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?

Post a total of 3 substantive responses over 2 separate days for full participation. This includes your initial post and 2 replies to other students. Please be sure to review the section "Substantive Participation Expectations" in my Instructor Policies prior to posting.Due Thursday Respond to the following in a minimum of 175 words: Select a child morbidity or mortality topic from the Child Morbidity and Mortality Presentation document.BreastfeedingSIDSImmunizationsEarly childhood cariesBully behaviorObesityPassenger/young driver safetySafe sexSports participationAdditional pre-approved topics include access to care, adolescent pregnancy, parental separation/divorce, single caregiver households, & poverty.This is an excellent opportunity to investigate a topic of interest & one that you will likely address with numerous patients & families in your clinical practice. I recommend choosing a topic you find engaging & do not yet know much about. If you wish to proceed with a topic not listed, please send a private message for approval before beginning. Discuss the following:Summarize the topic you selected, including your findings from the research. Define the relevance of the topic as it relates to children's health and clinical NP practice. Discuss treatment options, including any involved risks and benefits. Discuss controversies surrounding the topic by responding to opposing viewpoints. Note: Prepare to use your findings in the Child Morbidity and Mortality Presentation due in Wk 2.Due Monday Reply to at least 2 of your classmates. Be constructive and professional in your responses.

Learning ResourcesRequired ReadingsHarris, J.M. (2017). Healthcare strategic planning (4th ed). Chicago, IL: Health Administration Press Chapter 9, " Phase 4: Transition to Implementation" (pp. 183-204)Chapter 10, " Annual Review and Update " (pp. 209-228)Chapter 13, " Future Challenges for Strategic Planners" (pp. 279-290)Agency for Healthcare Research and Quality (2018). Promote your healthcare quality report to consumers. AHRQ. Retrieved from https://www.ahrq.gov/talkingquality/distribute/pro...Burns, S. (2019, March 27). How to create a strategic plan for your business. Forbes. Retrieved from https://www.forbes.com/sites/stephanieburns/2019/0...Jones, D., Ballard, J., Dyson, R., Macbeth, P., Lyle, D., Sunny, P., Thomas, A., & Sharma, I. (2019). A community engaged primary healthcare strategy to address rural school student inequities: A descriptive paper. Primary Health Care Research & Development 20(e26): 1–6. doi: 10.1017/ S1463423618000907 Retrieved from https://www.cambridge.org/core/services/aop-cambri...Jeffs, L., Merkley, J., Sinno, M., Thomson, N., Peladeau, N., & Richardson, S. (2019). Engaging stakeholders to co-design an academic practice strategic plan in an integrated health system: The key roles of the nurse executive and planning team. Nursing Administration Quarterly, (2), 186-192. Machicao, C. and Forbes Agency Council (2018, January 3). How to cure boring healthcare advertising. Forbes. Retrieved from https://www.forbes.com/sites/forbesagencycouncil/2...Discussion: Community Benefit vs. Organizational BenefitPerhaps you have been to a health fair sponsored by a local hospital in your community. Who benefits from such an effort? When you or your neighbors are screened for signs of illness (hypertension, for instance) or learn about available services, clearly the promotion benefits you, but what about the hospital? Having its name associated with "community service" benefits the organization. Any patients and/or clients the institution attracts may also result is some financial benefits.Social change is at the heart of Walden’s mission, therefore, in this Discussion, you will identify examples of promotion for social change in your community and analyze whether the promotion benefits the community, the organization, or both.To prepare for this Discussion:Review this week's Learning Resources.Identify two (2) local healthcare providers: one (1) should be with a for-profit and one (1) should be with a not-for-profit organization. Identify an example of each organization's effort in promoting a service or services as a form of positive social change.By Day 4Post a comprehensive response to the following:Describe how each organizations’ efforts in promoting a service fosters positive social change in the community.Describe how each organizations’ social change efforts benefits the organization. How does each organization's promotion benefit the community? How does it benefit the organization?Based on the promotion of each organization, are the interests of the community and the interests of the organization harmonious or are they in conflict? Explain.How may a non-profit organization be less able to launch a bigger, more professional, more impressive and more visible promotion than a for profit and how might that type of promotion impact the community?Support your work with specific citations from this week's Learning Resources and/or additional sources as appropriate. Your citations must be in APA format. Read a selection of your colleagues' postings.By Day 6Respond to at least two of your colleagues' postings in one or more of the following ways:Compare the social change efforts of your colleague’s organizations and yours. Describe any similarities and differences.Compare your colleague’s promotion descriptions to yours. Explain any similarities or differencesCompare the interests of the organizations that your colleague selected with yours. Describe any similarities or differences.Return to this Discussion in a few days to read the responses to your initial posting. Note what you have learned and/or any insights you have gained as a result of your colleagues' comments. You are welcome to post these final insights.