Activity #3: Combination

Chapter One: Management Today The challenges of working in the new economy recognize: 1.1 Working Today Talent Talented people- What they know, what they learn and what they can achive The source of organisational performance Develop skills and improve What is intellectual capital The combined brain power and shared knowledge of an organization's employees TO orginzations: Intellectual capital resents a strategic asset as human creativity, insight and decision making can be converted into superior performance To individuals: Intellectual capital is a personal asset, one to be nurtured and continually updated Things evolve, make sure we keep updated Intellectual capital: The package on intellect skills and capabilities that set us apart making us valable to potential employers Maintaining your talent: There is no escaping the fact that your career success will require a lot of initiative, self awareness and continuous learning Technology Tech is in our everyday lives Latest developments Smart phone, smart apparel, smart cars, smart homes We struggle to keep up with social media ana staying connected with messaging, full of email and voicemail What happenings as younger workers advance into management Flexibility Work ethic It is critical to build and maintain a high Tech IQ! What is Tech IQ: The ability to use current technologies at work and in your personal life, combined with the commitment to keep yourself updated as technology continues to evolve Intellectual capi5la is a combination of: Commitment x Competency = Intellectual capital How to make the world a better place Globalisation The worldwide interdependence of resources flows, product markets and business competition Under the influence, government leaders worry and about the competitiveness of nations just as corporate leaders worry about business competitiveness Emerging markets will power global growth over the next 20 years. By 2025 overall global consumption is forecast to reach $62 trillion, twice its 2013 level and fully half of this increase will come from the emerging world Consequence: Going to fast in uses resources, inflation, corporate greed It's cheaper to have things made in different countries (wages are low and going down) Shamrock organization 1 leaf - full time employees- standard career paths 2 leaf - “freelancers” 3 leaf - Part times without benefits (first to lose their jobs when employers face economic difficulties) The rising of emerging markets Now account for 60% of all low and medium technology manufacturing worldwide Total value add in high tech manufacturing from a low 26% in the 1970s to 48% at present China strategy to upgrade its industries and move the manufacturing value ching by prioritising 10 sectors Information technology, robotic, aerospace, maritime equipment, modern railway equipment, alternative energy vehicles, power equipment, agriculture equipment, advanced materials, biopharma and medical products Ethics A code of moral principa;s that sets standards for conduct that is “good” and “right” as well as “bad” and “wrong” Enron company huge corruption even in elections same thing happened with The Mechanism 1.2 - Organizations Organizational Purpose An orgnizations is a collection of people working together to achieve a common purpose Unique social phenomenon that enables its members to perform tasks far beyond the reach of individual accomplishment (synergy) The broad purpose of any orginzation is to provide goods or services of value to customers and clients A clear sense of purpose tied to: Quality of products and services Customer satisfaction Social responsibility Can be an important source of organisational strength and performance advantage All organisations are open systems (Systems that interact with its environment for renewal and growth) Organizations as systems All organizations are open systems that interact with their environment Continual process of obtaining resource inputs-people, information, resources and capital- and transforming them into outputs in the form of finished goods and services for customers One simple way to assess the impact of any organisation is to ask the question: How is the world different because it existed Value Creation: Organisations create value when they use resources well to produce good products and take care of their customers One simple way to assess the impact of any organization is to ask the questions: How is the world different because it existed? The 3 Ps of organizational performance Profit - is the decision economically sound? People - Does the decision treat people with respect and dignity? Planet - Is the decision good for the environment? Productivity: An overall measure of the quantity and quality of work performance with recourse utilisation taken into account Performance effectiveness: An output measure of task or goal accomplishment Performance efficiency: An input measure of the resource costs associated with goal accomplishment. Workplace changes that impact management Focus on valuing human capital Demise of “Command and control” Emphasis on teamwork Pre-eminence of technology New workforce expectations Importance of networking Concern for sustainability 1.3 Managers Importance of human resources and manger People are not ‘costs to be controlled’ High performing organizations treat people as valuable strategic assets Three takeaways 1. Give leaders broad authority 2. Encourage them to think like CEO 3. Challenge strong performers ealy with big opportunities Direct support, supervise and help activate the work efforts of others The people who managers help are the ones whose contributions represent the real work of the organisation Types of managers Line managers are responsible for work activities that directly affect organization’s output Staff managers use technical expertise to advise and support the efforts of line workers Functional managers are responsible for a single area of activity Quality of work life (QWL) An indicator of the overall quality of human experiences in the workplace QWL Indicators Respect Fair pay Safe working conditions Opportunities to learn and use new skills Room to grow and progress in a career Protection of individuals rights The organization as an upside-down pyramid A manager’s job is to support worker’s efforts The best managers are known for helping and supporting Customers at the top served by worker who are supported by managers 1.4 The management Process Managers achieve high performance for their organizations by best utilizing its humans and material resources Management is the process of planning, organizing, leading and controlling the use of resources to accomplish performance goals All managers are responsible for the four functions The functions are carried on continually Characteristics of managerial work Long hours Intense pace Fragmented and varied tasks Many communication media Filled with interpersonal relationships Managerial agendas and networks Agenda setting Develops action priorities for accomplishing goals and plans Networking Process of building and maintaining positive relationships with people who can help advance agendas Social Capital Capacity to attract support and help from others Learning The change in a behaviour that results from experience Lifelong learning The process of continuously learning from daily experiences and opportunities

The challenges of working in the new economy recognize: 1.1 Working Today Talent Talented people- What they know, what they learn and what they can achive The source of organisational performance Develop skills and improve What is intellectual capital The combined brain power and shared knowledge of an organization's employees TO orginzations: Intellectual capital resents a strategic asset as human creativity, insight and decision making can be converted into superior performance To individuals: Intellectual capital is a personal asset, one to be nurtured and continually updated Things evolve, make sure we keep updated Intellectual capital: The package on intellect skills and capabilities that set us apart making us valable to potential employers Maintaining your talent: There is no escaping the fact that your career success will require a lot of initiative, self awareness and continuous learning Technology Tech is in our everyday lives Latest developments Smart phone, smart apparel, smart cars, smart homes We struggle to keep up with social media ana staying connected with messaging, full of email and voicemail What happenings as younger workers advance into management Flexibility Work ethic It is critical to build and maintain a high Tech IQ! What is Tech IQ: The ability to use current technologies at work and in your personal life, combined with the commitment to keep yourself updated as technology continues to evolve Intellectual capi5la is a combination of: Commitment x Competency = Intellectual capital How to make the world a better place Globalisation The worldwide interdependence of resources flows, product markets and business competition Under the influence, government leaders worry and about the competitiveness of nations just as corporate leaders worry about business competitiveness Emerging markets will power global growth over the next 20 years. By 2025 overall global consumption is forecast to reach $62 trillion, twice its 2013 level and fully half of this increase will come from the emerging world Consequence: Going to fast in uses resources, inflation, corporate greed It's cheaper to have things made in different countries (wages are low and going down) Shamrock organization 1 leaf - full time employees- standard career paths 2 leaf - “freelancers” 3 leaf - Part times without benefits (first to lose their jobs when employers face economic difficulties) The rising of emerging markets Now account for 60% of all low and medium technology manufacturing worldwide Total value add in high tech manufacturing from a low 26% in the 1970s to 48% at present China strategy to upgrade its industries and move the manufacturing value ching by prioritising 10 sectors Information technology, robotic, aerospace, maritime equipment, modern railway equipment, alternative energy vehicles, power equipment, agriculture equipment, advanced materials, biopharma and medical products Ethics A code of moral principa;s that sets standards for conduct that is “good” and “right” as well as “bad” and “wrong” Enron company huge corruption even in elections same thing happened with The Mechanism 1.2 - Organizations Organizational Purpose An orgnizations is a collection of people working together to achieve a common purpose Unique social phenomenon that enables its members to perform tasks far beyond the reach of individual accomplishment (synergy) The broad purpose of any orginzation is to provide goods or services of value to customers and clients A clear sense of purpose tied to: Quality of products and services Customer satisfaction Social responsibility Can be an important source of organisational strength and performance advantage All organisations are open systems (Systems that interact with its environment for renewal and growth) Organizations as systems All organizations are open systems that interact with their environment Continual process of obtaining resource inputs-people, information, resources and capital- and transforming them into outputs in the form of finished goods and services for customers One simple way to assess the impact of any organisation is to ask the question: How is the world different because it existed Michal Porter - Value Chain Value Creation: Organisations create value when they use resources well to produce good products and take care of their customers One simple way to assess the impact of any organization is to ask the questions: How is the world different because it existed? Triple Bottom Line The 3 Ps of organizational performance Profit - is the decision economically sound? People - Does the decision treat people with respect and dignity? Planet - Is the decision good for the environment? Organizational Performance Productivity: An overall measure of the quantity and quality of work performance with recourse utilisation taken into account Performance effectiveness: An output measure of task or goal accomplishment Performance efficiency: An input measure of the resource costs associated with goal accomplishment. Workplace changes that impact management Focus on valuing human capital Demise of “Command and control” Emphasis on teamwork Pre-eminence of technology New workforce expectations Importance of networking Concern for sustainability 1.3 Managers Importance of human resources and manger People are not ‘costs to be controlled’ High performing organizations treat people as valuable strategic assets Three takeaways 1. Give leaders broad authority 2. Encourage them to think like CEO 3. Challenge strong performers easily with big opportunities Direct support, supervise and help activate the work efforts of others The people who managers help are the ones whose contributions represent the real work of the organisation Levels of management Types of managers Line managers are responsible for work activities that directly affect organization’s output Staff managers use technical expertise to advise and support the efforts of line workers Functional managers are responsible for a single area of activity Quality of work life (QWL) An indicator of the overall quality of human experiences in the workplace QWL Indicators Respect Fair pay Safe working conditions Opportunities to learn and use new skills Room to grow and progress in a career Protection of individuals rights The organization as an upside-down pyramid A manager’s job is to support worker’s efforts The best managers are known for helping and supporting Customers at the top served by worker who are supported by managers 1.4 The management Process Managers achieve high performance for their organizations by best utilizing its humans and material resources Management is the process of planning, organizing, leading and controlling the use of resources to accomplish performance goals All managers are responsible for the four functions The functions are carried on continually Four functions: Planning,organizing, leading and controlling Mintzberg’s 10 Managerial Roles Characteristics of managerial work Long hours Intense pace Fragmented and varied tasks Many communication media Filled with interpersonal relationships Managerial agendas and networks Agenda setting Develops action priorities for accomplishing goals and plans Networking Process of building and maintaining positive relationships with people who can help advance agendas Social Capital Capacity to attract support and help from others Learning The change in a behaviour that results from experience Lifelong learning The process of continuously learning from daily experiences and opportunities Katz’ Essential Managerial Skills

Chapter 22 Antihypertensive Drugs Hypertension Defined (JNC-8) Pharmacology Overview 7 main categories of drugs to treat HTN Adrenergic drugs (old friend) Angiotensin-converting enzyme (ACE) inhibitors Angiotensin II receptor blockers (ARBs) Calcium channel blockers (CCBs) Diuretics Vasodilators Direct renin inhibitors A. Adrenergic Drugs: 5 Subcategories and where they act A1. Adrenergic neuron blockers (central and peripheral)- we won’t talk about this A2. Alpha1 receptor blockers (peripheral) A3. Alpha2 receptor agonists (central) A4. Beta receptor blockers (peripheral) A5. Combined α and β receptor blockers (peripheral) A2. Peripherally Acting Adrenergic DrugAlpha1 Blockers (we’ve met these) Doxazosin, prazosin, alfuzosin Block alpha1-receptors which causes BP to decrease Reduces peripheral vascular resistance and BP by dilating both arterial and venous blood vessels Main Use: benign prostatic hyperplasia (BPH) Alpha1 Blockers REMEMBER Tamsulosin (Flomax)* is an α1 blocker BUT *Tamsulosin is not used to control BP, just for BPH. A3. Centrally Acting Adrenergic DrugsAlpha 2 agonist Clonidine and methyldopa 1- Stimulate alpha2-adrenergic receptors. in the brain Decreases sympathetic outflow from the CNS which decreases NE production 2. Stimulate alpha2-adrenergic receptors in kidneys remember alpha 2 opposes alpha 1 Dilates peripheral blood vessels → lowers peripheral resistance → Results in decreased BP So ….Clonidine (Catapres) Used primarily for its ability to decrease blood pressure in an urgent setting Also use in opioid withdrawal as previously discussed Oral (multiple times a day), and topical patch formulations Do not stop abruptly as it may lead to rebound hypertension In reality, Clonidine and methyldopa Not prescribed as first-line home antiHTN drugs High incidence of unwanted adverse effects: orthostatic hypotension, fatigue, and dizziness MIGHT be uses as adjunct drugs after other drugs have failed, in conjunction with other antiHTN such as diuretics A4. Adrenergic Drugs Selective Beta 1 Blockers Metoprolol, Atenolol Reduction of HR through β1 receptor blockade (remember adrenergic blocking of this receptor???) HR results in BP Cause reduced secretion of renin = BP A4. Adrenergic Drugs Selective Beta1 Blockers Nebivolol (Bystolic) Uses: hypertension and HF Action: blocks β1 receptors and produces vasodilatation, which results in a decrease in SVR High doses loses selectivity and blocks both β1 and β2 Less sexual dysfunction All BB- Do not stop abruptly; must be tapered over 1 to 2 weeks A4. Adrenergic Drugs NONSelective Beta Blockers Propranolol Acts equally on β1 and β2 Other uses include situational anxiety associated with public speaking, test taking As mentioned on previous slide, nebivolol at high doses becomes beta nonselective A5. Dual-Action Adrenergic Drugs α1 and β Receptor Blockers Dual antihypertensive effects of reduction in heart rate (beta1 receptor blockade) and vasodilation (alpha1 receptor blockade) Examples are carvedilol (common) and labetalol (not as common) A5. Dual-Action Adrenergic Drugs α1 and β Receptor Blockers Carvedilol (Coreg) Widely used drug that is well tolerated Uses: HTN, mild to moderate HF in conjunction with digoxin, diuretics, and ACE inhibitors Contraindications: severe bradycardia or unstable HF, bronchospastic conditions such as asthma, and various cardiac conduction problems Adrenergic Drugs Indications - HTN But also for Glaucoma (topical) BPH: doxazosin, prazosin, and terazosin (2 for 1) Management of severe HF when used with cardiac glycosides and diuretics Contraindications Acute HF- have to stabilize first MOAIs- yeah doesn’t everything interact with MAOIs? Peptic ulcers Severe liver/kidney disease Asthma (with beta blockers) Adrenergic Drugs: Adverse Effects Orthostatic hypotension 1st-dose syncope Rebound hypertension with abrupt discontinuation Most common: Dry mouth, drowsiness, constipation, sedation Interactions- always check for specific drug interactions Can cause additive CNS depression with alcohol, benzodiazepines, opioids Question #1 When administering an alpha-adrenergic drug for hypertension, it is most important for the nurse to assess the patient for the development of what response? Hypotension Hyperkalemia Oliguria Respiratory distress Answer A Hypotension This is a key point in patient education These drugs have strong vasodilating properties and may cause severe hypotension, especially at the beginning of therapy. B. Angiotensin-Converting Enzyme Inhibitorsaka ACE Inhibitors or ACEi Large group of safe and effective drugs Currently are 10 ACEi Often used as first-line drugs for HF and hypertension May be combined with a thiazide diuretic, loop diuretic, or Calcium Channel Blocker (CCB) You need to understand the basics ACE Inhibitors: Review RAAS ACE converts angiotensin I, formed through the action of renin, to angiotensin II Angiotensin 2 is a potent vasoconstrictor and also induces aldosterone secretion by the adrenal glands Aldosterone stimulates sodium resorption (H20 follows Na Both act to raise BP which causes kidneys to reduce renin production ACEi= Great drug to treat HTN BUT contraindicated in pregnancy (2nd,3rd trimester due to fetal renal damage) and breastfeeding first few weeks after birth B. ACE Inhibitors - PRIL Lisinopril (Prinivil) super common, often the 1st drug Enalapril (Vasotec) also common Captopril (Capoten) great if liver disease present Benazepril (Lotensin) Fosinopril (Monopril) Perindopril (Aceon) Quinapril (Accupril) Ramipril (Altace) Trandolapril (Mavik) Primary Effects of the ACE Inhibitors Prevent Na (and H2O) resorption by inhibiting aldosterone secretion (volume reduction) (GO BACK TO RAAS DIAGRAM) blood volume decreases work of the heart preload, or the left ventricular end-diastolic volume which is important in HF ACE SUMMARY OF ACTIVITY 1) Prevent vasoconstriction caused by angiotensin 2 (2) Prevent aldosterone secretion  less sodium and water resorption Cardioprotective Effects of ACEi They slow progression of left ventricular hypertrophy (ventricular remodeling) after MI so considered cardioprotective ACE inhibitors have been shown to decrease morbidity and mortality in patients with HF Renal Protective Effects of ACEi ACE inhibitors: reduce glomerular filtration pressure by volume reduction Cardiovascular drug of choice for patients with diabetes since it helps protect kidneys by reducing pressure. Sometimes used low dose for kidney protection with DM without HTN B. ACEi Enalapril (Vasotec) Only ACEi available in both oral and IV Enalapril IV does not require cardiac monitoring Oral enalapril: prodrug (metabolized in liver) Improves patient’s chances of survival after an MI Reduces the incidence of HF B. ACEi Captopril (Capoten) Uses: prevention of ventricular remodeling after MI; reduce the risk of HF after MI Shortest half-life Must be administered multiple times throughout the day so this limits its use Not a prodrug so good for patient with liver disease Question #2 A patient with diabetes has a new prescription for the ACE inhibitor lisinopril. She questions this order because her provider has never told her that she has hypertension. What is the best explanation for this order? The doctor knows best The patient is confused This medication has cardioprotective properties This medication has a protective effect on the kidneys for patients with diabetes Answer D ACE inhibitors have been shown to have a protective effect on the kidneys because they reduce glomerular filtration pressure. This property makes them the cardiovascular drug of choice for patients with diabetes. Question #3 A patient with a history of pancreatitis and cirrhosis is also being treated for hypertension. Which drug will most likely be ordered for this patient? Clonidine Prazosin Diltiazem Captopril Answer D Captopril Captopril is not a prodrug; therefore, it does not need to be metabolized by the liver to be effective. This is an advantage in patients with liver disease. ACE Inhibitors: Adverse Effects *Dry, nonproductive cough, which reverses when therapy is stopped. This is a class effect Dizziness- Note: First-dose hypotensive effect may occur Headache & Fatigue Possible hyperkalemia ** Angioedema: rare but potentially fatal Not safe in pregnancy-are contraindicated during the second and third trimesters of pregnancy because of increased risk of fetal renal damage C. Angiotensin II Receptor Blockers(ARB) Considered an alternative to ACEi Less likely to cause a dry cough and hyper K+ that is common with ACE inhibitors Angiotensin II Receptor Blockers: Mechanism of Action Go back to RAAS diagram! ARBs affect primarily 2 places 1. Vascular smooth muscle - blocks vasoconstriction 2. Adrenal gland -Selectively blocks the binding of Ang 2 to certain Ang 2 receptors inhibiting secretion of aldosterone Lowers volume retention and BP Angiotensin II Receptor Blockers -ARTAN Losartan (Cozaar)- very common Eprosartan (Teveten) Valsartan (Diovan) Irbesartan (Avapro) Candesartan (Atacand) Olmesartan (Benicar) Telmisartan (Micardis) Azilsartan (Edarbi) C. ARB Losartan (Cozaar) Beneficial in patients with HTN and HF Used with caution in patients with kidney or liver dysfunction and in patients with renal artery stenosis ***Not safe for breastfeeding women and should not be used in pregnancy (Cat C 1st trimester, Cat D 2nd-3rd trimester), potential fetal toxicity Appear to be equally effective for the treatment of hypertension and well tolerated ARBs less likely to cause cough and hyperK+ but can still happen Evidence that ARBs are associated with lower mortality after MI than ACE inhibitors Never take ACEi and ARBs at the same time* 5. Calcium Channel Blockers (CCB) Primary use: HTN, angina, some dysrhythmias Cause smooth muscle relaxation by blocking the binding of calcium to its receptors, preventing muscle contraction Results in: Relaxed blood vessels to the heart Decreased peripheral smooth muscle tone Decreased SVResistance Decreased BP E. Diuretics First-line antiHTN in JNC 8 guidelines Decreases fluid volume The results from diuresis: preload, Peripheral resistance Overall effect  Decreased workload of the heart and decreased BP Thiazide diuretics are the most commonly used diuretics for HTN Ie hydrochlorothiazide (HCTZ), chlorthalidone We will discuss diuretics further in the chapter on diuretics F. Vasodilators Directly relax arterial or venous smooth muscle (or both) Results in: Decreased SVR Decreased afterload Peripheral vasodilation Indicated for treatment of HTN May be used in combination with other drugs F. Vasodilators Hydralazine (Apresoline) Orally: routine cases of essential hypertension Injectable: hypertensive emergencies BiDil: specifically indicated as an adjunct for treatment of HF in African-American patients F. Vasodilators Sodium Nitroprusside (Nitropress) *Sodium nitroprusside and IV diazoxide are reserved for the management of hypertensive emergencies. Contraindications: severe HF, known inadequate cerebral perfusion (especially during neurosurgical procedures) F. Vasodilators Adverse Effects Hydralazine: dizziness, headache, tachycardia, edema, dyspnea, N/V/D, vitamin B6 deficiency, rash Sodium nitroprusside: hypotension, bradycardia, decreased platelet aggregation, rash G. Direct Renin Inhibitors Aliskirin (Tekturna) Blocks the RAS pathway at the point of activation. Inhibiting renin production prevents the downstream production of Ang II (potent vasoconstrictor) Adverse effects: N/V, severe hypotension, hyponatremia, hyperkalemia… Contraindicated in patients with DM taking ACEi or ARB Miscellaneous Antihypertensives Eplerenone (Inspra) Newer class of drugs called selective aldosterone blockers (remember RAAS?) Reduces BP by blocking the actions of aldosterone at its corresponding receptors in the kidney, heart, blood vessels, and brain Indications: routine treatment of hypertension and for post-MI HF Contraindicated if serum potassium levels are high (above 5.6 mEq/L) A Special Form of HTNTreatment of Pulmonary Hypertension Sildenafil and Tadalafil Commonly used for erectile dysfunction Used for pulmonary hypertension but with different trade names Sildenafil: Revatio* (Viagra for ED) Tadalafil: Adcirca* (Cialis for ED)

Here are 12 questions based on the Word Wall Spin the Wheel Activity focusing on Robber Barons and Labor Unions: Multiple Choice: What is a "Trust"? A) A labor organization formed by skilled workers. B) A large business combination that aims to control markets and reduce competition. C) A worker strike that demands higher wages. D) A type of factory producing steel. Answer: B Which labor union sought to include all workers, regardless of skill, gender, or race? A) American Federation of Labor (AFL) B) Industrial Workers of the World (IWW) C) Knights of Labor D) Pullman Company Answer: C Who was the founder of Standard Oil, known for his monopolistic practices? A) Andrew Carnegie B) Eugene V. Debs C) John D. Rockefeller D) Samuel Gompers Answer: C Which event involved a nationwide railroad strike that led to federal intervention and the arrest of Eugene V. Debs? A) Haymarket Square Riot B) Pullman Strike C) Homestead Strike D) Coal Strike of 1902 Answer: B What is "Vertical Integration"? A) A system where one company controls all phases of production from raw materials to finished product. B) A labor union negotiation process for better working conditions. C) The consolidation of competing businesses under a single company. D) A strike where workers occupy a factory to prevent its operation. Answer: A Which of the following was a key goal of the American Federation of Labor (AFL)? A) Overthrow the capitalist system. B) Establish worker-run factories. C) Secure higher wages, shorter hours, and better working conditions. D) Eliminate all forms of skilled labor. Answer: C Fill in the Blank: John D. Rockefeller used ___________ to gain control over the oil industry and eliminate his competition. Answer: Trusts The labor organization founded by Samuel Gompers that focused on craft unionism and collective bargaining was the ___________. Answer: American Federation of Labor (AFL) The ___________ advocated for direct action and sought to organize all workers into one large union, regardless of skill or background. Answer: Industrial Workers of the World (IWW) The ___________ was an 1894 labor strike against the Pullman Company that resulted in federal troops being sent to restore order. Answer: Pullman Strike Andrew Carnegie’s belief that the wealthy had a moral obligation to use their wealth for the betterment of society was known as the ___________. Answer: Gospel of Wealth The ___________ began as a peaceful rally for an eight-hour workday but turned violent after a bomb was thrown, leading to a nationwide backlash against labor unions. Answer: Haymarket Square Riot These questions combine multiple choice and fill-in-the-blank formats, reinforcing key concepts related to labor unions and robber barons.

Activity 3

Activity -3

Related quizzes

Related quizzes