frequently believed that a company should look for other options such as procuring venture capital. organizing a limited partnership or analyze their current capital before perpetrating to an IPO solution for enlargement. Geting another health care company could be a consideration ; acquisitions occur when two similar companies combine to organize a new company wholly. The purchaser of the other company takes control of the company because it is purchasing its portions ; this means that the company the purchases the other company has full control over its assets and assumes all liabilities from the company that is being purchased. Geting another company within the health care industry would let the Patton-Fuller Hospital to spread out within the community. While acquisitions occur when one company buys another company and establishes itself as the proprietor of both companies. a amalgamation is the consequence of two companies that agree to travel frontward together but go on to be owned and operated individually. Merging is frequently a good thought for a batch of companies because it allows companies to fall in together for both organizations’ best involvements to happen. Amalgamations allow concerns to rule within their industries but let them to each be separately owned and operated. There are menaces associated with traveling public through an IPO. One menace is that there is a loss of control. If Wall Street analysts don’t like the manner the company is being run. your stock monetary value may endure. which means difficult work has gone to blow. The board of managers may non wish the occupation you’re making. so your occupation is in hazard. And. of class. the stockholders may vote contrary to your sentiment. which could significantly impact your life. explains Harry S. Raphael. spouse of Raphael and Raphael. LLP. a Boston-based full-service accounting and concern consulting house. The menace of losing control of an organisation will run the hazard of losing the organisation. Besides. Public companies have a greater answerability for their actions and must besides run into rigorous demands from the Securities and Exchange Commission ( SEC ) that cause countless distractions to the direction squad. At the same clip. steady growing is expected on a quarter-by-quarter footing. If the outlooks are non met. there is a opportunity of the company non being financed by loaners and hence doing the company to travel bankrupt. Last. going IPO presents a different sort of communicating channel. both internal and external. which must be created and maintained. Much of this load falls on the main fiscal officer ( CFO ) . but investor and public dealingss houses play important functions in the operation and day-to-day life of a public company. every bit good. Such communications patterns for public companies - or those entrenched in the IPO procedure - can be critical ( Hell No We Won’t IPO. 2010 ) . The idea of buying an on-going concern would look to be a good thought nevertheless. there are possible issues to see: there is an bing repute. client base. providers. equipment. rentals and hard currency flow. The substructure and direction squad are besides in topographic point. These facts will do it hard for the concern to surge if all mentioned is negative alternatively of positive. There is the possibility of the marketer endorsing out merely you get ready to subscribe the trade due to emotional fond regards to the concern. Their merchandises may be unequal and/or defective. The stock list is old and outdated. The concern is on a downswing and sing a negative hard currency flow. Overall. it is hard to happen one good characteristic about the concern. except the gross revenues monetary value. When this state of affairs occurs. it is easier to get down a new venture than purchase an old one ( AllBusiness. 2010 ) . Unifying with another concern. of the same sort. is besides an option. However. there are menaces to see. The cooperation of the mark house bing direction is about a necessity for a amalgamation. This cooperation may non be easy or cheaply obtained. Furthermore. the diseconomies of graduated table if concern become excessively big which leads to higher unit costs. It’s besides will make clangs of civilization between different types of concern. Thus this reduces the effectivity of the integrating. Merger besides may be making a struggle of nonsubjective between different concerns. significance determinations are more hard to do and doing break in running of the concern. It besides consequences dissatisfaction among current staffs as places will be limited and the direction have to make up ones mind which staffs to keep the place after the dealing has taken place ( William. 2008 ) . Patton-Fuller Community Hospital is a in private owned and has many options on how they can spread out. Patton-Fuller now knows the strength. failings. chances. and menaces of the three enlargement options. They have to find what attack would outdo ease the infirmary demands. Mentions AllBusiness. Retrieved October 11. 2010 from hypertext transfer protocol: //www. allbusiness. com/specialty- businesses/minority-owned-businesses/459211-1. hypertext markup language Apollo Group. Inc. ( 2010 ) . Patton-Fuller Community Hospital. Retrieved on October 09. 2010. from hypertext transfer protocol: //ecampus. Phoenix. edu/secure/aapd/cist/vop/Healthcare/PFCH/pfchHome. htm Benton. G. L. ( 2005 ) . The Advantages and Disadvantages of Traveling Public. . IPO Planner. Guide and Resource Directory for Companies Going Public. Pillsbury Winthrop LLP. Retrieved on October 09. 2010. from hypertext transfer protocol: //ipoplanner. webzel. net/forum/00000003. hypertext markup language. Hell No We Won’t IPO. 2010. Retrieved October 11. 2010 from hypertext transfer protocol: //www. va- synergistic. com/inbusiness/editorial/finance/articles/hellno. hypertext markup language William. Peter ; The Advantages and Disadvantages of Mergers. November 15. 2008. Retrieved October 11. 2010 from hypertext transfer protocol: //www. associatedcontent. com/article/1189676/the_advantages_and_disadvantages_of_pg2. hypertext markup language? cat=3

Demonstrate the major differences between documentary and reality TV Essay

Demonstrate the major differences between documentary and reality TV programmes by comparing examples on similar subjects - Essay Example The basic assumption made by the current report is that both reality TV and documentaries are manipulative genres, which use objectivity (an impossibility in reality) as a way of excusing the purposeful arrangement of form and content to achieve a certain audience reaction. Certain other genres, including documentaries, may be said to be forerunners of reality TV. Among these are quiz shows, which had their peak of popularity in the 1950s and declined after a series of scandals. In these shows, average everyday individuals would compete against members of the scholarly and intelligence community for cash and other prizes by answering questions in a game-show format. Part of the draw of these shows, as in other reality TV shows as well as documentaries, was that the viewer was not watching an actor delivering planned lines, but rather was watching an individual who was just like them in many ways. The genre of quiz shows became wildly popular, partly as a result of this, but faded after quiz show scandals revealed that many of the so-called average everyday people were actually actors, being coached and given lines by the shows’ producers. However, the genre of game shows, which is closely related to quiz shows, survived the scandals and kept its place on network television, especially during the morning and daytime hours. â€Å"Various types of programme are believed to impart greater knowledge and â€Å"broaden the mind†: in part political programmes (which are not uniformly popular as a result of the disillusionment frequently expressed with respect to politics and politicians); to a greater extent magazine-style programmes, debates, reports and documentaries on a series of topics including society, travel, foreign countries, nature† (Attitudes, 2010). People are interested in this form of entertainment, and therefore, it

Same-Sex Marriage Essay Example | Topics and Well Written Essays - 500 words

Same-Sex Marriage - Essay Example According to the paper findings same sex marriage has undergone numerous milestones from the initial secretive affair which was prohibited by cultural and religious beliefs of the society to an open affair where weddings are done in public. The coupes are recognized as a man and wife despite the same sexes. This issue is openly against the norms; however, it has found its way to acceptance and legalization. The first time, when same –sex was mentioned and performed was in 342, in the early Roman Empire. Nero became the first emperor to marry a man. He later married two other males in different occasions. As the report declares there have been various perspectives on the legalization and acceptance of same-sex marriage. According to the religious views, the Bible defines marriage as a union of two people of opposite sex. This implies that same-sex marriage is a redefinition of marriage, which is contrary to the Bible. Most Christians have opposed this type of marriage based on ungodliness and against the word of God. This is opposition is reflected in most of the nations that have refused to recognize such marriages. The nations are well founded on religious beliefs. Similarly, the aspect of culture plays a critical role in reflecting what nature of morals a society should uphold. Most cultures across the world respect and recognize marriage between a woman and a man. This makes it difficult to accept marriage between two individual of same sexes. This is a taboo according to most cultures.

David Carson Influences | Modern Graphic Design

David Carson Influences | Modern Graphic Design Considered to be one of the worlds most influential graphic designers (Layers Magazine, 2007) David Carson is a name synonymously associated with post-modern design. This essay investigates Carsons career from its beginning in the design industry by means of a full biography before venturing on into post-modern and sub-cultural influences on the designer, the emergence and development of key aspects of post-modernist design within the work of David Carson and the positive and negative impact and influence he has had on modern graphic design. Biography: Born in Texas on September 8th, 1955 David Carson dedicated his early career to being a professional surfer, David attained a standing of number 8 in the world rankings while being a high school teacher in California (Encyclopaedia Britannica, 2012a).  A late starter to the graphic design industry, Carsons first real design experience came during a two-week commercial design course in Switzerland as part of his sociology degree. The class, taught by Swiss designer, Hans-Rudolf Lutz (Sacharoq, 1996: p.8), whose influence was so significant that Carson made a decision to pursue a career in graphic design and enrolled full time in a small art college upon his return home to the United States. In an interview with Marc Cameron, founder of fotorater.com; Carson explains the beginning of his design career: taking the advice of a friend who, at the time was the editor of Skateboarder magazine to contact the art director. I immediately started harassing this art director, sending him every little thing I was working on (Cameron, 2012a). This dogged persistence paid off and soon Carson was working in the studio voluntarily; pasting up advertisements and eventually composing an editorial spread for the magazine. Carsons first real job in the design profession was working as a designer at the surfer publication titled  Self and Musician as well as being an employed part-time designer for the magazine  Transworld Skateboarding (Encyclopaedia Britannica, 2012b). This enabled him to experiment with design, developing his now characteristic style of chaotic spreads overlapping photos and mixed up, altered typefaces. In 1989 Carson changed occupations and became art director of Beach Culture magazine producing a total of six magazines before the journal folded, this earned him more than 150 design awards (Encyclopaedia Britannica, 2012c) and a new position in a design role at its sister publication Surfer magazine, which catapulted him into the design spotlight. Carson then caught the attention of Marvin Jarret, publisher of Ray Gun an alternative music publication, who hired Carson as its art director in 1992. The monumental success of the publication between the years 1992 and 1995, with th e help of Carsons radical design vision, saw Ray Guns subscribers triple in numbers. This feat is most commonly attributed to the design strategy that seemed to be particularly appealing to the youth demographic (Kenyaferrand.com, n.d.) which led to several large corporations spotting an opportunity in Carsons design work to increase youth sales of their respective products. Commissions earned by Carson followed to design printed advertisements and direct television commercials. In 1995, Carson left Ray Gun and established his own design company David Carson Design. The business was an instant success, and Carson was able to secure a large and diverse corporate client base with companies such as Microsoft, Pepsi and Giorgio Armani. Carsons first book titled The End of Print: The Graphic Design of David Carson, released in 1995 and has since become the top selling graphic design book of all time with sales in excess of over 200,000 copies (David Carson Design, n.d.). Followed by the boldly experimental books  2nd Sight  (1997),  Fotografiks  (1999), and  Trek  (2003) (Encyclopaedia Britannica, 2012d). Post-modernist design influences on David Carson: Post-modernist design, described in the art and popular culture encyclopaedia as: A cultural, intellectual or artistic state, which lacks a clear central hierarchy or organizing principle and which embodies extreme complexity, contradiction, ambiguity, diversity and interconnectedness (artandpopularculture.com, u.d.). This is evident in Carsons hallmark style of distorted type and his rejection of the conventional ideas of typographic syntax, visual hierarchy and imagery. The text in Carsons work often challenges the fundamental criteria for legibility by the exploration of reverse reading, extreme forced justification, columns jammed together with no gutter and the erratic letter spacing across images, arranged in expressive rather than normative sequences. In his book, A Century of Graphic Design, author Jeremy Aynsley (2001: p. 233a) states that: Carsons work is greatly indebted to the work of Wolfgang Weingart and the Cranbrook academy, belonging to the tradition of deconstructive typography. This statement holds an immense amount of strength as Carson has characterised his style by embracing what could be considered as vernacular design, upsetting the rules of modernist typography with inconsistent weights and spacing of letterforms and adopting a multi-layered approach to both word and image; questioning the original meaning of the text and interpreting it into his own unique message. Aynsley (2001: p. 233b) goes on to explain how: Carson counters the modernist position form follows function, instead opting to use layout to explore the meaning. The typographic form is expected to represent ideas actively, rather than present a transparent medium. Much of Carsons work has also been influenced by the surfing sub-culture; his early professional surfing career allowed him to identify with and relate to his target audience. In his interview with Marc Cameron, Carson states: growing up around that culture put me in a more experimental mindset (Cameron, 2012b). This experimental and somewhat chaotic approach to design appealed to the sub-culture that surrounded the surfing and skating communities, and in a sense gave them their own identity with the styling of publications related to their specific demographic. Aynsley (2001: p. 232) has claimed that advertisers soon noticed the potential benefits of someone who could embody the interests of young consumers. Post-modernist theories in David Carsons work: David Carsons work holds true to many key aspects of post-modernism, especially with his philosophies countering of modernist theories such as form follows function. This is evident in the visually driven arrangement of type, by allowing letterforms or flow from spread to spread, by the extreme or unnatural cropping of single images or his highly expressive use of typography to express his own interpretation of the message to the viewer. The latter is most famously noted in his spread for an interview with Brian Ferry in Ray Gun magazine, an article which Carson states in his conference on design and discovery, published on Ted.com I found the interview boring, so I set the whole article in dingbat (Carson, 2009) During Carsons employment with Ray Gun, there were further embracements of post-modernist theories encompassed by audience participation within the magazines content. In his book, A History of Graphic Design, Phillip Meggs (1998: p.463a) has noted how Carson turned over half a dozen pages to the readers to display their illustrations for song lyrics. The encouragement of audience participation and engagement also acted as an enhancement of the sub-cultural identity to the already burgeoning audience generated by the publication. The impact of David Carson on modern graphic design: David Carson is arguably the most innovative and influential graphic designer of the 1990s (Blackwell, 1995: p. 1) and without doubt the most talked about, gaining an army of both admirers and detractors throughout his career. Blackwell (1995: p.10) has noted how Carson has progressed from being an unknown designer of a short-lived specialist magazine to being one of the most decorated designers in the world. This statement that holds weight in the sense that Carsons work has made a breakthrough from sub-culture to the mainstream of mass communication his work now considered being the cutting edge of the leading communications culture (Blackwell, 1995: p. 18). Carsons continual reinvention of the relationship between design and type, has changed the course of graphic design and crystalized the look and attitude of an entire generation, making him a powerful catalyst for design change (Aynsley, 2001: p. 233c). Running several workshops for graphic design students worldwide has provided Carson with a cult following of inspired young designers while at the same time angering some communications professionals who believed he had crossed the line between order and chaos (Meggs, 1998: p.463b). The lack of a prominent theory or a defined set of rules within Carsons work does not necessarily mean that the work is chaotic; instead it challenges conventional design practices with Carsons belief that as Blackwell (1995: p 27) claims that you cannot not communicate and Dont mistake legibility for communication. The benefits on studio work as a result of topics covered in this module: The topics covered in this module have dramatically benefitted my studio work; they have given me an insight into historical design practices and an understanding of key movements that I previously would not have considered in both my research and in producing potential design solutions. Post-modernism and David Carson in particular has been a monumental inspiration and my work in both the learning activities and the summative assessment covering the subject of his design work and processes; inspiring me to take a more expressive outlook on my design and not limiting myself to conventional solutions to design briefs. I now take into account how more expressionist designs can attract and engage the intended audience, more than traditional messages that offer little visual appeal. Designing pieces that have direct links to Carsons design philosophies; considering the emotion conveyed by a piece of work has added an extra dimension to previous practices and has reignited my passion for design.

Essay --

Walt Disney Every little girl and boy at some point in their life, wanted to be a Disney character of some sort whether it be Cinderella, Aladdin, Mushu, or even the famous Mickey Mouse. Walt Disney Company has been worldwide, and has had a moving impact on both children and adults since it first started in 1924. â€Å"All your dreams can come true – If we have the courage to pursue them† (Disney) Throughout Walt Disney’s life he has been an inspiration to all through his never-ending imagination, his magical theme parks, and his charming cartoons. Walt Disney was born in Chicago on 5 December 1901, the youngest of four sons, with a sister to follow. In 1906 his family moved to a forty acre farm in Marceline, Missouri. Walt’s father Elias, after four years of proving unsuccessful as a farmer and then being afflicted with typhoid, had to sale the farm and eventually move the family to Kansas City, Missouri. Walt would always speak of life in Marceline with a great sense of homesickness. To him the small town signified what was best about America. In Kansas City, Walt and his brother Roy helped their father deliver papers every morning and evening. A few years later they returned to Chicago, and while working several jobs, Walt took classes at the Chicago Academy of Fine Hope 2 Arts, the only art training that he would ever get. Even though as a child he was told he had no imagination he didn’t let that stop him from doing what he truly loved to do. One of the ways he is an inspiration to all is through his willpower to never give up. Disney's cartoons became widely popular in the Kansas City area, and through their success, he was able to purchase his own studio, Laugh-O-Gram, unfortunately, studio profits were unable to cover the... ...ted, warm loving woman who loved every child. Travers, who died in 1996, became a rich woman thanks to the film royalties but refused to work with Disney again. The new film is a Disney production. Her experience with Hollywood executives was so bruising that she agreed to a Mary Poppins stage musical by Sir Cameron Mackintosh on the proviso that "no Americans" be involved in its creation. But in Hope 5 the end Marry Poppins ended up winning five Academy Awards including best actress for Dame Julie Andrews. Throughout Walt Disney’s life its seen that his never-ending imagination, his magical theme parks, and his charming cartoons have encouraged and thaught people that no matter what your circumstances, or how many time you have fallen down, you need to get right back up and try again, and never give up. Because, â€Å"If you can dream it, you can do it† (Disney).

Chest Pain Care Plan

Acute chest pain related to ischemic cardiomyopathy as evidenced by tightness in chest. Patient will be chest pain free for duration of shift.Assess for chest pain q 4 hours during shift.Monitor vital signs q 4 hours during shift.Educate patient on importance of lifestyle modifications such as weight loss.Goal was met. Pt was chest pain free during shift.NURSING DIAGNOSIS OUTCOME/GOALS INTERVENTIONS EVALUATIONExcess fluid volume related to CHF as evidenced by patient weight gain of 2kg since hospitalization and +2 edema in lower extremities.Pt maintains adequate fluid volume and electrolyte balance as evidenced by vital signs within normal limits, and clear lung sounds throughout shift. Assess for crackles in lungs, changes in respiratory pattern, shortness in breath and orthopnea.Monitor weight daily and consistently with the same scale, at the same time of day, wearing the same amount of clothing.Educate pt on signs and symptoms of fluid volume excess, and symptoms to report.Goal w as met. Pt had normal vital signs and clear lung sounds throughout shift.NURSING DIAGNOSIS OUTCOME/GOALS INTERVENTIONS EVALUATIONRisk for ineffective peripheral tissue perfusion to right leg related to catheterization procedure as evidenced by interruption of arterial flow.Pt maintains tissue perfusion in right leg as evidenced by baseline pulse quality and warm extremity throughout shift. Assess right leg for pulse, skin color, temperature and sensation.Monitor cannulation site for swelling, bruits and hematoma.Educate patient on signs of reduced tissue perfusion and to report these signs. Goal was met. Pt’s right leg maintained tissue perfusion as evidenced by pulse quality and warm extremity throughout shift.NURSING DIAGNOSIS OUTCOME/GOALS INTERVENTIONS EVALUATIONRisk for anxiety related to impending heart surgery as evidenced by poor eye contact and lack of questioning.Patient is able to verbalize signs of anxiety by end of shift. Assess patient’s level of anxiety. Encourage patient to talk about anxious feelings.Assist the patient in recognizing symptoms of increasing anxiety and methods to cope with it.Goal was met. Patient verbalized the signs of anxiety by end of shift.