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Mr. JD is a 24-year-old who presents to Urgent Care with a 2-week history of cough and congestion. He says it started out as a “normal cold” and it will not go away. He has a productive cough for green mucous and has green nasal discharge. He says he has had a low-grade temperature for the past 2 days. John reports an intermittent frontal headache with this cold. He is otherwise healthy, with no known allergies.
In his assessment it is found that his vital signs are stable, temperature is 99.9 degrees F, tympanic membranes (TMs) are clear bilaterally, pharynx is erythematous with no exudate; there is greenish postnasal drainage; turbinates are swollen and red; frontal sinus tenderness; no cervical adenopathy, and lungs are clear bilaterally.

Is there any additional subjective or objective information you need for this client? Explain.

In addition to what we have been told there are several things that may be identified. On first glance it would be important to assess the patients skin color, assess if they were sweating or were cold. It would be necessary to ask about allergies and see if he has been exposed to any possible allergens or irritants. It would need to be determined if this was the first time this has happened or has been a common occurrence. Assessing any recent traumatic injuries, headaches, or nose bleeds may help the clinician determine the root cause of the problem. Family history, patients past medical history, social history, and any current medications is a definite must. His vitals are stable besides the climb in temperature, so you could ask how he was sleeping and if he was getting enough fluid intake.

Would you treat Mr. JDs cold? Why or why not?

I would definitely treat JD’s symptoms. He has been down and out for two weeks and his condition is not getting any better. His temperature is increasing, and he is symptomatic with tender mucous membranes, post nasal drip, and erythema. These are signs of an infection that should be treated. Not only is he at risk for getting worse but he could potentially expose others to his current illness. Clinical diagnosis of acute bacterial sinusitis requires prolonged, nonspecific upper respiratory signs such as rhinosinusitis and cough without improvement for more than 10 days, and symptoms such as fever, facial swelling, or facial pain (Woo & Robinson, 2016).

What would you prescribe and for how many days? Include the class of the medication, mechanism of action, route, the half-life; how it is metabolized in and eliminated from the body; and contraindications and black box warnings.

Many times, antibiotics are prescribed too quickly and often times will not be effective if it is a viral infection. Based on the assessment findings and the little we know about the patient; the patient could have possible sinusitis. The first-line treatment for sinusitis in adults is amoxicillin/clavulanate (875 mg amoxicillin/125 mg clavulanate) for 5 to 7 days (Woo & Robinson, 2016). This medication has a half-life of 1-1.3 hours, is metabolized by the liver and eliminated in the urine. It usually takes 30 minutes to be effective and peaks in 1-2 hours. This medication is an oral antibacterial combination that consist of the semisynthetic antibiotic amoxicillin and the β-lactamase inhibitor (FDA, n.d.). This bactericidal hinders bacterial growth by inhibiting the biosynthesis of bacterial cell wall mucopeptide (Woo & Robinson, 2016). For JD, it would be necessary to check a comprehensive metabolic panel to assess liver and kidney function. There is not a black box warning and usually does not have any side effects other than a possible rash. It is usually safe during pregnancy however before prescribing it would be necessary to assess allergies and inform the patient about potential side effects like a rash.

Would this treatment vary if Mr. JD was a 10 year-old 78 lb child? Include the class of the medication, mechanism of action, dosing, route, the half-life; how it is metabolized in and eliminated from the body; and contraindications and black box warnings

Amoxicillin is first-line therapy for sinusitis in children (Woo & Robinson, 2016). If the child has not recently been on antibiotics, they should be on a dose of 25-50mg/kg/d in divided doses. This bactericidal medication is an aminopenicillin that is taken orally, has a half-life of 1.3hrs, is metabolized in the liver and excreted in the urine, and works by inhibiting the bacterial cell wall mucopeptide (Woo & Robinson, 2016). As stated before, it does not have any black box warnings and patients kidney and liver functioning is a concern before use.

What health maintenance or preventive education is important for this client based on your choice medication/treatment?

I would instruct this patient to take the medication until it is gone; not stop it early. In addition, if they failure to respond within 3 to 5 days he should prompt notify his PCP and a change in therapy should be considered (Woo & Robinson, 2016). I would instruct the patient to get plenty of sleep, increase fluid intake, and take a probiotic once they are done with their regimen. Antibiotics have been known to kill of not only the bad bacteria in the gut but the good as well. Preventing side effects like diarrhea should be taken prophylactically. They should be taken on an empty stomach, 1 hour before a meal or 2 hours after meals (Woo & Robinson, 2016). For additional resources, I would tell the patient the pharmacist is a great tool for resource if they had questions when they picked up the medication but to always call the PCP for further questioning.

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July 1, 2023

Write a sample cover letter that highlights why you would be ideal for a marketing position at a Company of your pick in Florida . In the cover letter, you need to mention the position and discuss the tasks that would be required of you in that position. You can address the cover letter to either a real or fabricated person/organization. Do not address it to “To Whom It May Concern” or “Dear Sir/Madam” or anything else-generic.

Cover Letter Content: • Includes your contact information, date, salutation/greeting (with hiring manager’s full name, title, company, address), body, closing, signature - i.e., major components of a cover letter. • Components are organized logically and overall the letter is attractive. • Letter is concise. • Audience is clear; addressed to real or fabricated person/organization. • Identifies specific position and why you would be ideal for it. Discusses tasks required for that position and knowledge of potential employer. • Discusses your relevant skills, experience, etc. that will make you ideal for the position. • Includes request for interview or meeting with specific manner of follow-up/reverse call to action, note of appreciation, and mentions resume in closing.

BELLOW IS A PART OF MY RESUME TO HELP WRITE THE COVER LETTER.

Summary

Motivated sales driven rental manager focused on attaining a motivated and competitive work environment along with dynamic operating conditions. Customer service oriented and methodical with strengths in accounts maintenance.

Skills

· Key accounts and territory management

· Capital improvement planning

· Systems and automation applications

· Brand management

Experience

Enterprise Holdings | Miami, FL

Assistant Branch Rental Manager

11/2019 – 11/2020

· Remained calm and professional in stressful circumstances and when dealing with unhappy customers, effectively diffusing situations.

· Met with each associate to establish realistic monthly sales goals.

· Strengthened product branding initiatives and coordinated effective marketing campaigns.

· Reviewed employee performance every week and delivered constructive feedback to improve weaknesses.

· Upheld internal standards and productivity goals to meet sales and growth targets.

· Identified growth areas requiring immediate improvement and rolled out marketing program, boosting branch's fleet 16%.

· Executed non-negotiable strategies to foster better customer service and promote positive and engaging environment for all.

· Drove profit increases by leveraging market knowledge and natural leadership talents.

Enterprise Holdings | Miami, FL

Management Trainee

05/2019 - 11/2019

· Ranked 1st place on the sales performance ranking for 4 consecutive months with a total additional revenue of $160,000.

· Achieved a 4-month Customer Service score of 87%, 3 points above corporate average.

· Ran daily sales reports to assess performance and make proactive adjustments.

Equinox | Miami, FL

Sales Associate

10/2017 - 06/2018

· Arranged special accommodations for guests to maintain optimal satisfaction

· Managed all front desk operations for busy high-volume Health Club.

· Confirmed transactional data by verifying name and payment information and clearly communicating costs and fees to patrons.

· Participated Management Assistance, handling member's accounts and payments.

· Supported Membership Advising participating in more than 100 memberships sold.