Part 1: 25 y/o presents to Labor and Delivery with complaints of uterine cramping and lower back pain. Denies any vaginal bleeding at this time. Has related history of a preterm birth at 32 weeks gestation with her last pregnancy. The baby is 3 years old now and has no developmental issues.
 Her current gestational age is 30 weeks.
 She is O+ and all other lab values are normal. No noted STI’s.

1. Group Beta Strep is missing from the labs – most often is obtained at 35 – 37 weeks gestation.
 2. Without this information it is often determined to treat the patient anyway – presumptively to protect a premature baby from the risk.
 3. What other information would you like to ask her?
 4. What nursing intervention will you provide?
 5. What screening tests are often obtained to help determine her risk for preterm labor.
 6. And if it is determined she is in preterm labor what medications may you want to use with a doctors order?
 7. Please also give dose, side effects and possible result of the medication.

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Obama care 

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In this final project, you will create and evaluate a health promotion program that targets one of the following issues:

• Tobacco Cessation
• Diabetes
• Obesity
• Substance Abuse

After reviewing the Unit VIII study guide, examine the program and discuss the five major components of community health programming and the six steps of evaluation. Be sure to address the following:

1. Provide detailed background information on the topic.
2. Prove a minimum of three specific and realistic goals/objectives.
3. Provide detailed information on how you will use the five steps of programming (program planning) to create a community health intervention/program.
4. Provide detailed information on how you will use the six steps of evaluation to evaluate your program.

Your APA-formatted paper should be at least five pages (not including the title or reference pages). You are required to use at least your textbook as source material for your response. All sources used, including the textbook, must be referenced; paraphrased and quoted material must have accompanying citations

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The need to improve the nutrition of the elderly living in residential long term care is well recognized. This assignment involves a research review, formulation of questions for your observation of elderly meal times and a final response. 

A. Watch video A holistic approach, when working with people with dementia, leads to an improved quality of life. Eating and Drinking well: supporting people living with dementia (Links to an external site.)Links to an external site.

1. Questions: Food and Drink availability concerns – Food is associated with many activities and events. To improve good nutrition:
   • What was done to help make nutritious foods available to the patient?
   • How is the possibility of dehydration addressed? What is the fluid volume recommended?
   • What are special tools suggested to improve eating?
   • Preferences may change with age. What is done to help improve eating?
   • How does the environment affect eating?
2. Questions: Food and Drink through activity (min 11:30 – 12:00, 14:36)

•  How does knowing the story of the patient help improve overall nutrition?

1. Questions: Communication and relationships (min 20:47 – end)

•  How does good communication with staff improve nutrition?

B. Reading: “Best Practices for Nutrition, Food Service and Dining in Long Term Care Homes.” (http://www.dietitians.ca/Downloads/Public/2013-Best-Practices-for-Nutrition,-Food-Service-an.aspx (Links to an external site.)Links to an external site.)

1. What would you do to ensure texture changes are adequate for dysphagia?
2. How would you reduce polypharmacy regarding laxative use?
3. How would you induce a positive dining experience?
4. What are some tips you would enact to train your servers?

C. Reading: “Effectiveness of mealtime interventions on nutritional outcomes for the elderly living in residential care: A systematic review and meta-analysis“, R. A. Abbott

• Write five observation questions you would focus on based on the reading. Some suggestions are ‘mode of food presentation’ and ‘dining environment.’ Collaborate with the your group to finalize observation questions. 

Observation: You have two choices. Either visit on-site: Extra credit point for observing at Woodland Country Manor, Sommerville Road (Breakfast 7 am, lunch 11:30 am, dinner 4:30 pm) OR find one additional video showing elderly eating at meals. 

Final Response requirements. 

1. What are some of the most important steps needed to improve and/or maintain good nutrition?
2. What assessments/interventions would be important to conduct?
3. What  did you observe either in person or from the additional video? (Summarize your observations and reference the video.)
4. How did your observations compare with the information you gathered in the literature?

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Obstacles in EHRs Implementation

Discuss the major local, national, and international obstacles to implementing standardized terminologies within EHRs.

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