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Business/Business Plan term paper 2647. Business Plan: Progressive Consulting. What follows is a complete business plan for a hypothetical company. Resume Templates Download Free Premium 2010 ~ Ipralatam. Please. Sample Documentation Head - Youtube. copy or save to your disk and Download Free Premium Word 2010, use as an example in developing your own. Order Forms. business plan. If you would like to read a series of articles jump to Web. Marketing . For additional business aids click on Microsoft Resume Templates Premium Word, The Practical Tools of. 1. Templates - Text. 0 Executive Summary. Progressive Consulting will be formed as a consulting company specializing in. marketing of high technology products in international markets. Microsoft Templates Free Premium ~ Ipralatam. Its founders. are former marketers of Toc - Ucr Sub-Workgroups - Discharge - S&i, consulting services, personal computers, and market. research, all in Microsoft Templates Download 2010, international markets.

They are founding Progressive. Nursing Documentation - Youtube. Consulting to formalize the consulting services they offer. Progressive Consulting offers high-tech manufacturers a reliable, high. quality alternative to inhouse resources for business development, market. Microsoft Resume Templates Free Premium. development, and Assistant - 8+, channel development on an international scale. A true. alternative to in house resources offers a very high level of practical. experience, know how, contacts, and Microsoft Resume Download Word 2010 ~ Ipralatam, confidentiality. 33 Best Valentine Day Images On Pinterest. Clients must know that. working with Progrssive Consulting is Microsoft Resume 2010 a more professional, less risky way to. develop new areas even than working completely in Day Images Ideas, house with their own. people.

Progressive Consulting must also be able to maintain financial. Microsoft Resume Templates Download Free 2010. balance, charging a high value for Ucr Sub-Workgroups - S&i, its services, and delivering an Templates Free Word, even. Sales Order Templates - Text. higher value to its clients. Initial focus will be development in Resume Templates Premium Word 2010, the. 33 Best Day Images Ideas. European and Latin American markets, or for European clients in the United. 1. 3 Keys to Success. -Excellence in fulfilling the promise completely confidential, reliable, trustworthy expertise and information. -Developing visibility to generate new business leads. -Leveraging from Microsoft Download Premium 2010 ~ Ipralatam, a single pool of Ucr Sub-Workgroups Instructions, expertise into multiple revenue generation. opportunities: retainer consulting, project consulting, market research, and. Resume Templates Download Premium Word 2010. market research published reports. 2. 0 Company Summary. Internship Offer Collection. Progressive Consulting is a new company providing high-level expertise in. Microsoft Resume Templates Free ~ Ipralatam. international high-tech business development, channel development, distribution strategies, and marketing of Sample Documentation Toe Assessment, high tech products. It will focus. initially on providing two kinds of international triangles: -Providing United States clients with development for European and Latin. -Providing European clients with development for the United States and Latin.

As it grows it will take on people and consulting work in related markets, such as the rest of Latin America, and the Far East, and Microsoft Download Free Premium Word 2010, similar markets. As. it grows it will look for additional leverage by Templates, taking brokerage positions. and representation positions to create percentage holdings in product. 2. 1 Company Ownership. Microsoft Premium. Progressive Consulting will be created as a California C corporation based. in Los Angeles County, owned by Sample Assistant Job Description - 8+ Examples In, its principal investors and principal. operators.

As of this writing it has not been chartered yet and is still. Templates Word ~ Ipralatam. considering alternatives of Sample Assistant Examples, legal formation. 2. Resume Templates Download Premium 2010 ~ Ipralatam. 2 Startup Summary. Total start up expense (including legal costs, logo design, stationery and. - Discharge Instructions Framework. related expenses) come to $73,000. 2010. Start up assets required include $3,000 in. short term assets (office furniture, etc.) and $1,000,000 in initial cash to. handle the first few months of Valentine Day Images On Pinterest | Valentine Ideas, consulting operations as sales and accounts. receivable play through the Microsoft Resume Download cash flow. The details are included in the table. Stationery etc. $3,000 Brochures $5,000. Study Template (apple. Expensed equipment $3,000. Microsoft Resume Templates Download Free Premium ~ Ipralatam. Total Start-up Expense $18,350. Start-up Assets Needed.

Cash requirements $25,000. Start-up inventory $0. Sample Head Toe Assessment - Youtube. Other Short-term Assets $7,000. Total Short-term Assets $32,000. Long-term Assets WORD DOCUMENT HAS NO NUMBER HERE. Capital Assets $0. Total Assets $32,000. Total Startup Requirements: $50,350. Left to finance: $0. Start-up Funding Plan.

Investor 1 $20,000. Investor 2 $20,000. Total investment $50,000. Microsoft Download Premium 2010 ~ Ipralatam. Unpaid expenses $5,000. Short-term loans $0. Interest-free short-term loans $0. Subtotal Short-term Borrowing $5,000. Long-term Borrowing $0. Total Borrowing $5,000. Loss at Retailers Survey On New Birla Cement, start-up ($23,000) Total Equity $27,000.

Total Debt and Equity $32,000. 2. 3 Company Services. Progressive offers expertise in channel distribution, channel development, and market development, sold and packaged in various ways that allow clients. to choose their preferred relationship: these include retainer consulting. relationships, project based consulting, relationship and alliance. brokering, sales representation and market representation, project-based. Microsoft Templates Download ~ Ipralatam. market research, published market research, and information forum events. 2. 4 Company locations and Forms Templates, facilities. Free Premium Word 2010 ~ Ipralatam. The initial office will be established in A quality office space in the Los. Toc - - Discharge Instructions - S&i. Angeles County Dearborn Valley area of California, the heart of the U.S. high tech industry.

Progressive offers the Microsoft Resume Free Premium 2010 expertise a high-technology company needs to develop. Kenton Group, Fcc Form 477 Filing, In 2000 The Fcc Adopted A Semi. new product distribution and new market segments in Resume 2010, new markets. This can be. Survey Product Launch From Birla Cement. taken as high-level retainer consulting, market research reports, or project- 3. 1 Service Description. 1. Retainer consulting: we represent a client company as an extension of Microsoft Resume Templates Free Premium Word 2010, its. business development and market development functions. - Best Template. This begins with. complete understanding of the client company's situation, objectives, and. constraints. Microsoft Templates Download Free Word. We then represent the Retailers Product Launch From Cement client company quietly and confidentially, sifting through new market developments and new opportunities as is. Microsoft Resume Templates Download Free Premium ~ Ipralatam. appropriate to Internship Letter - Best Template Collection, the client, representing the client in Microsoft Templates Free Premium Word ~ Ipralatam, initial talks with.

possible allies, vendors, and channels. Administrative Assistant. 2. Project consulting: Proposed and billed on Free Word ~ Ipralatam, a per-project and per-milestone. basis, project consulting offers a client company a way to harness our. specific qualities and use our expertise to Format Template, solve specific problems, develop. Resume 2010. and/or implement plans, develop specific information. 3. Market research: group studies available to selected clients at $5,000 per. unit. In 2000 Adopted. A group study is packaged and Download Free Premium 2010, published, a complete study of Templates, a specific. market, channel, or topic. Examples might be studies of Microsoft Templates Download Free Premium, developing consumer. channels in Nursing Documentation Head Toe Assessment - Youtube, Japan or Mexico, or implications of Download 2010, changing margins in Sales, software. 3. 2 Competitive Comparison. The competition comes in Microsoft Free Premium Word 2010 ~ Ipralatam, several forms: 1. The most significant competition is Toc - no consulting at all, companies. choosing to do business development and Microsoft Templates Word, channel development and The Fcc, market. research in-house. Their own managers do this on their own, as part of their. regular business functions. Our key advantage in Templates 2010, competition with in-house. development is that managers are already overloaded with responsibilities, they don't have time for Sample Nursing, additional responsibilities in new market. development or new channel development.

Also, Progressive can approach. Microsoft Resume Templates Free 2010. alliances, vendors,and channels on Sample Nursing Head Toe Assessment, a confidential basis, gathering. information and Free Premium Word 2010, making initial contacts in Ucr Sub-Workgroups Instructions - S&i, ways that the Microsoft Resume Word corporate managers. Retailers Launch Shakti. 2. The high-level prestige management consulting: High-Tec, San Diego. Consulting Group, etc. These are essentially generalists who take their name- brand management consulting into Microsoft Resume Templates Premium Word ~ Ipralatam, specialty areas. Sample Administrative. Their other very important. weakness is the management structure that has the partners selling new jobs, and inexperienced associates delivering the work. We compete against them as. Resume Premium Word 2010 ~ Ipralatam. experts in Study (apple Iwork, our specific fields, and with the Microsoft Resume Templates Download Free Premium Word 2010 guarantee that our clients will. have the top-level people doing the actual work. 3. The third general kind of competitor is the international market research. On Pinterest | Valentine Ideas. company: International Electronic Data Corporation (IEDC), Dataquest,

Stanford Research Institute, etc. These companies are formidable competitors. for published market research and market forums, but cannot provide the kind. of high-level consulting that Triangle will provide. 4. The fourth kind of competition is the market-specific smaller house. For. example: Nomura Research in Templates Download Premium 2010 ~ Ipralatam, Japan, Select S.A. de C.V. in Mexico (now. Day Images | Valentine. affiliated with IEDC). 5. Resume Templates Download Free Premium. Sales representation, brokering, and deal catalysts are an ad-hoc business.

form that will be defined in 33 Best Valentine On Pinterest | Valentine, detail by the specific nature of each. 3. Microsoft Templates Download Free ~ Ipralatam. 3 Sales Literature. The business will begin with a general corporate brochure establishing the. Sample Head Toe Assessment. positioning. Microsoft Download Premium 2010 ~ Ipralatam. This brochure will be developed as part of the Sales Templates start-up. Literature and Microsoft Resume Templates Word 2010, mailings for the initial market forums will be very important, with the need to establish a high-quality look and feel for. Sales Forms Templates. . Microsoft Resume Templates Download Free Premium Word ~ Ipralatam. [truncated. Instructions - S&i Framework. because this plan is provided for purposes of illustration only] -The key fulfillment and delivery will be provided by the principals of Microsoft Download, the. business. The real core value is professional expertise, provided by a. Administrative Assistant Job Description - 8+ Examples In. combination of experience, hard work. and Microsoft Resume Download Free Premium Word, education (in that order). -We will turn to qualified professionals for free-lance back-up in market. research and presentation and Toc - - Discharge - S&i, report development, which are areas that we. can afford to contract out Resume Templates Download Premium 2010, without risking the core values provided to Administrative Assistant Job Description - 8+ Examples, the. Progressive Consulting will maintain latest Windows and Microsoft Templates Download Word, Macintosh. Offer Letter Format Collection. -1. Complete Email facilities in Internet, Compuserve, America Online, and. Microsoft Templates Free 2010 ~ Ipralatam. Applelink, for working with clients directly through email delivery of drafts. Sales Order. -2.

Complete presentation facilities for Microsoft Download Free Premium ~ Ipralatam, preparation and delivery of. Group, 477 Filing, In 2000. multimedia presentations on Microsoft Resume Free Word ~ Ipralatam, Macintosh or Windows machines, in Kenton Group, 477 Filing,, formats. Microsoft Resume Download Free 2010. including on-disk presentation, live presentation, or video presentation. -3. Complete desktop publishing facilities for delivery of regular retainer. reports, project output reports, marketing materials, market research. 3. 6 Future Services. In the Template Pages) future Progressive will broaden the coverage by expanding into. Microsoft Resume Templates Free Word. coverage of Kenton Group, Fcc Form In 2000 Adopted A Semi, additional markets (e.g. Microsoft Resume Templates Download Free Word. all of Latin America, Far East, Western. Europe) and additional product areas (e.g. Sample Examples. telecommunications and Microsoft Download Free Word ~ Ipralatam, technology. integration). Fcc Form A Semi. We are also studying the Templates Free ~ Ipralatam possibility of newsletter or. electronic newsletter services, or perhaps special on-topic reports.

4. Nursing Documentation Head Toe Assessment. 0 Market Analysis Summary. Microsoft Resume Templates Premium ~ Ipralatam. Progressive will be focusing on high-technology manufacturers of computer. hardware and software, services, networking, who want to sell into Documentation Toe Assessment - Youtube, markets. in the United States, Europe, and Latin America. These are mostly larger. companies, and Microsoft Resume Templates Download Free Premium Word ~ Ipralatam, occasionally medium-sized companies. Templates - Text. Our most important group of Resume Free Premium Word, potential customers are executives in Retailers On New Launch From Shakti, larger. corporations.

These are marketing managers, general managers, sales managers, sometimes charged with international focus and Resume Free Word ~ Ipralatam, sometimes charged with market. or even specific channel focus. Sample Nursing Head Toe Assessment - Youtube. They do not want to waste their time or risk. their money looking for bargain information or questionnable expertise. As. they go into markets looking at new opportunities, they are very sensitive. to risking their company's name and reputation. Professional experience. [truncated because this plan is provided for purposes of illustration only] 4. 1 Market Segmentation. -Large manufacturer corporations: our most important market segment is the. large manufacturer of high-technology products, such as Apple, Hewlett- Packard, IBM, Microsoft, Siemens, or Olivetti. These companies will be. calling on Microsoft Templates Download Premium 2010 ~ Ipralatam, Progressive for development functions that are better spun off. than managed in-house, and for market research, and for market forums. -Medium sized growth companies: particularly in software, multimedia, and. some related high growth fields, Triangle will be able to Kenton 477 Filing, The Fcc Adopted, offer an Download Premium Word ~ Ipralatam, attractive. development alternative to the company that is Valentine Ideas management constrained and. Templates Free Word. unable to address opportunities in Sample Nursing - Youtube, new markets and new market segments. Microsoft Download Free Word 2010. 4. Adopted. 2 Industry Analysis. Templates Download Premium Word 2010. The consulting industry is pulverized and disorganized, thousands of.

smaller consulting organizations and individual consultants for every one of. the few dozen well-known companies. Consulting is a disorganized industry, with participants ranging from Toc - Ucr Sub-Workgroups - Discharge Instructions Framework, major. international name brand consultants to tens of thousands of individuals. Download Free Premium ~ Ipralatam. One. of Kenton Group, Fcc Form In 2000 Adopted, Progressive's challenges will be establishing itself as a real consulting company, positioned as a relatively risk free corporate purchase. 4. 2. 1 Industry Participants. Microsoft Resume Templates Premium Word ~ Ipralatam. The consulting industry is pulverized and disorganized, thousands of. Sample Administrative Assistant Job Description - 8+. smaller consulting organizations and individual consultants for every one of. the few dozen well-known companies.

At the Microsoft Templates Free Premium Word highest level are the few well established major names in management. consulting. Most of Valentine Day Images On Pinterest, these are organized as partnerships established in major. Resume Word 2010. markets around the world, linked together by Sales Templates - Text, interconnecting directors and. sharing the name and Microsoft Resume Templates Download Free, corporate wisdom. Some evolved from accounting companies. (e.g. Arthur Anderson, Touche Ross) and Group, Fcc Form In 2000 Adopted, some from management consulting. (McKinsey, Bain). These companies charge very high rates for consulting, and. maintain relatively high overhead structures and fulfillment structures based. on Microsoft Resume Templates Download Word 2010, partners selling and junior associates fulfilling. Kenton 477 Filing, Adopted. At the Microsoft Resume Templates Free Premium Word 2010 ~ Ipralatam intermediate. level are some function specific or market specific consultants, such as the. market research firms (IEDC, Dataquest) or channel development firms. (ChannelCorp, Channel Strategies, ChannelMark).

Some kinds of Feasibility Template (apple Iwork, consulting is little more than contract expertise provided by. somebody looking for a job and Microsoft Resume Templates Download Premium 2010 ~ Ipralatam, offering consulting services as a stop-gap. measure while looking. Toc - - Discharge Instructions - S&i. 4. 2. 2 Distribution Patterns. Consulting is Microsoft Resume Free sold and purchased mainly on a word-of-mouth basis, with. Kenton Group, In 2000 Adopted A Semi. relationships and previous experience being by far the most important factor. The major name-brand houses have locations in major cities and Premium Word ~ Ipralatam, major markets, and executive-level managers or partners develop new business through. Ucr Sub-Workgroups - Discharge Instructions Framework. industry associations, business associations, and chambers of commerce and. industry, etc., even in some cases social associations such as country clubs. The medium-level houses are generally area-specific or function specific, and. are not easily able to leverage their business through distribution. Microsoft Resume Download Free 2010. 4. 2. 3 Competition and Study Template (apple Pages), Buying Patterns.

The key element in purchase decisions made at the Progressive client level is. trust in the professional reputation and reliability of the Resume Templates Free 2010 ~ Ipralatam consulting firm. 4. Order Templates - Text. 2. Resume Templates Free ~ Ipralatam. 4 Main Competitors. -The high-level prestige management consulting: Strengths: international locations managed by owner-partners with a high. level of Internship Offer Letter Format Template, presentation and Download Free Word 2010 ~ Ipralatam, understanding of general business. Sales Order Forms. Enviable. reputations which make purchase of consulting an easy decision for a manager, despite the very high prices. Weaknesses: General business knowledge doesn't. substitute for the specific market, channel, and distribution expertise of. Triangle, focusing on high-technology markets and Resume Templates Premium 2010, products only.

Also, fees. are extremely expensive, and work is generally done by very junior-level. consultants, even though sold by high-level partners. Sample Nursing Toe Assessment. -The international market research company: Strengths: International offices, specific market knowledge, permanent staff. developing market research information on permanent basis, good relationships. with potential client companies. Weaknesses: market numbers are not marketing, not channel development or. Microsoft Resume. market development. Kenton Group, Fcc Form A Semi. Although these companies compete for some of the Resume Download Premium Word business. Triangle is Administrative In after, they cannot really offer the same level of Download Free Premium Word ~ Ipralatam, business. understanding at a high level. -Market specific or function-specific experts. Strengths: expertise in market or functional areas. - Best Template. Triangle should not try. to Resume Premium 2010 ~ Ipralatam, compete with Normura or Select in Ucr Sub-Workgroups - Discharge Framework, their markets with market research, or. Templates 2010. with ChannelCorp in channel management. Weaknesses: the inability to Survey On New From Cement, spread beyond a specific focus, or to Microsoft Templates Download Word ~ Ipralatam, rise.

above a specific focus, to Internship Letter Format Template Collection, provide actuial management expertise, experience, and wisdom beyond the specifics. The most significant competition is no consulting at all, companies choosing. to do business development and Download, channel development and Sales Templates, market research in- house. Microsoft Download ~ Ipralatam. Strengths: no incremental cost except travel; also, the general work. is Sales Order Forms Templates - Text done by the people who are entirely responsible, the planning done by. those who will implement. Microsoft Download Free Premium Word ~ Ipralatam. Weaknesses: most managers are terribly overburdened. already, unable to find incremental resources in time and people to Offer Letter Format, apply to. incremental opportunities. Also, there is a lot of additional risk in market. development and channel development done in Resume 2010, house from the ground up. Finally, retainer-based antenna consultants can greatly enhance a company's. reach and extend its position into - Best Template Collection, conversations that might otherwise never. hanve taken place. 4. 3 Market Analysis. Microsoft Download Word 2010 ~ Ipralatam. As indicated by the illustrations, we must focus on a few thousand well- chosen potential customers in the United States,Europe, and Ucr Sub-Workgroups - Discharge, Latin America.

These few thousand high-tech manufacturing companies are the key customers. Potential Customers Customers Growth rate. U.S. High Tech 5,000 10% European High Tech 1,000 15% Latin America 250 35% 5. Microsoft Download Free Premium ~ Ipralatam. 0 Strategy Summary. Progressive will focus on three geographical markets, the United States, Europe, and Latin America, and in limited product segments: personal. computers, software, networks, telecommunications, personal organizers, and. technology integration products. Fcc Form In 2000 The Fcc A Semi. The target customer is usually a manager in. a larger corporation, and Microsoft Resume Premium ~ Ipralatam, occasionally an owner or president of Iwork, a medium- sized corporation in a high-growth period. Microsoft Word 2010. 5. 1 Pricing Strategy. Progressive Consulting will be priced at the upper edge of what the market. In 2000 The Fcc A Semi. will bear, competing with the name brand consultants. The pricing fits with. the Resume Templates Free Word 2010 general positioning of Triangle as high-level expertise. Consulting should be based on Feasibility (apple, $5,000 per day for project consulting, $2,000. per day for market research, and $10,000 per month and Templates Free Word 2010, up for retainer. Group, The Fcc Adopted. consulting.

Market research reports should be priced at $5,000 per report, which will of course require that reports be very well planned, focused on. very important topics very well presented. 5. 2 Sales Forecast. Microsoft Download Free Word. The sales forecast monthly summary is included in Assistant Job Description - 8+ Examples, the appendix. The annual. sales projections are included here in the following table. Sales 1995 1996 1997.

Retainer Consulting $200,000 $250,000 $325,000. Resume Templates Download ~ Ipralatam. Project Consulting $270,000 $325,000 $350,000. Market Research $122,000 $150,000 $200,000. Survey Launch Birla. Strategic Reports $0 $50,000 $125,000. Total Sales $592,000 $775,000 $1,000,000. Cost of sales 1995 1996 1997. Microsoft Templates Free Word 2010 ~ Ipralatam. Retainer Consulting $30,000 $20,000 $30,000. Administrative Assistant - 8+ Examples In. Project Consulting $45,000 $25,000 $31,000.

Market Research $84,000 $45,000 $50,000. Strategic Reports $0 $20,000 $40,000. Total Cost of Download Free Premium, Sales $159,000 $110,000 $151,000. 5. 3 Strategic Alliances. Toc - - S&i. At this writing strategic alliances with Smith and Microsoft Templates 2010 ~ Ipralatam, Jones are possibilities, given the Kenton Fcc Form 477 Filing, content of existing discussions. Given the background of. Microsoft Premium ~ Ipralatam. prospective partners, we might also be talking to European companies. including Siemens and Olivetti and others, and to United States companies. Administrative Assistant. related to Apple Computer. In Latin America we would be looking at the key. local high-technology vendors, beginning with Printaform. Resume Templates Download Free 2010. 6. Kenton 477 Filing,. 0 Management Summary.

The initial management team depends on Resume Templates Premium Word, the founders themselves, with little. Toc - - Discharge. back-up. As we grow we will take on Resume Templates Free, additional consulting help, plus graphic/ editorial, sales, and marketing. Valentine Day Images On Pinterest | Valentine Ideas. 6. 1 Organizational Structure. Progressive should be managed by working partners, in a structure taken. mainly from Smith Partners.

In the beginning we assume 3-5 partners: -At least one, probably two partners from Smith and Jones. -One strong European partner, based in Paris. The organization has to be very flat in Microsoft Download Word 2010, the beginning, with each of the. founders reponsible for his or her own work and Order Forms - Text, management. -One other strong partner. 6. 2 Management Team. The Progressive business requires a very high level of international. experience and expertise, which means that it will not be easily leveragable. in Microsoft Free 2010 ~ Ipralatam, the common consulting company mode in Retailers Launch Shakti Cement, which partners run the business and. Free Premium Word ~ Ipralatam. make sales, while associates fulfill. Partners will necessarily be involved. in the fulfillment of the core business proposition, providing the Administrative Assistant Job Description - 8+ expertise. The initial personnel plan is still tentative. Resume Templates Download Word ~ Ipralatam. It should involve 3-5. Survey On New Product Launch Birla Shakti Cement. partners, 1-3 consultants, 1 strong editorial/graphic person with good staff. Templates Premium 2010. support, 1 strong marketing person, an - Discharge, office manager, and Microsoft Templates Free 2010 ~ Ipralatam, a secretary. Later we add more partners, consultants and and sales staff. Founders' resumes are included as an additional attachment to Day Images On Pinterest | Valentine, this plan.

6. 3 Personnel Plan. The detailed monthly personnel plan for Free Premium Word 2010, the first year is included in Ucr Sub-Workgroups Instructions - S&i Framework, the. appendices. The annual personal estimates are included here as Table 5. Partners $144,000 $175,000 $200,000. Consultants $0 $50,000 $63,000. Editorial/graphic $18,000 $22,000 $26,000. VP Marketing $20,000 $50,000 $55,000. Microsoft Templates Download Premium Word 2010. Sales people $0 $30,000 $33,000. Office Manager $7,500 $30,000 $33,000. Sample Administrative Job Description - 8+ Examples. Secretarial $5,250 $20,000 $22,000. Subtotal $194,750 $377,000 $432,000.

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Advanced practice nurses by Microsoft Resume Download Premium the very nature of their scope of practice effectively combine both education and Administrative Job Description Examples In management into their delivery of care. Operating beyond the Resume Free Premium Word 2010, role of Retailers Survey Launch From Birla Shakti Cement educator, advanced practice nurses holistically assess patients’ needs with the understanding of patients’ primary role in Templates Download Word, the improvement and maintenance of their own health and wellness. In conducting assessments, advanced practice nurses carefully explore patients’ medical history and perform focused physical exams. At the completion of assessments, advanced practice nurses, in conjunction with patients, identify management goals and determine appropriate plans of care. A review of patients’ self-care management skills and application/adaptation to lifestyle is incorporated in initial histories, physical exams, and plans of care. Many advanced practice nurses (NPs, CNSs, nurse midwives, and nurse anesthetists) may prescribe and adjust medication through prescriptive authority granted to them by their state nursing regulatory body. Currently, all 50 states have some form of prescriptive authority for advanced practice nurses.3 The ability to prescribe and adjust medication is a valuable asset in caring for individuals with diabetes. It is a crucial component in the care of people with type 1 diabetes, and it becomes increasingly important in the care of Administrative Assistant Job Description - 8+ In patients with type 2 diabetes who have a constellation of Microsoft Resume Templates Word ~ Ipralatam comorbidities, all of which must be managed for successful disease outcomes. Many studies have documented the effectiveness of Feasibility Study Template advanced practice nurses in managing common primary care issues.4 NP care has been associated with a high level of satisfaction among health services consumers.

In diabetes, the role of advanced practice nurses has significantly contributed to Microsoft Templates Download Free Premium Word 2010 ~ Ipralatam improved outcomes in the management of type 2 diabetes,5 in specialized diabetes foot care programs,6 in the management of diabetes in pregnancy,7 and in the care of Sample Nursing pediatric type 1 diabetic patients and their parents.8,9 Furthermore, NPs have also been effective providers of diabetes care among disadvantaged urban African-American patients.10 Primary management of these patients by NPs led to improved metabolic control regardless of Download Word 2010 ~ Ipralatam whether weight loss was achieved. The following case study illustrates the clinical role of advanced practice nurses in the management of a patient with type 2 diabetes. A.B. is a retired 69-year-old man with a 5-year history of type 2 diabetes. Although he was diagnosed in 1997, he had symptoms indicating hyperglycemia for Study (apple Iwork 2 years before diagnosis. He had fasting blood glucose records indicating values of 118–127 mg/dl, which were described to Microsoft Templates Free Premium Word him as indicative of “borderline diabetes.” He also remembered past episodes of nocturia associated with large pasta meals and Italian pastries. At the time of initial diagnosis, he was advised to lose weight (“at least 10 lb.”), but no further action was taken. Referred by his family physician to Administrative Assistant Job Description - 8+ Examples the diabetes specialty clinic, A.B. presents with recent weight gain, suboptimal diabetes control, and foot pain. He has been trying to lose weight and increase his exercise for the past 6 months without success.

He had been started on glyburide (Diabeta), 2.5 mg every morning, but had stopped taking it because of dizziness, often accompanied by sweating and Microsoft Templates Download Word a feeling of mild agitation, in the late afternoon. A.B. also takes atorvastatin (Lipitor), 10 mg daily, for hypercholesterolemia (elevated LDL cholesterol, low HDL cholesterol, and elevated triglycerides). He has tolerated this medication and adheres to the daily schedule. During the past 6 months, he has also taken chromium picolinate, gymnema sylvestre, and a “pancreas elixir” in an attempt to Study Iwork improve his diabetes control. Resume Download Word! He stopped these supplements when he did not see any positive results. He does not test his blood glucose levels at home and - 8+ Examples In expresses doubt that this procedure would help him improve his diabetes control. “What would knowing the Templates Download Word 2010 ~ Ipralatam, numbers do for me?,” he asks. (apple Pages)! “The doctor already knows the sugars are high.” A.B. states that he has “never been sick a day in Resume Templates Free ~ Ipralatam, my life.” He recently sold his business and has become very active in a variety of volunteer organizations. He lives with his wife of 48 years and has two married children.

Although both his mother and father had type 2 diabetes, A.B. has limited knowledge regarding diabetes self-care management and states that he does not understand why he has diabetes since he never eats sugar. In the past, his wife has encouraged him to Format treat his diabetes with herbal remedies and Templates ~ Ipralatam weight-loss supplements, and she frequently scans the Internet for the latest diabetes remedies. During the past year, A.B. has gained 22 lb. Since retiring, he has been more physically active, playing golf once a week and gardening, but he has been unable to lose more than 2–3 lb. He has never seen a dietitian and has not been instructed in self-monitoring of blood glucose (SMBG). A.B.’s diet history reveals excessive carbohydrate intake in the form of bread and pasta. His normal dinners consist of 2 cups of Sample Administrative Assistant - 8+ Examples In cooked pasta with homemade sauce and three to four slices of Microsoft Resume Download Free Premium 2010 ~ Ipralatam Italian bread. During the - Youtube, day, he often has “a slice or two” of Templates Premium bread with butter or olive oil. He also eats eight to ten pieces of fresh fruit per day at meals and Internship Offer Letter - Best as snacks. He prefers chicken and fish, but it is usually served with a tomato or cream sauce accompanied by pasta. His wife has offered to make him plain grilled meats, but he finds them “tasteless.” He drinks 8 oz. of red wine with dinner each evening.

He stopped smoking more than 10 years ago, he reports, “when the cost of cigarettes topped a buck-fifty.” The medical documents that A.B. brings to this appointment indicate that his hemoglobin A 1c (A1C) has never been 8%. Microsoft Word 2010 ~ Ipralatam! His blood pressure has been measured at 150/70, 148/92, and 166/88 mmHg on Group, Fcc Form 477 Filing, In 2000 The Fcc Adopted separate occasions during the past year at the local senior center screening clinic. Although he was told that his blood pressure was “up a little,” he was not aware of the need to keep his blood pressure ?130/80 mmHg for both cardiovascular and renal health.11. A.B. has never had a foot exam as part of his primary care exams, nor has he been instructed in preventive foot care. Free! However, his medical records also indicate that he has had no surgeries or hospitalizations, his immunizations are up to date, and, in general, he has been remarkably healthy for many years. A physical examination reveals the following: Weight: 178 lb; height: 5?2?; body mass index (BMI): 32.6 kg/m 2.

Fasting capillary glucose: 166 mg/dl. Blood pressure: lying, right arm 154/96 mmHg; sitting, right arm 140/90 mmHg. Pulse: 88 bpm; respirations 20 per minute. Eyes: corrective lenses, pupils equal and reactive to light and Study Iwork accommodation, Fundi-clear, no arteriolovenous nicking, no retinopathy. Lungs: clear to auscultation.

Heart: Rate and rhythm regular, no murmurs or gallops. Vascular assessment: no carotid bruits; femoral, popliteal, and dorsalis pedis pulses 2+ bilaterally. Neurological assessment: diminished vibratory sense to the forefoot, absent ankle reflexes, monofilament (5.07 Semmes-Weinstein) felt only above the ankle. Results of laboratory tests (drawn 5 days before the office visit) are as follows: Glucose (fasting): 178 mg/dl (normal range: 65–109 mg/dl) Creatinine: 1.0 mg/dl (normal range: 0.5–1.4 mg/dl) Blood urea nitrogen: 18 mg/dl (normal range: 7–30 mg/dl) Sodium: 141 mg/dl (normal range: 135–146 mg/dl) Potassium: 4.3 mg/dl (normal range: 3.5–5.3 mg/dl) • Total cholesterol: 162 mg/dl (normal: 200 mg/dl) • HDL cholesterol: 43 mg/dl (normal: ?40 mg/dl)

• LDL cholesterol (calculated): 84 mg/dl (normal: 100 mg/dl) • Triglycerides: 177 mg/dl (normal: 150 mg/dl) • Cholesterol-to-HDL ratio: 3.8 (normal: 5.0) AST: 14 IU/l (normal: 0–40 IU/l) ALT: 19 IU/l (normal: 5–40 IU/l) Alkaline phosphotase: 56 IU/l (normal: 35–125 IU/l) A1C: 8.1% (normal: 4–6%)

Urine microalbumin: 45 mg (normal: 30 mg) Based on A.B.’s medical history, records, physical exam, and lab results, he is assessed as follows: Uncontrolled type 2 diabetes (A1C 7%) Obesity (BMI 32.4 kg/m 2 ) Hyperlipidemia (controlled with atorvastatin) Peripheral neuropathy (distal and symmetrical by exam)

Hypertension (by previous chart data and Free 2010 ~ Ipralatam exam) Elevated urine microalbumin level. Self-care management/lifestyle deficits. • High carbohydrate intake. • No SMBG program. Poor understanding of diabetes. A.B. Retailers Survey On New Product Shakti Cement! presented with uncontrolled type 2 diabetes and a complex set of comorbidities, all of which needed treatment. The first task of the NP who provided his care was to select the Free Word 2010 ~ Ipralatam, most pressing health care issues and prioritize his medical care to address them. Although A.B. stated that his need to lose weight was his chief reason for seeking diabetes specialty care, his elevated glucose levels and his hypertension also needed to be addressed at the initial visit. The patient and his wife agreed that a referral to a dietitian was their first priority. A.B. acknowledged that he had little dietary information to help him achieve weight loss and that his current weight was unhealthy and “embarrassing.” He recognized that his glucose control was affected by large portions of bread and pasta and Documentation - Youtube agreed to Microsoft Resume Download Free Word 2010 start improving dietary control by Administrative Assistant Job Description reducing his portion size by Resume Free Premium 2010 one-third during the week before his dietary consultation.

Weight loss would also be an Internship - Best Template, important first step in reducing his blood pressure. The NP contacted the Microsoft Resume Templates Download Free Word ~ Ipralatam, registered dietitian (RD) by telephone and Documentation Head Toe Assessment - Youtube referred the patient for a medical nutrition therapy assessment with a focus on weight loss and improved diabetes control. A.B.’s appointment was scheduled for Microsoft Templates Premium 2010 ~ Ipralatam the following week. The RD requested that during the intervening week, the patient keep a food journal recording his food intake at Sample Nursing Documentation Head Toe Assessment meals and Resume Templates Download Free Premium Word ~ Ipralatam snacks. She asked that the patient also try to estimate portion sizes. Although his physical activity had increased since his retirement, it was fairly sporadic and weather-dependent. Sample Examples! After further discussion, he realized that a week or more would often pass without any significant form of exercise and Templates Premium Word 2010 that most of (apple Pages) his exercise was seasonal. Whatever weight he had lost during the summer was regained in the winter, when he was again quite sedentary. A.B.’s wife suggested that the two of them could walk each morning after breakfast.

She also felt that a treadmill at home would be the best solution for getting sufficient exercise in inclement weather. After a short discussion about the positive effect exercise can have on glucose control, the patient and his wife agreed to Resume Templates Free Premium Word ~ Ipralatam walk 15–20 minutes each day between 9:00 and Feasibility Study Template (apple Iwork 10:00 a.m. A first-line medication for this patient had to be targeted to improving glucose control without contributing to Microsoft Word 2010 ~ Ipralatam weight gain. Internship Offer Letter Template! Thiazolidinediones (i.e., rosiglitizone [Avandia] or pioglitizone [Actos]) effectively address insulin resistance but have been associated with weight gain.12 A sulfonylurea or meglitinide (i.e., repaglinide [Prandin]) can reduce postprandial elevations caused by increased carbohydrate intake, but they are also associated with some weight gain.12 When glyburide was previously prescribed, the patient exhibited signs and symptoms of hypoglycemia (unconfirmed by SMBG). Microsoft Resume Premium 2010! ?-Glucosidase inhibitors (i.e., acarbose [Precose]) can help with postprandial hyperglycemia rise by blunting the effect of the Kenton Group, Fcc Form In 2000, entry of carbohydrate-related glucose into the system. Microsoft Templates Download Word 2010 ~ Ipralatam! However, acarbose requires slow titration, has multiple gastrointestinal (GI) side effects, and reduces A1C by only 0.5–0.9%.13 Acarbose may be considered as a second-line therapy for A.B. Offer - Best Collection! but would not fully address his elevated A1C results. Metformin (Glucophage), which reduces hepatic glucose production and improves insulin resistance, is not associated with hypoglycemia and can lower A1C results by 1%. Although GI side effects can occur, they are usually self-limiting and Microsoft Templates Free ~ Ipralatam can be further reduced by slow titration to dose efficacy.14. After reviewing these options and discussing the need for improved glycemic control, the NP prescribed metformin, 500 mg twice a day.

Possible GI side effects and Documentation Head the need to avoid alcohol were of Premium Word ~ Ipralatam concern to A.B., but he agreed that medication was necessary and Retailers On New From that metformin was his best option. The NP advised him to take the Microsoft Download Premium Word, medication with food to reduce GI side effects. The NP also discussed with the patient a titration schedule that increased the dosage to 1,000 mg twice a day over a 4-week period. She wrote out this plan, including a date and time for telephone contact and medication evaluation, and gave it to the patient. During the visit, A.B. and his wife learned to use a glucose meter that features a simple two-step procedure. The patient agreed to use the meter twice a day, at breakfast and dinner, while the Retailers On New Launch From Birla, metformin dose was being titrated. Microsoft Resume Templates Download Premium Word! He understood the Kenton Group, 477 Filing, In 2000 A Semi, need for glucose readings to guide the choice of medication and to evaluate the effects of his dietary changes, but he felt that it would not be “a forever thing.” The NP reviewed glycemic goals with the patient and his wife and assisted them in Resume Premium 2010 ~ Ipralatam, deciding on initial short-term goals for weight loss, exercise, and (apple Pages) medication.

Glucose monitoring would serve as a guide and assist the patient in modifying his lifestyle. A.B. Microsoft Resume Word 2010 ~ Ipralatam! drew the Order - Text, line at Microsoft Templates Word ~ Ipralatam starting an antihypertensive medication—the angiotensin-converting enzyme (ACE) inhibitor enalapril (Vasotec), 5 mg daily. He stated that one new medication at a time was enough and Internship Offer Collection that “too many medications would make a sick man out of me.” His perception of the state of his health as being represented by Microsoft Templates Free 2010 the number of medications prescribed for him gave the advanced practice nurse an important insight into the patient’s health belief system. The patient’s wife also believed that a “natural solution” was better than medication for treating blood pressure. Although the use of an ACE inhibitor was indicated both by the level of hypertension and by the presence of microalbuminuria, the decision to wait until the Kenton 477 Filing, A Semi, next office visit to further evaluate the need for antihypertensive medication afforded the patient and his wife time to consider the importance of adding this pharmacotherapy. They were quite willing to read any materials that addressed the Microsoft Free 2010 ~ Ipralatam, prevention of diabetes complications. Feasibility! However, both the patient and his wife voiced a strong desire to focus their energies on changes in food and physical activity. The NP expressed support for their decision. Because A.B. Resume Templates Free Premium! was obese, weight loss would be beneficial for many of his health issues. Because he has a sedentary lifestyle, is 35 years old, has hypertension and peripheral neuropathy, and is being treated for Template hypercholestrolemia, the Resume Download Free Word, NP performed an electrocardiogram in the office and Feasibility Study (apple Iwork Pages) referred the patient for an exercise tolerance test.11 In doing this, the Download Free Premium Word, NP acknowledged and Forms Templates - Text respected the Microsoft Templates Download Premium, mutually set goals, but also provided appropriate pre-exercise screening for the patient’s protection and Feasibility Pages) safety. In her role as diabetes educator, the Templates Download 2010, NP taught A.B. and his wife the Feasibility Template (apple Pages), importance of foot care, demonstrating to the patient his inability to Microsoft Download Premium Word ~ Ipralatam feel the light touch of the monofilament.

She explained that the loss of Documentation protective sensation from peripheral neuropathy means that he will need to be more vigilant in checking his feet for any skin lesions caused by Microsoft Resume Download Word 2010 poorly fitting footwear worn during exercise. At the conclusion of the visit, the NP assured A.B. that she would share the plan of Retailers On New Launch Shakti Cement care they had developed with his primary care physician, collaborating with him and discussing the findings of Microsoft Resume Download Free Word 2010 any diagnostic tests and procedures. She would also work in partnership with the Kenton Group, Fcc Form 477 Filing, In 2000 A Semi, RD to reinforce medical nutrition therapies and improve his glucose control. In this way, the Resume Templates Download ~ Ipralatam, NP would facilitate the Letter - Best Collection, continuity of care and keep vital pathways of communication open. Advanced practice nurses are ideally suited to play an integral role in the education and Templates Download Free Premium Word 2010 medical management of people with diabetes.15 The combination of clinical skills and Administrative Assistant Examples expertise in teaching and counseling enhances the delivery of Microsoft Premium Word 2010 care in a manner that is both cost-reducing and effective. Inherent in the role of advanced practice nurses is the understanding of shared responsibility for health care outcomes. This partnering of nurse with patient not only improves care but strengthens the patient’s role as self-manager. Geralyn Spollett, MSN, C-ANP, CDE, is associate director and an adult nurse practitioner at the Yale Diabetes Center, Department of Endocrinology and Metabolism, at Yale University in New Haven, Conn. She is an associate editor of Diabetes Spectrum. Note of disclosure: Ms.

Spollett has received honoraria for speaking engagements from Novo Nordisk Pharmaceuticals, Inc., and Aventis and Job Description - 8+ Examples In has been a paid consultant for Aventis. Both companies produce products and devices for the treatment of diabetes. 2017 by the American Diabetes Association. Diabetes Spectrum Print ISSN: 1040-9165, Online ISSN: 1944-7353 .