Tag Archive for: nursing

Diagnosing and Managing Common Endocrine and Musculoskeletal Conditions

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Discussion: Diagnosing and Managing Common Endocrine and Musculoskeletal Conditions

Endocrine and musculoskeletal conditions, especially when left untreated, can have a significant impact on women’s health. Many of these conditions present unique challenges for women, making risk assessments and routine screenings an important part of primary care. As an advanced practice nurse, you must identify signs and symptoms of these conditions and educate at-risk patients so they can also monitor themselves. For this Discussion, consider how you would diagnose, treat, and educate the patients in the following three case studies:

Case Study 1

A 33-year-old Caucasian female presents with concerns about a four-month history of diffuse musculoskeletal pain and stiffness associated with fatigue and dry eyes. The pain varies with the weather and is worse in the morning. Her menstrual periods are irregular and she has frequent dyspareunia. Physical exam is remarkable for pain at different points all over the body, including neck, back, chest, elbows, hips, buttocks, and knees

Case Study 2

A 28-year-old Latina obese female presents to the clinic with increasing body hair and irregular menses. She now has coarse body hair on her chest and upper back. Her menstrual periods used to be fairly regular, but now she can skip three or four months before her next menstrual cycle. She has never been pregnant. She has one male sex partner.

Case Study 3

A 28-year-old Caucasian female comes to clinic concerned about three episodes of urinary incontinence associated with difficulty walking. The first two episodes resolved spontaneously after a couple of days without residuals, but this current episode has lasted a week. Today she began to have some blurred vision. Physical exam is remarkable for mild edema of the optic disc and difficulty with heel-to-toe walking. Deep tendon reflexes are 2+ and there is no extremity weakness.

To prepare:

Review Chapter 8 of the Tharpe et al. text and the McSweeney et al. article in this week’s Learning Resources.

Review and select one of the three provided case studies. Analyze the patient information.

Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.

Reflect on the appropriate clinical guidelines. Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments.

Consider strategies for educating patients on the treatment and management of the disorder you identified as your primary diagnosis.

By Day 3

 

Post an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Then, based on the appropriate clinical guidelines, explain a treatment and management plan for the patient, including proper dosages for any recommended treatments. Finally, explain strategies for educating patients on the disorder.

itchy rash

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QUESTION No 1 A 17-year-old male presents with a complaint of a red, itchy rash over his torso and back x 1 week, which is keeping him up at night. He denies sick exposures or a recent visit to wooded areas. He denies other symptoms, significant history, or allergies.

1-In order of importance, describe three (3) questions that you would like to ask this patient and give a brief explanation of why?

2- From the information provided, list your differential diagnoses in the order of “most likely” to “possible but unlikely.”

QUESTION No 2

An 89-year-old female complains of a “stabbing chest pain” and points to the area just below her scapula at the right mid-clavicular line. She states that she had an upper respiratory infection last week that “just seems to hang on.” She has no other complaints.

1- In order of importance, describe three (3) questions that you would like to ask this patient and give a brief explanation of why.

2- Which lab or imaging tests would you order for this patient? Why?

community assessment:

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You will be working on this project for Modules 7 and 8. You must go out into your community to complete the windshield survey! This project cannot be completed by doing online research. For the paper, make sure interviews are cited as personal communication.  

Defining the Community

Your community can be a pediatric, adolescence, young adults, adult, elderly or a combination.

Clearly delineate the following dimensions before starting the process of community assessment:

  • Describe the population that is being assessed?
  • What is/are the race(s) of this population within the community?
  • Are there boundaries of this group? If so, what are they?
  • Does this community exist within a certain city or county?
  • Are there general characteristics that separate this group from others?
  • Education levels, birth/death rates, age of deaths, insured/uninsured?
  • Where is this group located geographically…? Urban/rural?
  • Why is a community assessment being performed? What purpose will it serve?
  • How will information for the community assessment be collected?

Assessment

After the community has been defined, the next phase is assessment. The following items describe several resources and methods that can be used to gather and generate data. These items serve as a starting point for data collection. This is not an all-inclusive list of resources and methods that may be used when a community assessment is conducted.

The time frame for completion of the assessment may influence which methods are used. Nonetheless, these items should be reviewed to determine what information will be useful to collect about the community that is being assessed. It is not necessary to use all of these resources and methods; however, use of a variety of methods is helpful when one is exploring the needs of a community.

Data Gathering (collecting information that already exists)

Demographics of the Community

  • When demographic data are collected, it is useful to collect data from a variety of levels so comparisons can be made.
  • If the population that is being assessed is located within a specific setting, it may be best to contact that agency to retrieve specific information about that population.
  • The following resources provide a broad overview of the demographics of a city, county, or state:
  • American Fact Finder—Find population, housing, and economic and geographic data for your city based on U.S. Census data
  • State and County Quick Facts—Easy access to facts about people, business, and geography, based on U.S. Census data
  • Obtain information about a specific city or county on these useful websites www.epodunk.com and www.city-data.com

Information from Government Agencies

  • Healthy People 2020—this resource is published by the U.S. Department of Health and Human Services. It identifies health improvement goals and objectives for the country to be reached by the year 2020
  • National Center for Health Statistics—this agency is part of the Centers for Disease Control and Prevention; this website provides statistical information about the health of Americans
  • Centers for Disease Control and Prevention (CDC)—The CDC website contains a large amount of information related to the health of the American population. The search engine within this website can be used to find relevant information
  • Federal agencies with statistical programs
  • Every state in the United States has its own specific health improvement plan and goals that are based on the Healthy People 2020 document. This information may be available on the state health department website.
  • State and local health departments provide information related to vital statistics for the community.

Other Data Sources

  • America’s Health Rankings—this website provides information about various health indicators for each state: https://www.americashealthrankings.org/
  • Other relevant data sources may be found by conducting an Internet search related to the topic that is being examined through the community assessment.

After data are collected from various sources, it is important to review the information and to identify assets and areas for improvement in the community by comparing local data (if available) versus state and national data. This will facilitate organization of the information that has already been obtained and will provide direction for the next step of the process.

Data Generation (data are developed that do not already exist):

Windshield Surveys

With the use of public transportation or by driving a vehicle around the community, one can observe common characteristics of the community.

Examples of key observations to make when one is assessing the community through a windshield survey include the following:

  • Age of the homes in the community
  • Location of parks and other recreational areas
  • Amount of space between homes and businesses
  • Neighborhood hangouts
  • Transportation in the community
  • Quality and safety of streets and sidewalks
  • Stores and other businesses
  • People out in the community
  • Cleanliness of the community
  • Billboards or other media displays
  • Places of worship
  • Healthcare facilities

Participant Observation

Spend time observing the population that is being assessed. Through observation of interactions among group members, much can be learned about the community, including the following:

  • Developmental level of the population
  • Effectiveness of peer-to-peer interactions
  • Respect for peers and others
  • Safety in the environment
  • Economic status

Informant Interviews

Informants could be people who are familiar with and interact with the population on a regular basis.

Examples of questions that may be asked of key informants include the following:

  • Strengths/assets of the community
  • Areas of improvement for the community
  • Concerns of community members
  • Access to health care
  • Emergency plans for natural or man-made disasters

Focus Groups

Focus groups (usually small groups of 6-12 people) can be helpful when one is gathering information about specific areas of concern within the population. Use of a focus group involves open dialogue about the population, whereas an interview or survey yields only individual responses.

  • Focus groups may be effective for assessing the following:
  • Satisfaction with services provided
  • Community resources used
  • Transportation issues within the community
  • Safety within the community
  • General concerns of members of the population

Surveys

Surveys may be used to collect data from the community. Selecting a sample of the target population may prove helpful in the collection of data that are easier to analyze. It is important to ensure that the sample is representative of the target population.

A survey should be developed that takes into consideration the developmental level of the group that is being assessed. Questions should be written at the appropriate developmental level, so they are answered in a way that makes the data useful. Surveys might include closed-ended (yes/no), multiple choice (several responses to choose from), Likert scale (Strongly Agree/Agree/Neutral/Disagree/Strongly Disagree), or open-ended (“why”/“how”) questions.

Topics that may be addressed in a survey include the following:

  • Demographic information
  • Status of employment
  • Safety within community
  • Safety in environment
  • Personal safety (seatbelts, helmets, etc.)
  • Stressors/stress management patterns
  • Risky behaviors
  • Support systems
  • Volunteer/community activities
  • Rest patterns
  • Nutrition
  • Dental hygiene
  • Health promotion activities

Level 1 headings are centered and bold. Level 2 headings are bold and at the left margin. Your submission should be a minimum of 2000 words (maximum 2500 words) in length and should completely answer the proposed questions as listed under “Define the community.” You should have a minimum of three (3) references.

APA formatting required and all responses should be combined into a single document for submission. Use the rubric as a guide for the evaluation method of the project.

Empathy map,

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To create your Empathy map, simply draw four quadrants on a piece of paper. Each quadrant represents a different aspect of yourself, the quadrants are as follows;

Seeing; The See quadrant explores what you see from the situation and how that impacts what you then do.

Doing; The Does quadrant explores the actions the Individual takes

Thinking; The Thinks quadrant captures what the Individual is thinking throughout the experience

Feeling. The Feels quadrant is the Individuals emotional state

Next, consider the following case study of Rosie and her family, explore the emotion in you. In each quadrant, write down the relevant aspects of each perspective. Your word count for this assessment is 500 words. Whilst APA referencing is not required for the purpose of this assessment as this work is based on your own personal knowledge you are required to submit a Bibliography which is not included in your word count. 

Case Study

Rosie is a 28-year-old single mother to Sam, her 6-year-old son. Sam was diagnosed with Neuroblastoma which is a form of cancer that is made up of cells that are found in nerve tissues of the body at the age of 4 and has been receiving a variety of known treatment options throughout this time inclusive of Chemotherapy which Sam is currently undergoing. Rosie has no current contact with any of her family members due to her traumatic childhood.

This has been a long journey for their family and Rosie has consistently struggled with watching Sam decline health wise throughout treatment and constantly analyses Sam’s quality of life. Sam cannot play sport of any kind, at times due to his level of unwellness he cannot hold a book at bedtime, he has not commenced school due to his treatment therefore has minimal friends to support him throughout this time period. Sam became extremely unwell during his last round of treatment which again provoked Rosie to assess how this medical intervention was helping her son.

Following Sam’s last round of treatment, scans took place which concluded the Neuroblastoma had again spread throughout Sam’s body however Doctors were confident that Sam would be eligible for a new drug trial. Following Rosie’s assessment of Sam who is undernourished and unwell from the impact of chemotherapy she has declined any further treatment for Sam and has requested support to prepare for Sam’s death with the inclusion of the Palliative care team.

automatic emergency defibrillator

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Reaching out a Solution  This assignment is designed to assist you in developing a thoughtful process for advocating about an issue as a nurse, from identifying a problem that needs to be solved through articulating a process for doing so.

This assignment consists of answering each of the questions listed below from the “Political Analysis and Strategies” chapter of your course textbook. Write each question as a new topic area; then follow with a paragraph or two to answer the question. Be sure to use APA guidelines for writing style, spelling and grammar, and citation of sources, if any used. This project should be no longer than 4 pages.

Let us assume that you are a school nurse in a high school. At a recent school athletic event, a spectator suffered a cardiac arrest in the stands. A coach of the home team went into the high school to fetch the automatic emergency defibrillator (AED) only to find out that it was not readily available. In the meantime, an emergency squad arrived and resuscitated the spectator. On Monday morning, you learn of the absence of the AED only to find out that it had been locked in the custodian’s closet. Reflect on the following questions outlined in the “Political Analysis and Strategies” chapter:

•What is the issue?

•Is it my issue, and can I solve it?

•Is this the real issue or merely a symptom of a larger one?

•Does it need an immediate solution, or can it wait?

•Is it likely to go away by itself?

•Can I risk ignoring it?

•What are the possible solutions? Are there risks to these solutions?

•What steps would you need to take in order to solve the issue?

•Does anyone else at the school need to be involved in the solution?

•Where is the power leverage in the school to reach the preferred solution?  Reaching a solution requires the use of power vested in the nurse.

Review Box 9-1 (Sources of Power) and determine which type(s) of power the school nurse has in this situation. State your reasons for your answer.

Assignment Preparation

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According to General Colin Powell, “Great leaders are almost always great simplifiers who can cut through argument, debate, and doubt to offer a solution everybody can understand” (as cited by Harari, 2002).

Assignment Preparation

For this assignment, imagine that you are the manager of a health care organization confronting numerous issues potentially affecting the provision of safe, high-quality health care practices. You have decided to focus first on the issue that has particular relevance to your area of specialization or professional goals, or that presents a situation you might expect to encounter in your leadership role. As you consider an appropriate course of action to address this issue, you have decided to begin by searching the case study literature with the intention of possibly gaining insight into the actions of other health care leaders who have dealt with similar issues and may have provided a sound solution to the problem or issues he or she faced.

A colleague with whom you have spoken about this has recommended the Buchbinder, Shanks, and Buchbinder text, Cases in Health Care Management as an excellent case study reference.

For your convenience, Appendix B lists all cases by topic (Leadership; Quality/Patient Safety; Finance; Healthcare Professionals/Human Resources; Health Disparities/Cultural Competence; Ethics/Law/Conflict of Interest; Crossing the Line/Fraud) and by primary and secondary settings.

In the Buchbinder, Shanks, and Buchbinder text, locate two case studies that are most closely aligned with the issue(s) you have decided to address. In addition, be sure that your selected case studies will enable you to

· Evaluate the effectiveness of different leadership approaches in facilitating collaborative professional relationships across disciplines.

· Evaluate health care leaders’ ability to communicate effectively.

· Analyze the role of communication in both creating and resolving a problem in health care leadership.

· Evaluate how effectively leaders address any issues involving ethical practice, diversity or inclusion.

· Evaluate health care leaders’ ability to manage and prioritize leadership responsibilities to resolve issues.

Note: The case studies in the text may not supply all of the information you may need. In such cases, you should consider a variety of possibilities and infer plausible conclusions.

Assignment Instructions

Complete the following steps:

1. Include a title page, abstract, and reference page.

o An APA Style Paper Tutorial [DOCX] and the associated APA Style Paper Template [DOCX] are linked in Resources to help you in writing and formatting your paper. Format your work per these documents.

2. Include on your cover page the titles of the case studies you have chosen. For example, your title could read: “Demonstrating Effective Leadership: Case 82 – When Yes Means No and Case 83 – Emergency Divert Status.”

o Include the case study in your references and use in-text citations when appropriate.

3. In the body of the paper, begin by briefly summarizing the facts surrounding the case studies. After you identify who the leaders are and the issues they are faced with, analyze the factors that you believe contributed to each issue.

o Note: In graduate level writing, you should minimize the use of direct quotes. Lengthy quotes do not count toward assignment minimums. It is your interpretation of the material and its application to practice that is assessed.

o Remember, the case studies may not supply all of the information you may need. In such cases, you should consider a variety of possibilities and infer plausible conclusions. However, please be sure to identify any speculations that you make as such.

o An excellent tool for analyzing factors that contribute to a problem is the Fishbone Diagram, linked in the Resources. Use of this tool is highly recommended, but it is optional, and you will not hand in your diagram with this assignment.

4. Compare and contrast the leadership approaches or styles these leaders use. Analyze how the approaches or styles make these leaders more or less effective in building interprofessional relationships across disciplines within the organization. Based on your analysis, determine how likely it will be that these leaders will be able to build and maintain such relationships with other communities and leaders outside their organization. Support your analysis with citations and appropriate APA references to peer-reviewed journals or scholarly sources.

5. Analyze how well these leaders communicate, verbally or in writing. Analyze the role of communication and communication strategies in both creating and resolving the issues presented in the case study.

6. Summarize and analyze how well the leaders managed professional responsibilities and priorities to resolve the issue in the case. What lessons could you take away from this case that could be applied by other leaders?

7. Summarize and evaluate how effectively the leaders addressed any issues involving ethical practice, diversity or inclusion in the case. What key lessons do these cases provide for leaders? Use examples to clarify and support your ideas.

Submission Requirements

Your paper should meet the following requirements:

· Written communication: Write coherently to support central ideas, in appropriate format, and with correct grammar, usage, and mechanics.

· Length of paper: 5–6 typed, double-spaced pages, not including the title page, abstract, and reference page.

· References: At least four different resources (peer-reviewed journals or other scholarly resource, assigned unit readings, and the like).

· APA formatting:

o Include a properly formatted title page, abstract, and reference page.

o An APA Style Paper Tutorial [DOCX] and the associated APA Style Paper Template [DOCX] are linked in Resources to help you in writing and formatting your paper. Format your work per these documents.

o Apply correct formatting to all in-text citations and references.

· Font and font size: Times New Roman, 12 point.

Research Critiques

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Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the Topic 1, 2, and 3 assignments and the guidelines below.

 

PICOT Statement 

Revise the PICOT statement you wrote in the Topic 1 assignment.

 

Research Critiques

In the Topic 2 and Topic 3 assignments you completed a qualitative and quantitative research critique. Use the feedback you received from your instructor on these assignments to finalize the critical analysis of the study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT statement.

Refer to “Research Critique Guidelines.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.

 

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT statement, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

Evaluation of Plan Effectiveness Criteria

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Evaluation of Plan Effectiveness Criteria

In the evaluation component of the Capstone project, you are expected to discuss how you would evaluate the effectiveness of the interventions.

Some questions you should seek answers to are:

  1. Would I be able to implement the interventions? If not, what barriers exist?
  2. What visible signs of success (for example, reduced health issues) would I look for? What is your projected effectiveness?

The evaluation component of the final paper should describe your evaluation of the implementation. Include responses to points 1 and 2 above. The evaluation component of the final Microsoft Word submission document should be a minimum of 2 pages.

The complete summary document should use the Mobilize, Assess, Plan, Implement, Track (MAP-IT) steps used in pulling together your project.

Over the past nine weeks, you selected an aggregate and conducted a risk assessment of its health, developed a care plan to address those health risks, and considered the effectiveness of the interventions on the health of the aggregate. It’s time now for you to present your final submission of this Capstone project.

Your final submission should include: the documentation of the work accomplished through your Capstone project, a Microsoft Word Document that contains the evaluation and summary, and a Microsoft PowerPoint presentation highlighting the main aspects of the project including the key things learned during the 10 weeks of working with this project.

The summary document should use the Mobilize, Assess, Plan, Implement, Track (MAP-IT) steps used in pulling together your project. The complete documentation of the work accomplished over the course of the project should contain a minimum of 6–7 pages in a Microsoft Word document and should include the following information:

  • A detailed description of the aggregate
  • A description of the aggregate’s strengths and weaknesses
  • A risk assessment of the aggregate
  • Diagnoses based on the risk assessment
  • A detailed care plan for the aggregate
  • Evaluation of Plan Effectiveness CriteriaA description of how at least one intervention might be implemented in the aggregate to address an identified issue
  • An evaluation of the effectiveness of the intervention

The Power Point presentation should be concise and should include the highlights of the Capstone project and the key things learned over the course of this project, from developing, planning interventions, and evaluating the care plan. Your presentation should not exceed 15 slides.

 

 

****The chosen aggregate is African Americans in Gadsden, Alabama (Etowah County)***

I will attach the previous assignments and the grading rubric for this

Thesis Statement 

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This week you will be writing an outline for your final paper. Your outline must include introduction, body, and conclusion sections and be in outline format.

Research Topic 

Is telehealthcare a good option for nursing homes?

Thesis Statement 

The benefits of telehealthcare outweigh its shortcoming, and it is thus wise to adopt it in the delivery of care with advancement in technologies.

In the introduction section of your outline, include the thesis statement you submitted for the Thesis Assignment, Your outline should stem directly from your revised thesis statement. You should also include topic sentences (for each section) and paragraph transitions that help tie your major points together.

you will need somewhere between 6-8 body paragraphs.

Helpful hints:

  • Your      outline should remain without bias. You must equally present the arguments      of both sides of the issue without revealing which side you agree with.
  • Your      outline must be written in third person.
  • Each      topic sentence should directly relate back to the thesis statement.
  • You      may use the outline template provided.
  • Remember      to use appropriate formatting as per APA (6th ed.): https://owl.english.purdue.edu/owl/resource/560/0

Template

Expository Essay Outline Template

When you write an expository essay that presents two sides of an issue without revealing bias, there are three primary organizational tactics that can be used:

1. Present all the major arguments on one side of the issue, and then present all the major arguments of the opposing viewpoint.

2. Present one of the major issues relating to the overarching topic, and in the same paragraph, discuss the viewpoints of both sides on this particular issue.

3.  In one paragraph, present one of the viewpoints on one major aspect of the controversy, and then follow that paragraph with another paragraph presenting the opposing views’ arguments related to the same aspect of the controversy. You then repeat that pattern one to three more times.

Carefully consider these options, choose one, and continue with this organizational strategy for your entire essay.

You may use the below outline template:

I. Introduction

a. Hook:________________________________________________________

b. Thesis statement:_______________________________________________

II. Body Paragraph 1

a. Transition:_____________________________________________________

b. Topic Sentence:_________________________________________________

i. Supporting detail 1:________________________________________

ii. Supporting detail 2:________________________________________

iii. Supporting detail 3:________________________________________

III. Body Paragraph 2

a. Transition:_____________________________________________________

b. Topic Sentence:_________________________________________________

i. Supporting detail 1:________________________________________

ii. Supporting detail 2:________________________________________

iii. Supporting detail 3:________________________________________

IV. Body Paragraph 3

a. Transition:_____________________________________________________

b. Topic Sentence:_________________________________________________

i. Supporting detail 1:________________________________________

ii. Supporting detail 2:________________________________________

iii. Supporting detail 3:________________________________________

V. Body Paragraph 4

a. Transition:_____________________________________________________

b. Topic Sentence:_________________________________________________

i. Supporting detail 1:________________________________________

ii. Supporting detail 2:________________________________________

iii. Supporting detail 3:________________________________________

VI. Conclusion

a. Transition:_____________________________________________________

b. Restatement of thesis:____________________________________________

Primary Prevention/Health Promotion

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Note: This is an individual assignment. Applying what you have learned thus far, develop a community teaching proposal designed to address the needs of your community.

Select one of the following as the focus for the teaching plan:

  1. Primary Prevention/Health Promotion
  2. Secondary Prevention/Screenings for a Vulnerable Population
  3. Bioterrorism/Disaster
  4. Environmental Issues

Complete the “Community Teaching Work Plan Proposal.” This will help you organize your plan and create an outline for the written assignment.

  1. After completing the teaching proposal, review the teaching plan with a community health and public health provider in your local community.
  2. Request feedback (strengths and opportunities for improvement) from the provider.
  3. Complete the “Community Teaching Experience” form.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin.