1. Emily, age 32, has an obstetrical history of G1, T0, P0, A0, and L0. Emily’s week of gestation is 39.1. Emily telephones the health care provider’s office and tells the nurse she believes she is in labor. Based on her assessment, the nurse advises her to have her husband bring her to the labor and birth unit. Emily arrives and is admitted. She is talkative and excited about being in labor and describes her contractions and discomfort as mild.The following are the assessment findings of the examining nurse: Maternal vital signs are stable. Fetal heart tones with the external fetal monitor are reassuring. Vaginal exam indicates the cervix is 3 cm dilated, 40% effaced, membranes intact with the presenting part engaged.Ten minutes after the vaginal examination by the nurse, Emily says, “I think I just wet my pants.” (Learning Objectives 2, 6, 7, and 8)What questions might the nurse have asked Emily to determine that she may be in true labor? What prenatal history information should the nurse have obtained during the telephone call?Explain the meaning of the nurse’s assessment findings. Identify the stage and phase of labor, listing the physiologic and psychological changes during this stage. What positions and activities would be appropriate for Emily based on the assessment data? Why?What are the nursing interventions that would be appropriate for the nurse to implement based on Emily’s statement that “I think I just wet my pants”?2. Diane, age 22, has been in labor for 8 hours. Her cervical examination reveals she is 3 cm, 30% effaced, and –1 station. Diane has been feeling most of her pain in her lower back. (Learning Objectives 3, 4, and 5)Given your understanding of the 5 P’s and the cardinal movements of labor, discuss why Diane is having back labor and why her progress is slow.What strategies may the nurse implement to assist Diane in progressing in her labor?1.Desiree, a 28-year-old G2P1, is admitted to the labor and birth unit. Her birth plan indicates that she is planning natural childbirth without pharmacological interventions. She has attended childbirth education classes. Desiree is considered low risk based on her personal and family health history and physical examination. Her pregnancy has progressed without complications. She is approximately 38 weeks pregnant. Vaginal assessment reveals cervical dilation at 10 cm, 100% effaced, and +1 station. Position of the fetus is LOA. The external fetal monitor indicates a reassuring fetal heart rate at 130 beats per minute. Maternal status is stable. (Learning Objectives 1, 5, and 8)Based on the vaginal assessment, what is the stage of labor and what are the appropriate nursing interventions for this stage of labor?Explain how the nurse determined that the external fetal monitor would be appropriate for Desiree. What factors would necessitate a change to internal fetal monitoring during labor?Desiree says, “I’m not sure I can cope with the pain much longer.” How would you respond, considering her birth plan, stage of labor, and assessment data?2.Emily, a 26-year-old G3P2, has been in labor for 5 hours and is 7 cm, 90% effaced, and +2 station.She has external fetal monitoring in place, which reveals a baseline fetal heart rate of 120 bpm, minimal variability, and occasional variable decelerations.Suddenly, as a contraction is beginning to subside, the fetal heart rate drops to a low of 80 bpm and has a slow return to the baseline 1 minute after the contraction has ended.(Learning Objectives 3 and 4)A.What is happening to Emily’s baby at this point in time?What does this mean?B.What role do you, as the nurse, play regarding fetal assessment and what interventions do you need to implement/recommend at this point in time?

IMPORTANT NOTE REGARDING WORD LIMIT REQUIREMENTS:Please note that each and every assignment has its own word limit.The suggestions I received for trust-building along with my own ideas for how I can improve on developing trustThe suggestion I received from my topic 6 discussion topic 1 post was very helpful. It focused on the importance of listening, and strategies and advice were given to me on how to improve this specific leadership skill. Furthermore, I was told that a way to improve my listening skills is to pay attention to nonverbal cues. I found that advice to be interesting because I never thought of that idea and now that it was brought to my attention, I can see the importance of this advice. For instance, when listening, I should be able to tell if the person is happy, upset, angry, sad, confused or if their facial expression is telling me that they are uninterested in the conversation or if they can tell I am not fully invested on the conversation (Tanveer Naseer Leadership, 2019). Therefore, I will work on improving these skills, such as learning more about common nonverbal cues, making eye contact when speaking with someone so they know I am actively listening, keeping a calm body posture with a pleasant facial expression so that I can seem inviting and allow the speaker to feel relaxed and safe around me. Therefore, with these ideas, I should be able to foster a better and lasting partnership.Three action steps I will take to foster trust and build a strong team the next time I lead a groupBased on the advice I received on trust-building, I have developed three action steps that I will take to foster trust and build a strong team the next time I lead a group. The first action step is to research and learn new tricks and strategies on how to stay focus during a conversation so that I can become a better listener. The second is to develop a stronger mental capacity so that I can take constructive criticism and be able to admit my mistakes and continue to take accountability for my actions without feeling attacked and becoming defensive. The third action step is to become more outgoing with positivity and find the good in the bad and always be optimistic. This third action step allows me to keep myself and others around me motivated and engaged and create a toxic-free environment, which will reduce stress and tension within the partnership. ReferencesTanveer Naseer Leadership. (2019). Listen up! 5 ways to improve your leadership listening skills. https://www.tanveernaseer.com/5-strategies-to-improve-leadership-listening-skills-jackie-edwards/ Respond to the bold paragraph ABOVE by using one of the option below... in APA format with At least two references and a minimum of 200 words..... .(The List of References should not be older than 2016 and should not be included in the word count.) Include at least one scholarly reference and appropriate in-text citations and Address all points on the DQ. One point will be deducted for not addressing each item mentioned above. Remember that presenting someone else’s work as your own is plagiarism. In replies to peers, provide feedback on the selected action steps along with ideas for additional action steps that could be taken to foster trust and build a strong team.Be sure to support your postings and responses with specific references to the Learning Resources.It is important that you cover all the topics identified in the assignment. Covering the topic does not mean mentioning the topic BUT presenting an explanation from the context of ethics and the readings for this classTo get maximum points you need to follow the requirements listed for this assignments 1) look at the word/page limits 2) review and follow APA rules 3) create subheadings to identify the key sections you are presenting and 4) Free from typographical and sentence construction errors.REMEMBER IN APA FORMAT JOURNAL TITLES AND VOLUME NUMBERS ARE ITALICIZED.,ReferencesAmerican Psychological Association. Publication Manual of the American Psychological Association (7th Ed.). Washington, DC: Author.

Table of Contents Learning Resource Competency DiscussionCompetency DiscussionDiscussion Topic AssessmentAssessmentWeb Page Module 1Explain how the U.S. healthcare system has evolved.Book Excerpt: Delivering Health Care in America: A Systems ApproachWeb Page Media: U.S. Health Care Delivery System: History and Evolution of the U.S. Health Care SystemWeb Page Article: The ACA Decision: Law and Philosophy. The Hastings Center ReportWeb Page Websites: Healthcare Reform in the USWeb Page Module 2Compare healthcare systems of different countries.Media: Creating a table in WordWeb Page Articles: Healthcare Systems In Other CountriesWeb Page Website: Health CanadaWeb Page Websites: IndicatorsWeb Page Module 2 Pre-Assessment SubmissionAssessment Submission Module 3Describe the development of the private health insurance industry in the U.S.Book Excerpt: Delivering Health Care in America: A Systems ApproachWeb Page Media: U.S. Health Care Delivery System: Historical Perspective of the U.S. Healthcare Delivery SystemWeb Page Article: An industry pioneer: Leading the way in health insuranceWeb Page Module 4Describe the healthcare-related programs associated with Medicare and Medicaid.Book Excerpt: Delivering Health Care in America: A Systems ApproachWeb Page Websites: Medicare and Medicaid BasicsWeb Page Website: Healthcare Research and TrendsWeb Page Module 4 Pre-Assessment SubmissionAssessment Submission Module 5Describe components of the Patient Protection and Affordable Care Act (PPACA).Book Excerpt: Delivering Health Care in America: A Systems ApproachWeb Page Media: U.S. Health Care Delivery System: Politics and PolicyWeb Page Article: Elimination of Pre-Existing ConditionsWeb Page Website: PPACA and the WorkplaceWeb Page Website: Patient Centered Medical Home Resource CenterWeb Page Websites: Accountable Care OrganizationsWeb Page Module 5 Pre-Assessment SubmissionAssessment Submission HE002 Assessment InstructionsReview the details of your assessment including the rubric. You will have the ability to submit the assessment once you submit your required pre-assessments and engage with your Faculty Subject Matter Expert (SME) in a substantive way about the competency.OverviewFor this Assessment you will examine the history of the U.S. healthcare system. Specifically, you will analyze the historic forces that have shaped the present-day healthcare system in the United States.InstructionsTo complete this Assessment, do the following:Be sure to adhere to the indicated assignment length.Download the APA course paper template available here.Download the Academic Writing Expectations Checklist to review prior to submitting your Assessment.HE002 Medicare/Medicaid Comparison ChartBefore submitting your Assessment, carefully review the rubric. This is the same rubric the SME will use to evaluate your submission and it provides detailed criteria describing how to achieve or master the Competency. Many students find that understanding the requirements of the Assessment and the rubric criteria help them direct their focus and use their time most productively.To pass this Competency, you must achieve a minimum rubric score of “Meets Expectations” (“Achieved”) or “Above Expectations” (“Mastered”). You will have three attempts to successfully complete this Assessment. Each attempt will count towards your total three attempts to achieve this Competency.RubricAll submissions must follow the conventions of scholarly writing. Properly formatted APA citations and references must be provided where appropriate. Submissions that do not meet these expectations will be returned without scoring.This Assessment requires submission of one (1) document: Save this file as HE002_firstinitial_lastname (for example, HE002_J_Smith). When you are ready to upload your completed Assessment, use the Assessment tab on the top navigation menu.Important Note: As a student taking this Competency, you agree that you may be required to submit your Assessment for textual similarity review to Turnitin.com for the detection of plagiarism. All submitted Assessment materials will be included as source documents in the Turnitin.com reference database solely for the purpose of detecting plagiarism of such materials. Use of the Turnitin.com service is subject to the Usage Policy posted on the Turnitin.com site.This assessment has five-parts. Click each of the items below for more information on this Assessment.Part 1: Evolution of the U.S. Healthcare SystemReflect on the historic events since World War II (WWII), after 1945, that have influenced the evolution of the U.S. healthcare system. Then, select three such historic events and explain the impact they had on the evolution of the U.S. healthcare system. Finally, using learning resources from this Competency and research from the Walden Library, explain three key historic events since WWII (after 1945) and the impact those events have had on the evolution of the healthcare system. Provide ONE topic per paragraph (3 separate paragraphs).Part 2: Comparison of Healthcare Systems in Different CountriesConsider the similarities and differences of the healthcare systems among the U.S., Germany, and Canada. Create a table that presents the similarities and differences of the healthcare systems among the U.S., Germany, and Canada. Be sure to cite scholarly sources used to inform the content of the table.Pertinent information for your table should include:Total populationGross national income per capitaLife expectancy at birth for males and femalesTotal expenditure on health per capitaTotal gross domestic product percentage (GDP %) expenditure on healthIn one paragraph, summarize any insights you gained from analyzing the differences among the three countries.Part 3: The Complexities of the U.S. Private Insurance SystemReflect on the important historic factors that led to the development of the private health insurance industry. Next, think about the current regulations that govern private health insurance and how those impact the delivery of health services. Briefly outline the history of the insurance system and current regulations.Describe one important historic factor that led to the development of the private health insurance industry. (1-2 paragraphs).Describe one current regulation that govern private health insurance (e.g, COBRA, HIPPA, EMTALA). (1- 2 paragraphs).Part 4: Medicare and MedicaidDuring the late 1950s and early 1960s, the groundwork for Medicare and Medicaid began. In 1965, during the Johnson administration, Congress passed amendments to the Social Security Act and created the Medicare and Medicaid programs. Since 1965, there have been many additions and changes to the programs.Based on the learning resources in this Competency and your research from the Walden Library, complete the Medicare/Medicaid Comparison chart with the key provisions, participant eligibility, and the enactment date for the following programs:Medicare AMedicare BMedicare CMedicare DMedicaidPart 5: Patient Protection and Affordability Care ActThe passage of the Patient Protection and Affordability Care Act (PPACA) has many different components that impact healthcare services by expanding access, lowering costs, and improving quality.Based on the learning resources in this Competency and your research from the Walden Library, address the following:Describe each of the following concepts that evolved from the PPACA:Elimination of Pre-existing Conditions (1 -2 paragraphs)Patient-Centered Medical Home Model (PCMH) (1 -2 paragraphs)Accountable Care Organization (ACO) (1 – 2 paragraphs)Prevention and Wellness (two programs) (1 -2 paragraphs)