Essay on Time Value Of Money - 1655 Words

Time Value of Money Time Value of Money To make itself as valuable as possible to stock holders; an enterprise must choose the best combination of decisions on investment, financing and dividends. In any economy in which firms have the time preference, the time value of money is an important concept. Stockholders will pay more for an investment that promises returns over years 1 to 5 than they will pay for an investment that promises identical returns for years 6 through 10. Essentially one must determine if future benefits are sufficiently large to justify current outlays. The development of mathematical tools of the time value of money is important as the first step towards making capital allocating decisions (Malawi, 2008).†¦show more content†¦Compounding is the arithmetic process of determining the final value of a cash flow or series of cash flows when compound interest is applied (Malawi, 2008). The following are the variables used in the mathematical modeling of time value of money: FV = Future value PV = Present value A = Annuity Value i = Interest rate n = Number of periods As an example, what is better, investing a $100 per month or investing $1200 once a year for the next 20 years at an interest rate of 5%? Using the future value of annuity relationship, FVa = A *[ ], one finds that saving on a monthly basis gains us ($41,009-$39,679) $1,330.0 after 20 years. Table 1, Example of annuity earnings for $1,000.0 (Block Hirt, ch9 p242) Even better would be to invest the whole amount up front as an asset with interest compounded annually: = Original Investment x (1+interest rate)^number of years (Investopedia ULC, 2008) and let it set for 20 years as demonstrated in table 2. Where: FV = PV (1 + i)n i = interest rate = 5% = 0.05 n = number of years = number of periods = 20. PV = $24,000 Table 2, $24,000 compounded over a 20 year period. First Year $24000.00 x 1.05 = $25200.00 Second Year $25200.00 x 1.05 = $26460.00 Third Year $26460.00 xShow MoreRelatedTime Value of Money1028 Words   |  5 Pagestoward understanding the relationship between the value of dollars today and that of dollars in the future is by looking at how funds invested will grow over time. This understanding will allow one to answer such questions as; how much should be invested today to produce a specified future sum of money? Time Value of Money In most cases, borrowing money is not free, unless it is a fiver for lunch from a friend. Interest is the cost of borrowing money. An interest rate is the cost stated as a percentRead MoreTime Value of Money1033 Words   |  5 PagesTime Value of Money (TVM), developed by Leonardo Fibonacci in 1202, is an important concept in financial management. It can be used to compare investment alternatives and to solve problems involving loans, mortgages, leases, savings, and annuities. TVM is based on the concept that a dollar today is worth more than a dollar in the future. That is mainly because money held today can be invested and earn interest. A key concept of TVM is that a single sum of money or a series of equal,Read MoreTime Value of Money967 Words   |  4 PagesTime Value of Money The time value of money relates to many activities and decision in the financial world. â€Å"Understanding the effective rate on a business loan, the mortgage payment in a real estate transaction, or the true return on an investment depends on understanding the time value of money† (Block, Hirt, 2005). The concept of time value of money helps determine how financial assets are valued and how investors establish the rates of return they demand. Many different types of companiesRead MoreTime Value of Money2180 Words   |  9 PagesFinance Ââ€" Time Value of Money We earn money to spend it and we save money to spend it in the future. However, for most people spending money in the present time is more desirable since the future is unknown. We can gratify the desire to spend money today rather than in the future by knowing the basic law in finance Ââ€" time value of money. This means that a dollar today is worth more than a dollar at some time in the future. Unfortunately, people very often want to buy things at the present time whichRead MoreTime Value of Money3904 Words   |  16 PagesTime Value of Money Problems 1. What will a deposit of $4,500 at 10% compounded semiannually be worth if left in the bank for six years? a. $8,020.22 b. $7,959.55 c. $8,081.55 d. $8,181.55 2. What will a deposit of $4,500 at 7% annual interest be worth if left in the bank for nine years? a. $8,273.25 b. $8,385.78 c. $8,279.23 d. $7,723.25 3. What will a deposit of $4,500 at 12% compounded monthly be worth at the end of 10 years? a. $14,351.80 b. $14,851.80 c. $13,997.40 d. $14Read MoreTime Value of Money5284 Words   |  22 Pages12/9/2012 Chapter 9 The Time Value of Money 1 Chapter 9- Learning Objectives ïÆ' ¼ Identify various types of cash flow patterns (streams) that are observed in business. ïÆ' ¼ Compute (a) the future values and (b) the present values of different cash flow streams, and explain the results. ïÆ' ¼ Compute (a) the return (interest rate) on an investment (loan) and (b) how long it takes to reach a financial goal. ïÆ' ¼ Explain the difference between the Annual Percentage Rate (APR) and the Effective Annual RateRead MoreTime Value of Money2092 Words   |  9 PagesTime Value of Money The time value of money (TVM) or, discounted present value, is one of the basic concepts of finance and was developed by Leonardo Fibonacci in 1202. The time value of money (TVM) is based on the premise that one will prefer to receive a certain amount of money today than the same amount in the future, all else equal. As a result, when one deposits money in a bank account, one demands (and earns) interest. Money received today is more valuable than money received in the futureRead MoreTime Value of Money2124 Words   |  9 PagesTime Value of Money: Simple Interest versus Compound Interest Outline I. Applications of Time Value of Money 1.1 Example One 1.2 Example Two 2. Interest 2.1 What is Interest? 2.2 Three Variables of Interest 1. Principal 2. Interest Rate 3. Time 2.3 Why is Interest Charged? 3. Simple Interest 3.1 What is Simple Interest? 3.2 Simple Interest Formula 4. Compound Interest 4.1 What is Compound Interest? 4.2 Compound Interest Formula Read MoreTime Value of Money712 Words   |  3 Pageswill pay the bank over the life of the loan? $123,945.04 4. What is the effective rate of interest on a CD that has a nominal rate of 7.25 percent with interest compounded monthly? EAR = (1+.0725/12)^12 – 1 = 7.5% 5. What is the future value of $4,950 placed in a saving account for six years if the account pays 3%, compounded quarterly? PV = 4,950 N = 6 x 4 = 24 I =3/4 = .75% Pmt = - FV = $5,922.24 6. Your firm, Vandelay Industries, has just leased a $32,000 BMW for youRead MoreTime Value of Money and Present Value1154 Words   |  5 Pagescollege 15 years from today and the other will begin 17 years from today. You estimate your children’s college expenses to be $23,000 per year per child, payable at the beginning of each school year. The annual interest rate is 5.5 percent. How much money must you deposit in account each year to fund your children’s education? Your deposits begin one year from today. You will make your last deposit when your oldest child enters college. Assume four years of college Solution: Cost of 1 year at

Nursing Care of Epilepsy

Question: Writing an essay about the nursing care of a client? Answer: Epilepsy can be defined as a neurological disorder characterized by recurrent unprovoked seizures ( Blume et al, 2001) due to abnormal, excessive or synchronous neuronal activity in the brain (Fisher et al, 2005). The electrical impulses when transmitted to the muscles causes twitching and convulsions. Seizure is an event where there is sudden, excessive and abnormal discharge of electrons in the brain which is accompanied by alteration in sensory and motor functions and level of consciousness. Epilepsy is a serious neurological condition that affects 1-2% of the population. Moreover, one in twenty children have seizures at any time during childhood and adolescence. Epilepsy becomes more common after the age of 50 years. It can be concluded that the cumulative incidence of epilepsy is 3-5% (Govt. Western Australia, 2008) Main causes of epilepsy are: Head injury during birth or in any accident in adult life Low oxygen during birth Infections like encephalitis or meningitis Stroke or any injury to brain Brain tumors Abnormal level of some substances like blood sugar and sodium. However, in 70% of cases of epilepsy the cause cannot be identified. But some triggers for seizures are known, avoiding which will help the patient lead a better life. Missing medication Heavy alcohol Drug use like cocaine Lack of sleep Some drugs interfere with medication Sign and symptoms of epilepsy seizures depend on which part of the brain is affected, according to which it is divided into three types 1. Generalized seizure : All areas of the brain are involved. The patient may cry or make sounds, the body becomes stiff for few seconds to a minute followed by rhythmic movements of arms and legs. Eyes of the patient are generally open and it appears that he is not breathing and turns blue and makes noisy breathing sounds. When the patient regains consciousness gradually he remains confused for some minutes or hours.2. Partial or focal seizures : In this type, only some area of the brain is involved and depending on the area involved the symptoms differ. For example, if area controlling hands is involved there will be jerky movements of the hands, other areas involved may have symptoms like some repetitive actions e.g. smacking of lips, picking ones clothes. Sometimes the patient may become confused.3. Absence or petit mal seizures : It is more common in children, characterized by impairment of consciousness, child staring blankly, some repetitive movements like repeatedly blinking the eyes. These seizures usually last for few seconds and can occur many times in a day. Impact of seizures on the client: Epilepsy affects the quality of life of the people who suffer with this condition. The impact it has is much more than the injury the seizures itself causes. Seizures produces medical injury or injury from unfavorable and unpredictable interaction with the environment. Patients can fall, fracture bones or strike on head. Burns are also common in epilepsy. A patient holding cigarette at start of seizure may burn his arms or legs without being aware of it. In the kitchen, hot objects can be dangerous. Injuries can occur if patient is driving, climbing ladder or while using power tools. Patients can drown while swimming or bathing. Aspiration and hypoxia are the major complications though aspiration pneumonia is more often in hospitalized patients who are intubated after having seizures. The main cardiac complication is arrhythmias. Every year, 0.2% people with poorly controlled epilepsy die suddenly. Patients who did not undergo surgery for epilepsy and continued to have seizures have slow memory loss. Patients with repeated temporal seizures may cause a change in personality called `Geschwind syndrome. Seizures at work are distressing for the co-workers and the patient feels dismissed and is usually moved to a remote office and isolated. Seizure make schooling difficult due to decreased cognitive abilities, child feels isolated, he cannot participate in sports activities and examination cause stress and sleep deprivation which increase the tendency to seizures ( Blum,D, 1999). Social stigma impact: There has always been a social stigma and prejudices among people about patients suffering from seizures. Some believed that they were possessed by devil spirits. They were subjected to forceful sterilization and prohibiting marriage. When a person is diagnosed with seizure, he is immediately prohibited from driving though alcoholics are allowed to drive who are involved in accidents or injuries (Blum,D, 1999). Impact on quality of life: Earlier the sole emphasis of the treatment was the control of the seizures but recently in the last 5 to 10 years, the attention has been increased to improve the quality of life of people. The quality of life of patient is not good. He cannot perform daily action like driving, sports, memory loss, school difficulties, depression, social isolation and unwanted pregnancy (Blum,D, 1999). Impact on finance: The cost of treatment of epilepsy which includes cost of treatment during and after the seizures, outpatient visits, diagnostic tests like MRI, EEG, medication, lab test, blood tests and blood chemistry. Some of these costs may be covered by healthcare systems but costs to patients like missed work days, unemployment or underemployment (Blum,D, 1999). Impact of medication: The medication have as much impact as the seizures itself. Medication causes changes in cognitive function on a daily basis, it causes the patient to feel sedated and makes them feel that their thinking is foggy. Some medication causes depression, metal blunting, irritability and suicidal tendency. Some medication for epilepsy interfere with birth control medication resulting in unplanned pregnancy (Blum,D, 1999). Complexity Of Care Provision The physician, assistant and epilepsy nurse are involved in the primary care of an epileptic patient. The role of epileptic nurse treating epileptic patients is very useful in assessing the symptoms, diagnosis, tests and risk management (Ridsdale et al, 2002). Epilepsy nurse is an important part of the epilepsy care team. They play a pivotal role providing coordinated care and education to patients with complex uncontrolled epilepsy. Primary care physician are the first level of care who deal with epileptic patients of all types. However, most of the PCPs have very brief formal training in neurology. They receive minimal formal training for its management. Due to increasing work load and reduced time for each patient, it becomes difficult for the PCP to educate and counsel the patient and cover all the issues associated with the condition. The PCPs make the initial diagnosis, begins the treatment and adjust drug doses. Neurologist specializes in dealing with epileptic patient. He is able to diagnose the specific type of epilepsy and use specific approach to treat the patients condition. The neurologist advises neuroimaging tests. However, community based neuroimaging that is available to most neurologists is inadequate to diagnose mesial temporal sclerosis and are referred to tertiary centre for neuroimaging. General neurologists are not trained to differentiate seizures from pseudo-seizures and patients with uncontrolled seizures or patients who have suspicious events; these patients are referred to EEG-video telemetry. Moreover, it has been noticed that most of the patients with epilepsy do not reach tertiary canters until they have had uncontrolled seizures for 10-20 years. By this time, the patients has suffered huge social damage and insurance companies only pay for direct costs and do not pay indirect costs and noneconomic costs. Most of the patients do not continue with a single insurer for long enough time to cover the cost of epilepsy surgery and later many insurers are reluctant to allow patient access to tertiary care. Nursing care plan for Jessica: The nursing care plan for Jessica is prioritized based on the more serious and complicated health condition at hand. It is prioritized as: Compliance of medication for epilepsy Prohibit her to drive especially for long hours. To educate her about the trigger which can lead to another seizure. Compliance of medication for diabetes Weight control Diet counselling and regular exercise Lifestyle changes which include adequate rest, adequate sleep, avoiding alcohol. On the initial visit, assess the originator of seizure in the patient. Rational: medication, lack of sleep, alcohol enhance brain activity which increase the risk of seizure.^8 Supervision of the activities after the seizure Rational: Improving patient safety.^8 Assess the patients feeling regarding the treatment received and self perception of the treatment performed on the patient Rational: To judge the acceptance of clients medical treatment.^8 Assess the patients level of knowledge of the severity of the illness and co-occuring uncontrolled diabetic condition. Rational: To know the extent of clients knowledge of her condition and to assess if the patient will be cooperative towards the treatment and precautions advised.^8 Explain again the pathophysiology of the disease, its severity, prognosis, treatment and management Rational: To provide an opportunity to the client to clarify any misconception and the state of the illness.^8 Review the medication, dosage, instructions and reason for discontinuation and non-compliance of the medication as instructed by the doctor. Rational: It will further assist in understanding the clients health condition.^8 Discuss the benefits of good general health like adequate diet and appropriate weight for her height especially with regards to diabetes, adequate rest, regular exercise, lifestyle changes, avoidance of food and beverages containing harmful substances especially which may trigger seizures. Rational: To educate the client about healthy food habits, reduction of weight and regular exercise.^8 To educate the patient about the increased risk of seizures with uncontrolled diabetes due to hyperglycemia in Type 2 diabetes. Rational: To educate the patient about the severity and correlation of his co-existing conditions.^8 Educate client about driving and using power tools Rational: Improving patient safety Improving the life of people suffering with epilepsy and their families requires sustained and coordinated efforts which address the psychological, physiological, cognitive and social dimensions. There are several other forms of therapies which are used to improve the quality of life of the patient like behaviourial therapy which involves strategies to help people manage their epilepsy and its effects in daily life. Conclusion To improve the quality of care for patients suffering with epilepsy, coordinated and sustained efforts are required on few areas like 1. Early identification of epilepsy and other simultaneously occurring medical conditions.2. Improving treatment for seizures which includes improving seizure medications, ensuring appropriate use of medication and compare effectiveness of different medications. Improving treatment for refractory epilepsies3. Improving communication between healthcare providers and patients.4. Developing a national strategy for performance measurement and quality improvement in epilepsy care: Improving practice guidelines and performance metrics5. Evaluating and accrediting epilepsy centre (England,M Liverman,C Schultz,A Strawbridge,L, 2012).. References 1. Government of Western Australia Department of health, Neurosciences and the senses health network2. Blum,D 1999, Total impact of epilepsy: biological, psychological, social and economic aspects, Barrow quarterly, Vol 15 No 13. Health care: Quality, access and care, Epilepsy across the spectrum: promoting health and understanding, National academic press4. Gumnit,R 2010, Caring for patient with seizures: a 21st century approach, Clinical and health affairs, Minnesota medicine5. Nursing management of seizures, 2006, SCDDSN revision6. Knight,M 2014, Management of epilepsy in primary care and the community7. American society of registered nurses, 2008, Epilepsy nurse care, The journal of nursing8. Epilepsy- 3 Nursing Diagnosis and intervention, reviewed from https://nursing-care-plan.blogspot.in/2014/01/epilepsy-3-nursing-diagnosis-and.html9. Epilepsy Nursing management, Nursing diagnosis, goals, interventions, patient education, NSGMED Nursing journal and articles, 2014, reviewed fr om https://www.nsgmed.com/neuro/epilepsy-nursing-assessment-nursing-diagnosis-goal-interventions-patient-education/10. England,M Liverman,C Schultz,A Strawbridge,L, 2012, Epilepsy across the spectrum:Promoting health and understanding. A summary of the institute of medicine report, Epilepsy and behaviour11. Epilepsy and Nursing care plan, 2011, reviewed from https://www.nursing-help.com/2011/04/epilepsy-and-nursing-care-plan.html12. Epilepsy, reviewed from https://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Epilepsy13. Brennan,M Whitehouse, F,2012, Case study: Seizures and hypoglycemia, American diabetes association, reviewed from https://clinical.diabetesjournals.org/content/30/1/23.full14 Epilepsy in adults, reviewed from https://www.patient.co.uk/doctor/epilepsy-in-adults