...Review of Clinical Signs Murphy’s Sign of Cholecystitis Series Editor and Contributing Author: Frank L. Urbano, MD Contributing Author: MaryBeth Carroll, RN, BSN C holecystitis is a common condition that results from inflammatory, infectious, metabolic, neoplastic, and congenital disorders. The greatest incidence of acute cholecystitis occurs in adults 30 to 80 years of age. There is a 2 times greater incidence of gallstones in women than in men.1 Cholecystitis is characterized by a recurring mild-tomoderate, right upper quadrant and epigastric abdominal pain. Pain often radiates to the right posterior scapula and back. Nausea, vomiting, low-grade fever, and leukocytosis are often present. Symptoms are commonly associated with consumption of high-fat meals 1 or more hours prior to the onset of pain.1-4 Murphy’s sign may be a useful tool in establishing the diagnosis of cholecystitis. Confirmation of the diagnosis depends on a combination of physical findings and laboratory and imaging studies. A corollary, the sonographic Murphy’s sign, may be useful as well.1-5 SIGNS OF CHOLECYSTITIS MURPHY’S SIGN Elicitation: Palpate the right subcostal area while the patient inspires deeply Positive response: The patient feels pain upon this maneuver and may have an associated inspiratory arrest SONOGRAPHIC MURPHY’S SIGN Elicitation: Palpate the right subcostal area using an ultrasound transducer while the patient inspires deeply Positive response: The patient feels pain upon...
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...Company Overview: The organization we choose for the research and our group report writing is Australia’s most popular retail industry Woolworths. We choose Woolworths supermarket on of the brand of the Woolworths Limited Australia. Woolworths limited is well known retail giant over Australia and New Zealand. Woolworths started its first business in city of Sydney by opening its first store in the basement of Imperial arcade in 1924.Current stage Woolworths operates many of the retail brands like Big W, Woolworths, Dan murphy, Cell master, BWS and many more. And it serves 2.4 million customers a week (Woolworthslimited.com.au, 2014). We choose Woolworth’s supermarket located at North Ryde in Macquarie centre, which is known as the store of destination of Woolworths. Store is located inside the Macquarie centre. Store is very popular store because of its largest fresh department with onsite production of the mood. This retail store can be taken as the largest organization where this store operates 24hr work including while trading and while closed. Store has 287 staff including casuals and part time and 14 salaried managers. Store weekly sales are 1.7 million dollar average and daily operating hour is 8 am in the morning till 10pm. One of our group members does works in the Woolworths supermarket store Macquarie centre. According to his experience and analysis during the working hours in that organization he was concerned and focused in the Larger number of employee has been...
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