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CASE STUDY Joshua Jones

Anna (age 35) and Tom (age 36) Jones have an appointment with you for an evaluation of their son, Joshua, who is 5 years old. They bring all their children to the appointment, including Tommie (6 months), Joshua (5), Sally (7), Mari (11), and Janey (15). You quickly recognize that the entire family needs assistance, not just Joshua.

Joshua was recently diagnosed with acute myeloid leukemia, and he is not expected to live more than a few months. He has been withdrawn and irritable, is crying a lot, and has not been interested in playing or doing the things he used to enjoy before his diagnosis. Also since the diagnosis, his siblings have been fighting a lot at home with each other and their parents and refusing to do their chores. Mari and Janey, the two oldest, are refusing to go to school.

In your initial post, answer the following questions from your perspective as their psychiatric nurse practitioner.

Based on Joshua’s presentation, how would you relate his developmental milestones to his clinical presentation and perception of death and dying? When providing grief therapy, what information would you provide Joshua and his parents regarding Joshua’s perception of his terminal illness?
Select one of the Jones’ children (except Joshua) and identify the normal developmental milestones you would expect based on their current age. Identify an age-appropriate national or community resource related to grief or a sibling with cancer and explain the benefit of the resource you provided.
What, if any, cultural considerations should you apply when working with the Jones family?

Sample Solution

It might be noticed that exchange in banks are voluminous and dreary, and fall into constrained classes/heads of record. It might, in this manner, be more proper that the assessment of the inward control is made for every class/classification of exchange. On the off chance that the activity of interior control assessment is legitimately done, it help the evaluator to decide the adequacy or generally of the control frameworks and in like manner empower him to reinforce his review methodology, and lay fitting accentuation on the danger inclined ranges. Interior control would incorporate bookkeeping control regulatory controls. a)Accounting controls: Bookkeeping controls spread regions straightforwardly worried with recording of monetary exchanges and upkeep of such registers/records as to guarantee their unwavering quality. Inward bookkeeping controls are additionally visualizing such systems as would decide obligation and fix responsibility as to protecting of the advantages of the bank. It would not be strange of notice that there is a qualification between bookkeeping framework and inside bookkeeping controls. Bookkeeping framework conceives the preparing of the exchange and occasions, their acknowledgment, and fitting recording. Inward controls are strategies, technique and methods so outlined and normally incorporated with frameworks, as would empower aversion and in addition location of blunders, oversights or abnormalities during the time spent execution and recording of exchange/occasions. The inside bookkeeping controls as would guarantee aversion of blunders, exclusions and inconsistencies would incorporate after: I. No exchange can be enrolled/recorded unless it is authorized/affirmed by the assigned power. II. Built-in double control/supervisory systems guarantee that there is an autonomous programmed keep an eye on information/vouchers. III. No single individual has power to start exchange and record through all stages to the general record. Every day exchanges are precisely and instantly recorded, and the control and auxiliary recor
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