Questions and answers Essay Example | Topics and Well Written Essays - 1250 words - 1

Questions and answers - Essay Example Paul’s teachings differ from those of Jesus’ in his definition of heaven. Paul describes heaven in his teachings as where the body of Jesus Christ dwells, while Jesus described the Kingdom of heaven as prophetic Kingdom of the Israelites here on earth. Paul’s also differed with Jesus when it comes to teachings on authority. Jesus directed that people should obey authority and pay taxes while Paul’s teachings mostly condemned authority. Paul also differed from Jesus in his teachings where he emphasizes that one’s faith alone is required in salvation. This is different from what Jesus taught since he stipulated that in order for a person to have salvation; faith, repentance, and Baptism are necessary. Another difference that characterizes Paul’s teaching from those of Jesus was how the teachings were delivered. Paul’s teachings were mostly in form of letters to different congregations while those of Jesus were mostly delivered in form of parables. 2. Explain the schism between the Roman Catholic and Eastern Orthodox churches. There are various issues that contributed to the schism between the Roman Catholic and the Eastern orthodox churches. ... d to the schism between the two factions of Christianity were issues that surrounded priesthood, the major one being the celibacy of priests which the orthodox churches were greatly opposed to. The papal authority was one of the major issues that led to the schism between the west and the east. Eastern orthodox churches were greatly opposed to the religious and political power that revolved bishops and moreover the pope. These eastern orthodox churches argued that the pope was meant to be the servant of God thus to the people and not a form of authority on earth. In fact, before the separation of the two factions scholars have argued that the pope was the most powerful authority in the known world at the time. Disagreement over the Holy Spirit also contributed greatly o the two factions ex communicating each other (Fisher 328). For instance the western faction stipulated that the Holy Spirit came from the Son and the Father while the eastern faction stipulated that â€Å"the Holy Sp irit proceeds only from the Father† (Fisher 328). 3. What issues did each of the Protestant Reformers (Luther, Calvin, the English Reformers) have with the Roman Catholic Church? Luther One of the major issues that that Martin Luther had against the Roman Catholic was the understanding of salvation. According to the Roman Catholic, in order for a person to be forgiven of their sins after being baptized they must seek repentance and then confess to a priest their sins. Martin Luther differed with this since after studying the bible intensely, he understood that salvation was available to anyone as long as they repented since God offered salvation to all people through the death of his son Jesus. Calvin John Calvin also had issues with the Roman Catholic on the application and understanding of

Doctor Faustus Essay Example | Topics and Well Written Essays - 250 words

Doctor Faustus - Essay Example Faustus. Marlowe warns the person who reads against such trade-offs, revealing in the doom of Dr. Faustus that an agreement with the devil can never harvest true rewards (Marlowe 6). Also, the book concerns the apprehension between science and magic. Dr. Faustus has all the skills and knowledge to identify the world completely as a human being can, but he opts to submerge himself in the mysterious arts of magic in the anticipations of learning more (Marlowe 12). The result of the play undoubtedly asserts Marlowe’s conviction that magic is a substandard to science and the accurate obscurities of the Christian life. Dr. Faustus’s main character mistake is that he wishes the boundaries of humanity and knowledge to be extended past what is logical (Marlowe 13). This play is a morality story on wanting more than what is offered to us. Through Dr. Faustus, the person who reads realises that they should be pleased with what is, instead of what they would want the world to

Marks and Spencer Clothing Ranges | Analysis

Marks and Spencer Clothing Ranges | Analysis This report is pertaining to Marks Spencer UK Ref : 1) Identify and explain the different customer needs. Who are the three MS clothing ranges aimed to serve? Assume that the Perfect and Classic ranges serve essentially the same customer segment. 2) Identify and explain the order winners and qualifier for these three different clothing ranges at MS. 3) Apply the polar diagram to analyse and compare the different operations performance objectives for these three different clothing ranges at MS. Introduction: MARKS SPENCER (UK) Marks Spencer (MS) is a commercial organization and is one of the UK leading retailer of clothing and home product. Other than that, MS also selling high quality of foods and at the same time also provided financial service. MS claim to have 21 million of customer that visit to their store weekly and have 600 stores in UK and the business is expanding globally. MS have 2000 supplier and 75000 employees all around the world. MS also is the No. 1 women wear and lingerie provider in UK. Meanwhile the market share of men and children wear is expanding. Lastly, due to MS Plan A, a five year eco plan, MS is now more known for their green credential to become carbon free and no landfill waste by the year 2012. 1.0 Identify and explain the different customer needs which the three MS clothing ranges aimed to serve? Assume that the Perfect and Classic ranges serve essentially the same customer segment. 1.1 Identify the Segmentation. Market segmentation can be defined as the process of dividing a market into different segmentation by take in the consideration of the customers common needs or characteristic. (Schiffman Kanuk, 1997,p.46) In reference to the case study, the product agenda in the Marks Spencer can be divided by understanding segmentation is Season, Gender, Age. Season There are 4 seasons in United Kingdom, which is spring, autumn, summer and winter. By further reference to the case study, spring and autumn is the peak sales season of the Marks and Spencer. The clothing during spring and autumn is casual wear. And during this time, is when all the high-fashion wear take place as no heavy clothing is required. The figure below show the suitable clothing to be worn during spring and autumn season. Gender Marks and Spencer is targeted more on the women rather than man. This is factual that women are usually more into shopping and purchasing clothing than men. Take for instance; I usually go shopping for clothes once a year usually a few weeks before the Chinese New Year. It is Chinese tradition to wear new cloth during the celebration. Whereas my girl friend will keep on shopping whenever she likes together shopper impulse. The case study has a focus on women buying behavior pertaining to clothes. Age Product needs and interests vary with consumer age. Marketers have found age is a very useful demographic variable for distinguishing segments. (Schiffman Kanuk, 1997,p.53) By referring to the case study, Marks Spencer core and potential customer are women aged between 35 to 55. Where the women at this age are very active and the purchasing power is high. 1.2 Customer needs Customer needs are defined, XXXXXXXX. In the case of Marks Spencer the needs of women customers can be divided into the size, quality, design, pricing and also the services that are available to them in providing, them providing their personal and environmental needs. 1.2.1 The Size of the Clothing The different sizes of the clothing are one of the most important issues towards customer needs. A cloth can be designed with a very supreme layout, the colour can be extremely beautiful, the price can very reasonable and the quality can be fantastic, however when customer wants to purchase a particular clothing but not available in size, will result in customer behavioral stress with a perceptional and altitude change towards the item. MS should strategically consider in term of the size availability of the clothing that they wish to sell as compared to the women in Malaysia, the size are normally in the range S, M, L and XL as their body are relatively smaller if compare to the women in UK. 1.2.2 The Quality of the Clothing The quality is important to the customer and required need. The customer wants his money worth when she wears the clothes. From the case study, one of the customer stated that the cloth she purchase must be value for money. The busy lifestyle of today, the customers now need to be met by MS. They will preferred that the clothing that they purchase can be wash well and not require specialist washing and the cloth have to long last , colour not to fade and wont shrink while in wash. This is same for all the customers around the world. The customer is expecting the price will mirror the quality level of the product (Erickson and Johansson,1985 cited in Brassington and Pettitt, 2007,p.223). The quality of the goods and services accepted have to be equal to the money that they invested. 1.2.3 The design of the Clothing Good design satisfies customer, communicates the purpose of the product or service to its market, and bring financial rewards to the business. The objective of good design, whether of product or service is to satisfy customers by meeting their actual or anticipated needs and expectations (Slack, et al., 2010) The customers demand a good design of clothing and shall be not recognized as MS on the first sight especially for the premium and high fashion clothing. Customer needs for something that is more presentable and different from the other brands. This is best described for the autograph range clothing. The design has to be supreme, outstanding. As what we understand that the hot sales season of MS is during Spring And Autumn, and during this two season, heavy clothing is not required and this is the time when the people wear out fashion and trendy clothing. Therefore the design needs to be the main consideration of MS while they make the purchase decision. Whereas, the customers in Malaysia especially for women, they will rather visit a boutique rather than a supermarket to buy their clothing even though the price is higher because of the design. As the cloth in the boutique are unique and rarely found in other shops and this will eliminate the chances to get embarrassed as 2 person we ar the same clothing at a function or dinner. 1.2.4 The services A good service usually helps to make sales successful. Customers who come to MS expected to receive a good service, such as after sales service, consultant service and other basic services. However, in the case study, one of the customers stated that she would not make a special trip to buy a high-fashion item and rather to have an impulse purchase. The busy lifestyle today, purchase through the internet is becoming a common thing. MS do have this service, and the customers do not have to go to the store to view and to purchase for the clothing. The electronic catalogue on the website and online purchase is available. This is one of the services that are demanded by the customer. This service is productive as customers now do not need to step out from their home to purchase. Especially in a critical weather condition, helps remove customer stress. As for the goods to be delivered, somehow, if MS will set up a special department to deal with the delivery, the lead time will be reduced and the satisfaction level of customer on the service will be enhanced. 1.2.5 The Pricing Price- the main consideration of customer on purchase. Form the case, the customer had stated that they would pay a high price but the design and quality must be there. But it is not applicable for all the customer as for the customer which comes from a middle and low income level, pricing will be an issue. As in Malaysia, if the product sell is cheap and worth, even though there is no advertisement, the store will have a lot of customers. From the consumer perception, the price of a product reflects the value that they attach to whatsoever is being exchanged. While the customer is making purchase decision, the marketer is considered be making a promise to the customer about what is the product and what is the value of it. The consumer is then going to determine the promise against the price and thus decide whether it is worth paying (Zeithaml, 1988 cited in Brassington and Pettitt, 2007,p.223). The same applies to MS, if the prices are lower compare to the competitor, and with good quality, automatically the customer will be there to purchase. Thus, pull up the profit of the MS. It will also create the loyalty of the customer towards MS. 2.0 Identify and explain the order winners and qualifier for these three different clothing ranges at MS. 2.1 Order Winner Order winner are those factor which directly and significantly contribute to winning business. (Slack, et al., 2010, P.69) In a simply words, order winner is the characteristic of a firm that cause the customer to purchase the goods and services from firm. Order winner play an important role to not only to end sales but also to secure new business. The ability of a firm in the strategic initiative as cost, price, lead time, quality, reliability, brand equity and etc can enhance a firm order winner. The order winner for classis and perfect range is for core customers with a busy life, versatility, fitness, reasonable price and quality The order winner for Autograph range is its Fashionable, unique and exclusive designs. The order winner for Per una range is Limited editions, special and more exclusive styles, competitive prices. 2.2 Order Qualifiers Qualifier are those aspect of competitiveness where the operations performance has to be above particular level just to be considered by the customer. (Slack, et al., 2010, P.69).Order qualifier is the characteristic to be equipped by a firm to make it outstanding among all the other firm and competitors. In a simple words, order qualifiers make the firm differ from its competitors. The order qualifiers for classis and perfect range are Timeless essentials reflecting ones style and finesse. The order qualifier for Autograph range is Collection with no more than 60 of each color and way and style. The order qualifier for Per Una Range is its Superb designs at very affordable prices 3.0 Apply the polar diagram to analyse and compare the different operations performance objectives for these three different clothing ranges at MS. 3.1 Polar Diagram Polar diagram is a useful way to representing the relative importance objective for a product or services. This is called the polar representation because the scales which represent the importance of each performance objective have the same origin. (Slack, et al., 2010, P.53). The polar diagram below can be used to analyse and compare he different operations performance objectives for the three different clothing range at MS. The 5 factor in the polar diagram are Cost, Quality, Design, Size availability and also the Sales volume SKU. 3.1.1 Cost Cost is the major performance objective especially for the firm which compete against each other in term of price as the lower the cost, the lower the price the firm can sell to customer. When the firm able to lower its cost but can maintains the quality, it is giving the firm the cost objective. (Slack, et al., 2010, P.40) By referring to the polar diagram, the cost for the Autograph range is the highest followed by the Per Una Range, meanwhile the cost for perfect and classic range is the lowest among the three MS Clothing range. The cost directly reflect the selling the price of three MS product range. The price of Autograph range is the most expensive among three as the product under this range use the design of top designer and high quality raw material. When the cost increases, automatically the selling price will be higher. 3.1.2 Quality Quality is a major influence on customer satisfaction or dissatisfaction. Quality is consistent conformance to customers expectation, which also mean doing thing right. High quality of goods and services that is offer to customer will ensure the return of the customer. This will give the firm a quality advantages. (Slack, et al., 2010, P.40) By referring to the polar diagram, the quality of the Per Una Range is the supreme follow by The Autograph Range then by the Perfect and Classic range. The material use in Per Una range product is Superb quality materials while the material use in the Autograph and Perfect Classic range is High quality and high quality fabrics material. This had show that the high quality material had been used by MS in producing their all range of clothing to ensure the quality of clothing is maintain at high level and ensure the customer satisfaction. By using the high quality material, the issue such as shrink colour fading will be eliminate. 3.1.3 Flexibility (The availability of Size) The flexibility simply means that the ability of the form to change the operation in some way. It also means that the firm will be able to react toward different and unexpected circumstances. The ability of the firm to give individual treatment to the different customer will give the firm flexibility advantage. (Slack, et al., 2010, P.46) The polar diagram show that the flexibility of the perfect and classis ranges in term of size is above the other two. This is due to the product available in this range are wide and quantity are large. Compare to the Autograph range, the product are unique and only limited number is available, those who miss the chances to purchase will be difficult to find another as it is purposely create the demand in a limited supply. Other than that the product in perfect and classic range is being sale in a wide range and in a large quantity. 3.1.4 Speed A firm might want to do thing fast, thus minimizing the time form the customer order and receiving it in full. The speed advantages means that the faster the customer can get the goods, the more they will buy and thus, the more the firm can gain from it. (Slack, et al., 2010, P.42) The product can be found almost all the outlet of the MS. Mean while, the product in the Autograph range can be found in selected store only with a lesser amount. On the other hand, the product under per una range can only be found in a limited number in the specific store only. There polar diagram are clearly show the different sales volume SKU of the three different clothing range of MS where the larger the volume of the SKU, the faster the customer can get the goods that they wish to purchase. 3.1.5 Dependability Dependability means that doing thing in time for customer to receive their goods or services exactly when they are needed, or at least when they were promise. When the firm able to perform this, it will give the dependability advantages to the firm. (Slack, et al., 2010, P.44) The polar diagram show that the dependability of the Autograph range is superior of the other two clothing range. The design of the Autograph range is to a wider audience within a unique environment, which means a special design by the famous designer. The design of Per Una Range is slightly below the Autograph range where it is affected by the latest trend but will outdate very fast. When it comes to the perfect and classic range, the design is more to casual and return to basic. Design play an important role in the expensive clothing range as they customer willing to pay just for the design, but when come to basic cloth, customer prefer value-for-money prices.

Gender Discrimination at Wal-Mart Essay -- case study, gender, manager

Introduction Discrimination continues to run rampant throughout organizations in both the United States and worldwide. The Supreme Court case, Dukes vs. Wal-Mart Stores, Inc., dealt with 1.5 million current and former female Wal-Mart employees that claim that they had been a victim of gender discrimination. The ensuing pages will discuss the specific issues that the plaintiffs encountered, followed by suggestions from a human resource manager’s stand point in rectifying adverse impact within the Wal-Mart organization. Gender Discrimination at Wal-Mart In the case of Dukes vs. Wal-Mart Stores Inc. (Dukes), the court found that there was a lack of significant proof that Wal-Mart had a general policy of discrimination (Schipani, 2013). The plaintiffs needed commonality to establish uniformed disparity within the Wal-Mart organization, and statistical evidence was deemed unworthy of proving this commonality (Schipani, 2013). The numbers were astounding; seventy-two percent of the hourly workforce of Wal-Mart are women, yet only 10% are store managers, and a mere 4% of female Wal-Mart employees are district managers (Bernardin & Russell, 2013). The numbers seem to reflect a painfully obvious presence of discrimination, and with Wal-Mart’s market power within its industry, it can be frightening to evaluate the impact their practices have on the American employment culture. Wal-Mart maintains aggressively, a distinct and consistent corporate culture through out its operations. The issue is that local managers and supervisors are given unguided discretion on the hiring, firing, promoting, and disciplining of employees (Hart, 2006). These individual managers bring with them their own beliefs, biases, stereotypes, and assumpt... ...e Rights & Employment Policy Journal, 10(2), 355-394. Hoobler, J., Wayne, S., & Lemmon, G. (2009). Boss' Perceptions of Family-Work Conflict and Women's Promotability: Glass Ceiling Effects. Academy of Management Journal, 52(5), 939-957. Ngo, H. Y., Foley, S., Wong, A., & Loi, R. (2003). Who Gets More of the Pie? Predictors of Perceived Gender Inequity at Work. Journal of Business Ethics, 45(3), 227-241. Parcheta, N., Kaifi, B., & Khanfar, N. (2013). Gender Inequality in the Workforce: A Human Resource Management Quandary. Journal of Business Studies Quarterly, 4(3), 240-248. Rosen, E. I. (2005). Life Inside America's Largest Dysfunctional Family. New Labor Forum, 14(1), 31-39. Schipani, C. (2013). Class Action Litigation After Dukes: In Search of a Remedy for Gender Discrimination in Employment. University of Michigan Journal of Law Reform, 46(4), 1249-1277.

Explain how Golding establishes the main themes of The Spire through his portrayal of Jocelin in the first five chapters of The Spire

The bent and twisted hunchback Jocelin is the cornerstone for interpreting and bringing forth the multitude of interesting themes within the novel. Through Golding's experience of World War II, he established many scathing criticisms of humanity in his literature. In The Spire this is represented by the character of Jocelin, a Dean of a nameless cathedral obsessed with the vision of erecting a four-hundred foot spire. Jocelin is the penultimate antihero, the introduction of the story tells us how â€Å"He was laughing chin up, and shaking his head. God the father was exploding in his face. † It defies the expectations of what context a Dean would place God into, especially in humour, so very early on into this novel are these very slight and gentle implications of corruption, this is also exacerbated when the slight phallic pun of â€Å"Eighteen inches† is joked by Golding, and we get a sense of†¦ â€Å"expecting the reverse† in the chapters to come. Jocelin later lustfully examines Goody Pangall, what is interesting to note is to note is how Jocelin refers to her while looking at her, he mentions her only as â€Å"Pangall's wife† which is incredibly reminiscent of Steinbeck's Of Mice And Men where the female of the story is only referred to as â€Å"Curley's wife† and her actual name is not specified, names are quite symbolic in terms of how much value the other characters revere her, and over here in The Spire, Jocelin only seems to associate her as a nameless object, devoid of human definition. When you take away the name of the character, you disassociate that character from the main frame of other characters who actually do have names, and Jocelin plays up further on this, â€Å"She is entirely woman, he thought, loving her;† shows also his frame of mind early on, his definition of the characters is placed onto a spectrum, with women this is shown as either â€Å"Girl† or â€Å"Entirely woman†, this then can be taken further to show how Jocelin categorises people around him according to how much pleasure and pain they cause him. The presentation of Jocelin up to this point is a sexually repressed Dean, and we have the theme of obsession rising for the first time, however expressed in a Freudian shell that Jocelin's initial sexual innuendos of The Spire is in reality, behaviour stemming from his sexual repression of Goody Pangall. This is just one of many forms of Jocelin's twisted obsession, and that his obsessive thoughts is expressed in many facets of his metaphoric ideology and associations of events and people in the cathedral Golding portrays this shapeshifting obsessive compulsive behaviour in the actual narrative of the story as well, there is a constant shift of narrative within the novel, between Third person and First person, â€Å"Then he dared to think again, in the warmth at his back†¦.. It is my guardian angel,† the narrative is unstable, much rather like the mindset of Jocelin himself, and also implies that Jocelin may interpret and view himself in Third person while in his mind, since the form of the narrative is shapeshifting from several perspectives to another, and also occasional parenthesis â€Å"and two men posed so centrally in the sundust with their crows (and what a quarry noise and echo as they lever up the slab and let it back),† to indicate more First person narrative but in a more personal and reflective manner, and its through this First person narrative that we can note the use of archaic language, † I do Thy work; and Thou hast sent Thy messenger to comfort me,† this shows us the biblical self highlighting of Jocelin to make himself seem more important than he really is. Almost, justifying his work of the spire by expelling all qualms. Another frequent theme that Golding has presented in The Spire is immaturity and the role of childhood in the motivations of character. â€Å"to think how the mind touches all things with law, yet decieves itself as easily as a child,† Childhood here represents stupidity, and its from the immaturity of our actions that cause us to do stupid things, Jocelin touches upon this when examining Goody Pangall, â€Å"She is entirely woman, he thought, loving her; and this is foolish, this childish curiosity shows it. † surprisingly this is the rare times where we see Jocelin refuting himself rather than justifying himself. Its also worth noting that this is not the first time that Golding has used children to carry his critique of humanity, in Lord of the Flies we are shown the adult behaviour's and faults reflected in children, Golding uses this as a metonym to describe that the entire faults of human behaviour are the attempts to recreate childhood and to be free from responsibility, that we give birth to the belief that anything is possible and everything is allowed. When the ground underneath the â€Å"Pit† starts moving, and later on in the book when the stone of the tower starts â€Å"singing†, Jocelin has brought the cathedral to such a position by allowing and justifying every absurd suggestion. Its this very childish frame of thought which sets his imagination loose and Jocelin believes he is comforted by â€Å"an angel sent from God† yet ironically this is only the burning sensation of his spine by tuberculosis, this is an important metaphor, since it conveys the theme of the corrupting tendency of arrogance, that Jocelin's own arrogance is the cause for his own physical deformation is a very powerful axiom that Golding relays, since Golding's seeming objectives behind his work are to tell the story of humanities own arrogance by glorifying the evil of his characters in his literature, incredibly similar to John Milton's Poem Paradise Lost where the evil of Satan is intensified by his devious and intelligent planning, is similarly reflected in Jocelin, where his evil is intensified by his metaphoric interpretations of events and arrogance, ironically arrogance was the sin of Satan himself, even more so that Jocelin is supposedly a religious Dean of a cathedral. The main characteristics of Jocelin so far are, a hungry curiosity for women and sex, Self glorification, Childish immaturity, farfetched imagination which creates a metaphorical perception, and arrogance. These are essentially ramifications of one main theme so far, the notion of Escapism. Through these acts and mindframes Jocelin creates an alternate world to ignore the current reality, the idea of escaping or rather creating, in Mary Shelley's Frankenstein Victor creates the creature as a trophy almost to credit his own scientific intellectualism, and Jocelin's view of his seperate reality is still incomplete, and he feels he needs to create The Spire to serve as a metaphor for his seeming â€Å"closeness† to God, â€Å"I am about my father's business,† it almost seems that some part of Jocelin's twisted psyche is not fully dedicated to his dream, and this is perhaps the flaw in Escapism that Golding tries to present, more implied that if Jocelin represents the extreme borderline of human naivety, how can the rest of humanity practice Escapism when it clearly does not work for the rather vacuous Jocelin? In Jocelin's insensitivity to the truth, we find his sensitivity for lies. In the bigger picture we find Jocelin's hunger for power â€Å"I never guessed in my folly that there would be a new lesson and every level, and a new power† and that building a path or a tower to God, will imbue you with the power of God, and with his treatment of other characters, for instance Roger Mason, he tries to invite Roger Mason further into the messianic visions of the spire, â€Å"God revealed it to me, his unprofitable servant. † claiming these own visions as his own, and more relatively, attempting the to grasp the power of God in his own spindly hands. That is not the holiest prophecy; that is the most devious heresy. Its through Jocelin's arrogance does the issue or theme of pride arise, Its when we place ourselves above other people and see ourselves as higher, that we try to recreate our image into some sort of powerful deity or demigod which cannot be dominated, which Golding has shown to have a very ironic sense of humour by using Jocelin to represent religion; the very thing expected to fight pride, becomes the very thing to personify it. Perhaps its inevitable to become the thing you pretend to be. The ultimate Theme of this book is humanity, Golding's written account of the faults in humanity is found clearly in The Spire through Jocelin, its only through relating to Jocelin, and placing ourselves within his persona, can we really understand him deeply The biggest point however, is that when you explain behaviour and people by relating it to yourself, you can no longer hate them or fear them, you will always respect them neutrally, because you can always find the same desires in your own h eart.

Postpartum: Childbirth and Marie Wilson Marie Essay

Marie Wilson, a 34-year-old female client who is gravida 4, para 3, is transferred to the postpartum unit two hours after a prolonged 14-hour labor and forceps delivery of a male infant weighing 9 lb, 2 oz. The placenta was intact upon delivery. The labor and delivery nurse reports that Marie was catheterized for 600 ml of yellow urine just before delivery. Her record indicates that she had a repair of a 4th degree laceration. A postpartum assessment reveals that her vital signs are stable: blood pressure 120/80, pulse 84, respirations 20, temperature 98.9Â ° F. Additional assessment indicates that her fundus is firm and located 1 cm above the umbilicus, and the perineal sutures are intact with edges well-approximated. The client describes herself as exhausted and without pain, since she has had no sensation below her waist since receiving epidural anesthesia. A 1,000 ml bag of Lactated Ringer’s solution containing 10 units of Pitocin (oxytocin) is infusing via an 18 g peripheral IV in the left forearm at 125 ml per hour, with 300 ml remaining in the bag. The IV is patent, without redness or swelling, and can be discontinued when this bag’s infusion is complete. 1. Prior to discontinuing the IV Pitocin (oxytocin), which assessment is most important for the nurse to obtain? A) Vital signs. B) Vaginal discharge. C) Uterine firmness. D) Oral intake. Correct answer(s): C 2. What is the priority nursing diagnosis for Marie, who is experiencing residual effects of epidural anesthesia? A) Risk for injury. B) Impaired physical mobility. C) Altered urinary elimination. D) Risk for infection. Correct answer(s): A 3. What is the priority nursing action to address Marie’s needs related to the repair of her 4th degree perineal laceration? A) Provide prescribed oral pain medication and stool softener. B) Encourage warm sitz baths 2 to 3 times daily. C) Apply perineal ice packs consistently for the first 24 to 48 hours. D) Teach proper and frequent use of the peri-bottle. Correct answer(s): C

United States v Merck Medco

United States v Merck Medco Parties The parties in the case involve the United States government and Medco Health Solutions, which is an international company that offers medical services. The government side has a number of parties, including the department of Justice. Specifically, the department of Justice represents the Inspector General in charge of Health and Human services. This shows that the department of Justice is the American institution charged with the responsibility of ensuring that sanity is upheld in society.Advertising We will write a custom case study sample on United States v Merck Medco specifically for you for only $16.05 $11/page Learn More The office of personnel management is also mentioned as the party in the case. The department of Justice in the case represents the personnel office. The government side is the complainant while Medco Solutions is the accused. On the accused side, Diane Collins, George Bradfort, William Gauger and Joseph Piacentile are mention ed as parties. Facts There are many facts in the case involving the United States government and Merck-Medco Solutions. One is that Medco is a company that prescribes treatment to patients. It offers pharmacy services to employees in both private and public sector. Medco company runs mail order pharmacies and call centers that are licensed by individual states and other bureaucratic institutions. The company conscribes employees that are approved by the government to exercise their professions. The company offers mail order treatments and allied benefit services to federal workers, retirees and their dependents (Showalter, 2007). Medco Company entered into various agreements with state agencies such as Federal Employees Health Benefits Program. Medco is a product of a merger between Merck Company and Medco RX Services Company. Therefore, in this, the word ‘Medco’ represents all its subsidiaries, forerunners and descendants. Another actuality is that Collins was the depu ty president and general manager of Merck-Medco RX Services from early 1999 to early 2001. Furthermore, Bradford and Gauger are specialized pharmacists who were conscribed by Medco Company before 1999. On May 6, 1999, Hunt and Gauger filed a qui tam action in the district court. On February 10, 2000, Piacentile filed another qui tam in the same court. Hunt and Gauger qui tam and Peacentile qui tam were merged into a single case. The two cases form the basis of this case. Moreover, it is a fact that the United States asserted that Medco and defendant Collins presented claims for payment of funds into various government financed health care plans including Blue Cross Shield Association and the Government Employees Hospital Association. Again, the United States government asserted that it had some civil claims against Medco Company and Collins. The government disputed that Medco Company had breached the contract by going against state pharmacy policies and rules (Showalter, 2007). Furt hermore, the company had contravened the pharmaceutical codes of ethics. Medco Company failed to fulfill its contractual performance accords by failing to testify its performance accurately under Federal Plan policies. The government confirmed that Medco Company failed to convene its responsibilities by suggesting bogus payments. On the other hand, the company used false credentials to lessen legal responsibilities.Advertising Looking for case study on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More This was done by annulling instructions for which no evidence existed in Medco’s management Database. Again, the company called off prescriptions without a legitimate explanation. It is factual that the company gave out prescriptions without accurately carrying out DUR test and without aptly contacting prescribers. It is a reality that Medco Company utilized the services of under qualified technicians to carry out functions that are legally preserved for experts. Such functions must always be performed by an expert in the field of pharmacy or must be supervised by a pharmacist. Such mistakes included arbitrating and giving prescriptions to patients without being assessed or directed by a qualified pharmacist. Litigation The criticisms in this case were filed under the federal false claims act and state false claims acts against Medco Health Solutions. The cases assumed that Merck and Medco analytically deceived government-funded health indemnity plans by tolerating bribes in exchange for referring patients to particular goods, furtively tolerating rebates from medicine producers in exchange for rising the market share of goods, surreptitiously rising long-standing medicine expenses and failing to conform to state-mandated reputation of care values. This was conducted in a number of ways. One of the ways included requesting general practitioners to change patient prescriptions (drug subst itution) by offering deceptive, bogus or imperfect information that undermined the integrity of patients. The managers were only concerned about profits. Another technique employed was secretively rising the price of drugs offered to recipients by intentionally interchanging patients’ prescriptions to stop them from taking advantage of soon to be produced standard drugs. Lastly, the company was accused of defying fundamental state obligations governing pharmacist regulation of drug execution procedures. Through such behavior, the United States assumed that Merck and Medco dishonored their agreements with government-funded health indemnity plans (Showalter, 2007). These cases were revealed by whistleblowers in support of the United States government. On June 20, 2003, the United States interceded in the case following a widespread examination of realistic accusations and evidentiary support offered by parties. This study was performed by several national organizations, includi ng the Office of Inspector General of the Department of Health and Human Services, the Defense Criminal Investigative Service, the U.S. Attorney’s Office, the Office of Inspector General of the Office of Personnel Management, and the Eastern District of Pennsylvania. On December 9, 2003, the United States modified the case by adding two administrators of Medco as defendants.Advertising We will write a custom case study sample on United States v Merck Medco specifically for you for only $16.05 $11/page Learn More In the modified case, these managers were blamed for hiding deliberate obliteration of patient treatment, annihilating and ordering the demolition of patient prescriptions and giving confusing reports concerning the conspiracy when interrogated by the Department of Justice. The modified case also added another case, which was the violation of the law as regards to Public Contract Anti-Kickback Act for making shocking payments to health progra ms to persuade them to choose Medco as a pharmacy benefit director for government indentures. Decisions In this case, the court decided that Merck-Medcos conformity programs were either fictional or inadequate in approval of the irresponsible obligations mentioned. The conclusion did not clarify the extent of the Merck-Medco observance plan but the Court evidently concluded that the company presented bogus claims in thoughtless disrespect of their falsity. The resolution did not state that the top executives had any authentic information that the claims presented by Merck-Medco were bogus, but it surmised that the observance plan that was in place at Merck-Medco was obviously not enough to identify and stop the false assertions (McClellan, 2010). Obviously, the Government was not in a position to prove overwhelmingly that managers and bosses of the corporation had concrete data as regards to the supposed counterfeit statement or satisfactory participation in the billing procedure to have irresponsible disregard or intentional unawareness of the bogus claims presented to Blue Cross and Blue Shield. In this case, the court ruled that Medco Company had contravened the law and had bridged the contract. The company had no option but to pay the government a huge amount of money as compensation for damages. Effects on healthcare The Merck-Medco case is the first that an outworker has been pronounced for violating criminal law in part since the observance plan was imperfect and inadequate. Consequently, a number of proposals aimed at intensifying the conformity program have been put forward. Firstly, any healthcare company should set up and circulate a code of conduct in the company as fast as possible if it is not yet publicized (Tauber, 2005).Advertising Looking for case study on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More The administrator agreement must be designed to serve as a top observer with unswerving task for all conformity actions (Showalter, 2007). The person in charge must have direct admission to the CEO and the Board of Directors. Compliance manager must be given power, authority to separately investigate and act on issues related to law, and policies that oblige the corporation to operate or not operate in particular ways. Furthermore, all workers in the healthcare sector must be educated about the existence and the particulars of the companys observance plan. To do this, normal reports, at least weekly, should be issued to the Board of Directors as regards to any interior surveys (Tauber, 2005). Managers in the healthcare organizations should set up episodic interior reviews and institute techniques for supervising observance and incessantly examining the hotline system for detecting contraventions. Furthermore, reporters must be guaranteed of their security. Finally, the organization should set off any interior inquiry based on plausible information regarding reported crimes. References McClellan, M. (2010). A National Strategy to put Accountable Care into Practice. Health Affairs, 29(5). Showalter, S. (2007). The Law of Healthcare Administration (5th ed.) New York: Health Administration Press. Tauber, A. (2005). Patient Autonomy and the Ethics of Responsibility. Cambridge: MIT Press.

Trouble with Did and Had

Trouble with Did and Had Trouble with Did and Had Trouble with Did and Had By Maeve Maddox Ive begun to notice the use of did in contexts that call for had. In an episode of CSI New York, the Sinese character remarks: If I didnt do it, he would have killed me. Hes referring to something bad he did earlier in the episode. He wasnt killed, so the act hes referring to is both contrary to fact and in the past. The statement is an example of the contrary-to-fact past conditional. Because the if clause refers to a contrary-to-fact past event, it requires the past perfect form of the verb. If I hadnt done it, he would have killed me. Heres another example of using did when had was called for: Did you bring any beer? I wish I did. The speaker has arrived at a gathering of friends. Its clear from the context that hes wishing hed thought to bring some beer. The main verb in the first sentence is bring. The second sentence conveys a regret that the speaker did not carry out an act in the past. Since the bringing of the beer remained undone in the past, the past tense of bring is called for in the second sentence: Did you bring any beer? I wish I had (brought some is understood). What do you think? Do errors like these portend a further erosion of the past perfect? Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Grammar category, check our popular posts, or choose a related post below:Comma After i.e. and e.g.Expanded and ExtendedMay Have vs. Might Have

Finding Forest Land for Sale

Finding Forest Land for Sale Buying your first forested property can quickly turn into a nightmare. You can make the process much easier if you develop a plan using the following tips. Its also a good idea to use available legal and technical professionals as your budget allows. Foresters, lawyers, and accountants will help you ensure that the property is what you really want and that you are legally protected after all transactions are nailed down. Finding a Timber Market Value All you really have to do is find out what the property is worth and how much you are willing to spend to acquire the property. Alas, the devil in these details! Finding a fair market value for land and timber and knowing what you have to pay for the property isnt always easy- and they may not necessarily be the same. Land and permanent property appraisals may be separate from a timber appraisal. Initially, you need to brush up on tree measuring and selling of timber on the property to be appraised. The timber value can, in very few cases, be as much or more than the land value, and so its extremely important that it be assessed. A forestry novice will be quite lost without putting in some minimum study time and should find a forestry professional to determine the approximate value of the timber. Finding a Fair Market Property Value The next step is to put a value on the property and determine the amount you are willing to spend. You first start by verifying that the seller has what he or she says. This means researching bare-land values and performing a  timber analysis to determine volumes and values. Also, you need to explore what costs and revenues you will incur as you manage the property. This includes taxes, timber sales/management expenses, and hazard risks. A land appraiser who is also a forester should be consulted. Putting It All Together The biggest question to ask yourself when buying property is what you can afford to spend on land and trees. There are many formulas that can assist you, but the main questions are the following: What is the competition for your particular property type? Competition,  which equals demand, can influence your final offer,Where is the property situated in terms of access and timber markets and what amenities does the forest offer- including ponds or lakes, hunting, and other forms of real or potential forest recreation potential. Remember the old real estate adage- location, location, location!What is the current price for property in the area? You must know what others are paying for similar types of property. Why the seller is selling is a reasonable question to ask and often influences price.According to expert Mark Bice, RMS Inc., knowing why a seller sells can be beneficial. Various reasons including divorce, estate taxes, and death will encourage a quick and reasonable sale.

System Analysis and design (case study) Case Study - 1

System Analysis and design ( ) - Case Study Example At Emory, a collection of mobile apps have been rolled out to cater for research, medicine, running school services and human resources. The school has 20 apps focusing on delivery of digital information and creation of an efficient and cost-effective infrastructure. The apps find usage in the memorial hospital where a clinical mobile app is used in massive transfusion1. Bring-your-own-device (BYOD) is a movement that has brought radical transformations in various enterprises helping organizations to boost their productivity to unimaginable heights. The employees to the organizations have also been more engaged. However, the technology has been faced with some challenges2. For instance, the major challenge is increased mobile security breaches. Employees in most organizations especially in the U.S are allowed to carry their mobile devices to the work place. However, following policies set on the use and management of the devices is a problem the organizations have to contend with. The mobile devices have a great potential of transforming how the daily activities of an organization are conducted. However, to realize the full potential, employees have to be educated on how the mobile devices can be fully utilized. There is lack of an organization-wide awareness about the mobile capabilities which is hurting the productivity of the organizations. To realize the value of the mobile enterprise, there has to be aggressive collaboration between the employees and the organizations3. The employees must be trained on the various ways of utilizing the apps on their mobile devices for the good of the organization. Training has to go beyond the basics of exchanging emails and sending instant messages4. If the companies are to succeed in the future, they will have to meet the high standards and requirements that are offered by Millennials for the mobile technologies and functions. The IT departments should consider working on apps such

Workplace Observation Paper Essay Example | Topics and Well Written Essays - 500 words

Workplace Observation Paper - Essay Example The portal does indicate an attempt to increase employees’ sense of belonging. Wal-Mart previously did not encourage employees to speak out about their working experiences with the retail giant. Walmartfacts.com is now available for employees to post their positive experiences. Where Wal-Mart fails in communications is in addressing the negative issues, the subjects that have brought about all the negative headlines. The retailer is still reluctant to meet with union leaders in communities where it has proposed new store locations. Edd Snyder, executive director, corporate communications, at GM, offers advice that counters avoidance of opposing groups. â€Å"You must find some common ground. The idea is to bridge [differences] and talk and be in constant communication with the other organization. Find common threads† (Frank, 2005). The corporate culture at Wal-Mart is very different from the individual cultures In each store location. Every community has its own set of values or standards. Some are more blue-collar oriented, while others are more white-collar with higher levels of education. The low cost strategy, which many critics believe has ignored environmental and human rights issues does appeal to those who are price conscious. Wal-Mart’s mission statement includes â€Å"our fist responsibility is to provide all consumers (1) the best products and services with guaranteed satisfaction under one roof† (uwstout.edu). Wal-Mart follows through on this promise, by providing securing relationships with low cost suppliers and manufacturers.

Fredrick Douglasss Essay Example | Topics and Well Written Essays - 750 words

Fredrick Douglasss - Essay Example He joined the abolition movement and became its leader because of his excellent command at speaking. This paper discusses about Frederick Douglass as a personality who struggled very hard in his life and can be seen as a shining star by his appreciators. Frederick Douglas was born in 1818 at Maryland (Lampe, 1998). As a child, he learnt to read and write by the support of white children and men as he used to notice them reading and writing. From his childhood, he identified that only education can transform his status from a slave to a freeman. He tried multiple times to run away from his masters and at last became successful. He thought about running from slavery to freedom by the support of his education. He also used to read newspapers with the help of which, he was able to comprehend political and social content (McFeely, 1991). He believed in his right of freedom. Douglass used to narrate his story as a slave in abolitionist gatherings and after noticing his vigor and eloquence at speaking, he was made the leader of the movement. He used to deliver lectures on the issue of anti-slavery. He became a member of American Anti-slavery society and took part in tours for highlighting the curse of slavery (Oakes, 2007). During his struggle at making people acknowledge that slavery is a curse and every person has equal right to remain free, he was attacked several times but he continued to pursue his mission. Douglass’s speeches were so inspirational and convincing that people liked them and continued to listen to them. When Douglas used to orate in a public gathering, the crowd was usually heavily populated because of the expressiveness and strength of his words (Lampe, 1998). People used to give weight to his words because of his elaboration and power of speech. Douglass remained the property of his master until and unless he did not raise funds for his freedom by carrying out a tour of Ireland and England for the anti-slavery movement. After coming back f rom England, Douglass started to turn out many newspapers with abolitionist topics (McFeely, 1991). Douglass was well aware of the effectiveness of the newspapers as in his childhood, he had seen their power and influence on people. This was the reason that motivated Douglass to start his own newspapers for the education of masses of US. Frederick Douglass not only worked for anti-slavery movement but also spoke for women rights as according to his perception, all human beings were equal and had the right to have their civil liberties. He was of the opinion that women should have equal right to vote as men. In his view, nobody was to be deprived of any civil right in order to lead a life that is not suffocating whether the person is black or a woman. It was the strength of the words of Douglass that resolution related to women’s right to vote got passed (McFeely, 1991). According to Douglass, it was only education and knowledge that kept the power of bringing the black out of the curse of slavery (Lampe, 1998). He struggled for gaining equal rights of education for African American population. Douglass felt that no fortified insurgence was required by the African American population but only knowledge acquisition was enough to gain their due right of freedom (Oakes, 2007). He emphasized on the acquirement of education. During the American civil war, Douglass struggled for the obtainment of rights of his people and after the declaration

Careers in Math Essay Example | Topics and Well Written Essays - 500 words

Careers in Math - Essay Example This change in gas prices has been attributed to many things, including the war in Iraq, and Hurricanes Katrina and Rita. This is a real life example of the pre-calculus concept of functions. The problems with modeling this situation are obvious. There are so many factors that could be involved it is difficult to tell which is the actual cause of the change, and then there is the difficulty with the rate of change. Finally, there is the pesky problem of the spot price and the difficulties with assessing how spot prices affect retail prices. Retail prices usually follow the spot price shifts, but they sometimes lag behind (This Week in Petroleum 2005). These are the sorts of issues that must be analyzed and solved by mathematicians working out in the real world. One person who designs and runs numerous mathematical models for decision making purposes is Amanda Peterson, who works in the Operations Research department of the Dynamic Research Corporation. Often, decision problems can be solved using mathematical equations, but there are "cases when the situation is too detailed for a math model alone or the customer prefers a more visual product" (MAA Online 2005). Then she writes a computer program called a simulation model to simulate the different aspects of the problem. Decision makers can use this model to test different scenarios.

Nuclear Arms Race - Part 2 Assignment Example | Topics and Well Written Essays - 1000 words

Nuclear Arms Race - Part 2 - Assignment Example As the time passed by, the world observes technological advancements and the scientific technology also experienced a boom in their inventions, innovations, and advancements, which evolved the phenomenon of nuclear weapons. Thus, they became likely to be potential and sustained their growth through the nuclear guns, missiles and other weaponries until the beginning of the twenty first century (Lambers, 2006). The cold war between U.S. and USSR contributed to substantial, immense, and drastic crash and collision to the political, cultural, and technological aspects of these countries as both of them made efforts and techniques consecutively that prohibited each other from getting hold on to the nuclear power domination. Although, the nuclear arms and weapons are environment friendly when involved in the development process, yet it accompanies colossal damage to the environment when used in wars or other terrorist activities. The nuclear war not only results in the overwhelming and det eriorating impacts to the environment but at the same time thousands of people also come under the calamitous effects of the nuclear war (Siracusa, 2008). The wealth and funds that come under spending on the production and manufacturing of nuclear arms and weapons has been under many arguable and disputable discussions and dialogues in the recent times. According to the pieces of information, there are adequate amount of nuclear weapons available with the super powers, even though, the countries are continuously in the process of trading the nuclear weapons. The capital spent and the financing provided to the nuclear armaments and artillery must come under close observations by the governments of the countries, as they are the foremost and key source of mammoth obliteration and leaves an indelible imprint on the societies and its inhabitants (Schwartz, 1998). The immediate impacts of the nuclear wars and weapons evidence the loss of innumerable lives of the people at once, as when t he explosion hits a portion of land, it kills the nearby people on a large scale on abrupt basis. However, the nuclear arms and ammunitions make shocking, disturbing, and distressing long-term impacts on the environment, as the explosions are the one chief source of origin that is evident to the global warming. The increasing global warming is eventually making the lives of the human race miserable (Goldstein, 2009). One of the consequences of the nuclear weapons was that it involved a huge amount of money and capital for the research and development process as the innovation and advancement in technology made the research more expensive with the use of sophisticated and complicated equipments and machineries. The technological advancement and expansion, the actions and events involved in the process of nuclear arm building and manufacturing should not be adequate to avoid in the long term. One of the major consequences and risks that the human populace suffers from is the eye burns and impairments due to the reason that the discharge and emission of the heat energy in the form of dangerous ultraviolet light from the nuclear weapons causes intense harm to eyes. The eye damage can be in the form of flash blindness that is on provisional and short-term basis as it causes sightlessness and remains for a span of time. The retina is vulnerable to certain type and

Biographies of the Justices Essay Example | Topics and Well Written Essays - 500 words

Biographies of the Justices - Essay Example He stands out as a judge with a moderate judicial temperament who has equally pleased and disappointed both conservatives and liberals. Appointed by a Republican president, Souter had been expected by some to be a solid conservative on the court. Nevertheless, his Oyez biography notes that he has shored up the "moderate camp" of the Court and has been instrumental in preventing it from shifting too far to the right. This propensity to avoid extremes is, to me, a desirable characteristic in a person who wields tremendous influence over the lives of so many people The justice whom I like the least is Antonin Scalia (http://www.oyez.org/oyez/resource/legal_entity/103/). Here is a justice who has ruffled feathers both on the Court and off. He has a confrontational and abrasive style that has led to consternation among his associates and his opponents, while usually pleasing extreme conservatives. He takes a very dogmatic and red-line view of the law that leaves little room for nuance. Unfortunately, the complexity of many issues that can come before the Court often requires a more nuanced approach in order to reach the optimal decision. Scalia is also the justice who surprised me the most. I had always considered him to be an unabashed conservative in the political sense of the word.

Nuclear Arms Race - Part 2 Assignment Example | Topics and Well Written Essays - 1000 words

Nuclear Arms Race - Part 2 - Assignment Example As the time passed by, the world observes technological advancements and the scientific technology also experienced a boom in their inventions, innovations, and advancements, which evolved the phenomenon of nuclear weapons. Thus, they became likely to be potential and sustained their growth through the nuclear guns, missiles and other weaponries until the beginning of the twenty first century (Lambers, 2006). The cold war between U.S. and USSR contributed to substantial, immense, and drastic crash and collision to the political, cultural, and technological aspects of these countries as both of them made efforts and techniques consecutively that prohibited each other from getting hold on to the nuclear power domination. Although, the nuclear arms and weapons are environment friendly when involved in the development process, yet it accompanies colossal damage to the environment when used in wars or other terrorist activities. The nuclear war not only results in the overwhelming and det eriorating impacts to the environment but at the same time thousands of people also come under the calamitous effects of the nuclear war (Siracusa, 2008). The wealth and funds that come under spending on the production and manufacturing of nuclear arms and weapons has been under many arguable and disputable discussions and dialogues in the recent times. According to the pieces of information, there are adequate amount of nuclear weapons available with the super powers, even though, the countries are continuously in the process of trading the nuclear weapons. The capital spent and the financing provided to the nuclear armaments and artillery must come under close observations by the governments of the countries, as they are the foremost and key source of mammoth obliteration and leaves an indelible imprint on the societies and its inhabitants (Schwartz, 1998). The immediate impacts of the nuclear wars and weapons evidence the loss of innumerable lives of the people at once, as when t he explosion hits a portion of land, it kills the nearby people on a large scale on abrupt basis. However, the nuclear arms and ammunitions make shocking, disturbing, and distressing long-term impacts on the environment, as the explosions are the one chief source of origin that is evident to the global warming. The increasing global warming is eventually making the lives of the human race miserable (Goldstein, 2009). One of the consequences of the nuclear weapons was that it involved a huge amount of money and capital for the research and development process as the innovation and advancement in technology made the research more expensive with the use of sophisticated and complicated equipments and machineries. The technological advancement and expansion, the actions and events involved in the process of nuclear arm building and manufacturing should not be adequate to avoid in the long term. One of the major consequences and risks that the human populace suffers from is the eye burns and impairments due to the reason that the discharge and emission of the heat energy in the form of dangerous ultraviolet light from the nuclear weapons causes intense harm to eyes. The eye damage can be in the form of flash blindness that is on provisional and short-term basis as it causes sightlessness and remains for a span of time. The retina is vulnerable to certain type and

Sarahs Key Essay Example for Free

Sarahs Key Essay The dance ‘The Oppression of the Jewish Race’ was based on the stimulus ‘Schindlers List’ directed by Steven Spielberg. The dance is in narrative structure based on the journey of the Jewish race from freedom to oppression. The feelings within this dance vary. In the first section, the dance begins with a light playfulness where happiness and hope are portrayed by the dancers. This hopefulness gradually fade however, as the dance steadily progresses into bleakness and has a numbing quality to it. The dancers continue in this despair with outwards signs of pain being expressed. The feeling in the end section of the dance is one of utter hopelessness and anguish. The dance concludes with this feeling as it is how the Jews felt by the end of the Holocaust and as many of their lives ended when the Holocaust was taking place during World War II. This was the motivations that the choreographer used to choreograph this dance. The overall choreographic intention is to convey the oppression of the Jewish race. Through five sections of the dance this is displayed as each section gets progressively worse in a narrative structure that depicts different parts of the Schindlers List movie the stimulus. I was given the role, by the guest choreographer, of a teenage Jewish girl who is a similar age to me. Using the Stanislavski techniques I developed my character for each section of the dance. In the beginning I am happy and free, using emotional memory to get into character before I begin dancing. As the dance progresses my character becomes less and less happy and free. By the second section, I have lost all emotion and my movements are no longer free but more mechanical. My facial expressions slowly transform into those of pain and my movement reflects this as they are bound. When in the gas chambers I brought the idea of pain in my movements and expressions as my character passes away. I brought the understanding of what the Jewish race would have gone through during this time, through my character. Section 1 – The Beginning The beginning section of the dance is acting. There are seven dancers on stage, each interacting with someone. One dancer (a small boy character) runs onto the performance space from stage left to find his toy car, which he finds and then plays with. Another dancer runs on from stage right (a small girl character) with her toy doll. The boy then snatches the doll away from the girl and teases her with it as she chases after him. The boy’s mother then enters (third dancer to enter the stage) from stage left and tells off the boy for being mean to the girl. The girl’s mother then enters the performance space and supports the girl as she is apologised to by the boy. At the same time as this apology is taking place. A grandmother and her granddaughter are making their way through the space beginning from upstage right. This is when I enter the performance. I run onto the performance space from upstage left, waving as I enter. I move through the space to interact with two of the other dancers, by hugging both of them as they are my grandma and friend. I then walk down stage with the grandmother and friend and my focus is on the other dancers who are greeting each other, the mood is light and free. The dancers then make their way down stage to form a line. They then take whatever prop that they have with them (e. g. the car for the boy) and have it in their hand. Activity One Choreographic Intention The dance ‘The Oppression of the Jewish Race’ was based on the stimulus ‘Schindlers List’ directed by Steven Spielberg. The dance is in narrative structure based on the journey of the Jewish race from freedom to oppression. The feelings within this dance vary. In the first section, the dance begins with a light playfulness where happiness and hope are portrayed by the dancers. This hopefulness gradually fade however, as the dance steadily progresses into bleakness and has a numbing quality to it. The dancers continue in this despair with outwards signs of pain being expressed. The feeling in the end section of the dance is one of utter hopelessness and anguish. The dance concludes with this feeling as it is how the Jews felt by the end of the Holocaust and as many of their lives ended when the Holocaust was taking place during World War II. This was the motivations that the choreographer used to choreograph this dance. The overall choreographic intention is to convey the oppression of the Jewish race. Through five sections of the dance this is displayed as each section gets progressively worse in a narrative structure that depicts different parts of the Schindlers List movie the stimulus. I was given the role, by the guest choreographer, of a teenage Jewish girl who is a similar age to me. Using the Stanislavski techniques I developed my character for each section of the dance. In the beginning I am happy and free, using emotional memory to get into character before I begin dancing. As the dance progresses my character becomes less and less happy and free. By the second section, I have lost all emotion and my movements are no longer free but more mechanical. My facial expressions slowly transform into those of pain and my movement reflects this as they are bound. When in the gas chambers I brought the idea of pain in my movements and expressions as my character passes away. I brought the understanding of what the Jewish race would have gone through during this time, through my character. Section 1 – The Beginning The beginning section of the dance is acting. There are seven dancers on stage, each interacting with someone. One dancer (a small boy character) runs onto the performance space from stage left to find his toy car, which he finds and then plays with. Another dancer runs on from stage right (a small girl character) with her toy doll. The boy then snatches the doll away from the girl and teases her with it as she chases after him. The boy’s mother then enters (third dancer to enter the stage) from stage left and tells off the boy for being mean to the girl. The girl’s mother then enters the performance space and supports the girl as she is apologised to by the boy. At the same time as this apology is taking place. A grandmother and her granddaughter are making their way through the space beginning from upstage right. This is when I enter the performance. I run onto the performance space from upstage left, waving as I enter. I move through the space to interact with two of the other dancers, by hugging both of them as they are my grandma and friend. I then walk down stage with the grandmother and friend and my focus is on the other dancers who are greeting each other, the mood is light and free. The dancers then make their way down stage to form a line. They then take whatever prop that they have with them (e. g. the car for the boy) and have it in their hand. Each dancer, in time with the music, kneels down and places their prop on the ground and has one last moment with it. The dancers focus stays on the ground as they all stand up and then simultaneously they raise their heads, their focus up and out. This concludes this section. I learnt this section by getting into character and portraying the emotions that a teenage Jewish girl would. I interact with the other character and I had to really make sure that I used ensemble awareness when getting into the line so that there was equal space between the dancers next to me and to be in a straight line. I portray the intentions of the dance by interacting with the other dancers, showing my relationship with them – this portrays that Jewish race was free to be who they are. My interaction with my prop shows how the Jewish race is still holding on to its individuality but has to eventually let it go. Section 2 – Free Motif This section involves free and flowing movements. The focus of the dancers is all on the movements as it begins with a series of retire step with arms open and moving in a circular motion (half of the dancers go upstage and the other half continue to move toward stage right along down stage), into a drag turn with the left leg and foot is out and the arms are extended on a diagonal, with the body on a tilt. The dancers then run forward and reach toward the sky before they bend and contract their bodies, running backwards with their arms curved alongside their torsos. This is followed by many flowing movements, with the opening of arms, reaching out and looking up. The section finishes with the dancers dropping to their knees with their arms out in front of them. As they get up the pain on their faces begins to show as they enter into the Hitler salute and lifting the right leg at the same time and then coming together to shuffle along with our hands placed on one another shoulders. This ending of the section shows the Nazi regime tightening and sending to Jewish people to concentration camps, their freedom being taken away from them. This section also involves many contemporary contractions and I have had to work on ballet technique. When practising the retires I needed to focus is on pointing my feet, keeping my left arm extended in second and staying up on releve. Through the use of focus and expression I brought the idea across that I was free yet not happy as I know that something is wrong, being in the ghettos. Section 3 – Mechanical Motif The dancers facial expressions in this section are completely blank when completing the dance moves, almost, no sign of any emotion, almost like a robot. Their focus is directly out or in the direction they are moving to. This reinforces the idea that they are losing the very essence of who they are, their humanity and individuality and are beginning to live as though they are like machines. This section is performed through twice. The first time it its completed is in complete unison, the second time they are dancing the same movements but repeated different moves three times so it looks like each dancer is doing something different though they all end at the same time. This section involves a series of isolations of the arms, feet, legs and body as the dances move mechanically. After the isolations is a back bend. The dancers place their hands on the small of their back; tilt back and head facing the sky. This is the only place in this section when the dancer’s faces show expression – pain, with mouths open to show the intensity of it. The dancers then hunch over with knees bent, walk forward and then stand up with hands clasped up by their shoulder, before they drop to the floor. Once on the floor the dancers sit back on their knees and circle round in a back bend and then stand up. This whole sequence is repeated as stated before except for the circled backbend and that concludes this section. I had to practice the sharpness of the movements and keeping myself void of Each dancer, in time with the music, kneels down and places their prop on the ground and has one last moment with it. The dancers focus stays on the ground as they all stand up and then simultaneously they raise their heads, their focus up and out. This concludes this section. I learnt this section by getting into character and portraying the emotions that a teenage Jewish girl would. I interact with the other character and I had to really make sure that I used ensemble awareness when getting into the line so that there was equal space between the dancers next to me and to be in a straight line. I portray the intentions of the dance by interacting with the other dancers, showing my relationship with them – this portrays that Jewish race was free to be who they are. My interaction with my prop shows how the Jewish race is still holding on to its individuality but has to eventually let it go. Section 2 – Free Motif This section involves free and flowing movements. The focus of the dancers is all on the movements as it begins with a series of retire step with arms open and moving in a circular motion (half of the dancers go upstage and the other half continue to move toward stage right along down stage), into a drag turn with the left leg and foot is out and the arms are extended on a diagonal, with the body on a tilt. The dancers then run forward and reach toward the sky before they bend and contract their bodies, running backwards with their arms curved alongside their torsos. This is followed by many flowing movements, with the opening of arms, reaching out and looking up. The section finishes with the dancers dropping to their knees with their arms out in front of them. As they get up the pain on their faces begins to show as they enter into the Hitler salute and lifting the right leg at the same time and then coming together to shuffle along with our hands placed on one another shoulders. This ending of the section shows the Nazi regime tightening and sending to Jewish people to concentration camps, their freedom being taken away from them. This section also involves many contemporary contractions and I have had to work on ballet technique. When practising the retires I needed to focus is on pointing my feet, keeping my left arm extended in second and staying up on releve. Through the use of focus and expression I brought the idea across that I was free yet not happy as I know that something is wrong, being in the ghettos. Section 3 – Mechanical Motif The dancers facial expressions in this section are completely blank when completing the dance moves, almost, no sign of any emotion, almost like a robot. Their focus is directly out or in the direction they are moving to. This reinforces the idea that they are losing the very essence of who they are, their humanity and individuality and are beginning to live as though they are like machines. This section is performed through twice. The first time it its completed is in complete unison, the second time they are dancing the same movements but repeated different moves three times so it looks like each dancer is doing something different though they all end at the same time. This section involves a series of isolations of the arms, feet, legs and body as the dances move mechanically. After the isolations is a back bend. The dancers place their hands on the small of their back; tilt back and head facing the sky. This is the only place in this section when the dancer’s faces show expression – pain, with mouths open to show the intensity of it. The dancers then hunch over with knees bent, walk forward and then stand up with hands clasped up by their shoulder, before they drop to the floor. Once on the floor the dancers sit back on their knees and circle round in a back bend and then stand up. This whole sequence is repeated as stated before except for the circled backbend and that concludes this section. I had to practice the sharpness of the movements and keeping myself void of expression of emotion during this section so that I could effectively portray the end of the Jewish races freedom through my movements. Section 4 – Bound Motif This section has the dancers focus mostly on the hands. There is a mixture of point and flexing of the feet as the hands are cupped. The dancers then contract and then lift up, back flexed and hands flat above head. Then the chest and stomach concaves as the dancers turn and then lift their leg. They then swoop the arms while bending to the right. The dancers then swing around to push out their cupped hands. They then turn again, still with the arms cupped and circle their head around while raising the cupped hands. The dancers then walk back into a cluster as this section conclude. I had difficulty alternating between flexing and pointing my feet and I had to practise this to be able to show the bound movements that are the constriction that the Jews are going through. Section 5 – Gas Chamber Scene This is the section where all of the dancers act/dance their death in the gas chambers. Our black dresses are taken off and the dancers are ‘naked’. Each of the dancers begins by raising their heads in unison as if to look at the ‘shower heads’ that release the gas. The expression is a mixture of hope and utter despair. The music then drops and the dancer’s shoulders hunch over and it is if they had been punched in the stomach. All the dancers then interact with one another as they slowly die. The last person dies as the violin ends, with a single lifted hand that comes shakily down as the dance ends. This death symbolises how the Jews dies as one group, their dignity stripped away and their race slandered. I had to practise this is a lot with another dancer and working together to try and project the death of our characters. This help to show the intention of how they still helped each other even as they were dying. When I performed I used weight bearing in the death scene as I hold one of the dancers who fall onto me. This is to show the support that the Jews are still giving one another. Throughout the different sections my focus varies from out at the audience, to my hands and then focusing on the different movements. This is to enhance the ideas of going from freedom to oppression. There are many relationships with the other dancers through interaction with the other dancers. This is particularly in the beginning section and in the death scene. I interact with two of the dancers at the beginning as I hug them and walk with them. In the death scene I hold one of the dancers and then with my ‘grandma’ we clasp hands and hold her. expression of emotion during this section so that I could effectively portray the end of the Jewish races freedom through my movements. Section 4 – Bound Motif This section has the dancers focus mostly on the hands. There is a mixture of point and flexing of the feet as the hands are cupped. The dancers then contract and then lift up, back flexed and hands flat above head. Then the chest and stomach concaves as the dancers turn and then lift their leg. They then swoop the arms while bending to the right. The dancers then swing around to push out their cupped hands. They then turn again, still with the arms cupped and circle their head around while raising the cupped hands. The dancers then walk back into a cluster as this section conclude. I had difficulty alternating between flexing and pointing my feet and I had to practise this to be able to show the bound movements that are the constriction that the Jews are going through. Section 5 – Gas Chamber Scene. This is the section where all of the dancers act/dance their death in the gas chambers. Our black dresses are taken off and the dancers are ‘naked’. Each of the dancers begins by raising their heads in unison as if to look at the ‘shower heads’ that release the gas. The expression is a mixture of hope and utter despair. The music then drops and the dancer’s shoulders hunch over and it is if they had been punched in the stomach. All the dancers then interact with one another as they slowly die. The last person dies as the violin ends, with a single lifted hand that comes shakily down as the dance ends. This death symbolises how the Jews dies as one group, their dignity stripped away and their race slandered. I had to practise this is a lot with another dancer and working together to try and project the death of our characters. This help to show the intention of how they still helped each other even as they were dying. When I performed I used weight bearing in the death scene as I hold one of the dancers who fall onto me. This is to show the support that the Jews are still giving one another. Throughout the different sections my focus varies from out at the audience, to my hands and then focusing on the different movements. This is to enhance the ideas of going from freedom to oppression. There are many relationships with the other dancers through interaction with the other dancers. This is particularly in the beginning section and in the death scene. I interact with two of the dancers at the beginning as I hug them and walk with them. In the death scene I hold one of the dancers and then with my ‘grandma’ we clasp hands and hold her. Activity Five Technique Contemporary ballet is a form of dance which incorporates elements of both classical ballet and modern dance. It takes its technique and use of Pointe work from classical ballet, although it permits a greater range of movement that may not adhere to the strict body lines of ballet technique. Many of its concepts come from the ideas and innovations of 20th century modern dance, including floor work, balletic movements and turn-in of the legs Most contemporary ballet focuses on the movement rather than a storyline, though this dance is an exception. Contemporary ballet does not focus on symmetry, and having a stage that is unbalanced is characteristic of the style. It focuses more on a physical interpretation of a theme. Contemporary ballet dancers curve, twist and bend their upper bodies, which is different to ballet, which is all about having perfect posture and control. This dance has a series of contemporary ballet based movement like contractions, curved backs, flexed feet and abstract movements Activity Five Technique Contemporary ballet is a form of dance which incorporates elements of both classical ballet and modern dance. It takes its technique and use of Pointe work from classical ballet, although it permits a greater range of movement that may not adhere to the strict body lines of ballet technique. Many of its concepts come from the ideas and innovations of 20th century modern dance, including floor work, balletic movements and turn-in of the legs Most contemporary ballet focuses on the movement rather than a storyline, though this dance is an exception. Contemporary ballet does not focus on symmetry, and having a stage that is unbalanced is characteristic of the style. It focuses more on a physical interpretation of a theme. Contemporary ballet dancers curve, twist and bend their upper bodies, which is different to ballet, which is all about having perfect posture and control. This dance has a series of contemporary ballet based movement like contractions, curved backs, flexed feet and abstract movements Two movements/moments that I found difficult: Moment/Movement one: I had to work quite a lot on my retire in the second section. I needed to make sure that my left arm is support and is strong in second position. I also to make sure that my left foot connects with my right leg on the side of my knee. I need to focus on my left hand as my right arm is circling around. In the performance, because I practised them, I performed this movement with clarity and confidence, whilst think of how I practised it. Moment/Movement 2: In the beginning I had to work on becoming my character, the teenage Jewish girl who is happy and free. Using Stanislavski techniques, I remembered a time when I was feeling happy and free, using my emotional memory to get into character before I begin dancing each practise. During the actual performance I got into character before entering the performance space, remember how I was happy and free from the practises prior to the performance. Breath My breath is used to show my emotion in the dance. In section one and two my breath comes easy and is free flowing like the movements. In section three it is sharp and restricted as the movements and isolations are causing this. In section four and five my breath is laboured and shaky as I am in pain and in despair. Two movements/moments that I found difficult: Moment/Movement one: I had to work quite a lot on my retire in the second section. I needed to make sure that my left arm is support and is strong in second position. I also to make sure that my left foot connects with my right leg on the side of my knee. I need to focus on my left hand as my right arm is circling around. In the performance, because I practised them, I performed this movement with clarity and confidence, whilst think of how I practised it. Moment/Movement 2: In the beginning I had to work on becoming my character, the teenage Jewish girl who is happy and free. Using Stanislavski techniques, I remembered a time when I was feeling happy and free, using my emotional memory to get into character before I begin dancing each practise. During the actual performance I got into character before entering the performance space, remember how I was happy and free from the practises prior to the performance. Breath My breath is used to show my emotion in the dance. In section one and two my breath comes easy and is free flowing like the movements. In section three it is sharp and restricted as the movements and isolations are causing this. In section four and five my breath is laboured and shaky as I am in pain and in despair.

Anaemia During Pregnancy: Case Study

Anaemia During Pregnancy: Case Study ANAEMIA DURING PREGNANCY The wonder and joy ofpregnancyis matched by the bodys ability to adapt to looking after the growing baby. In addition to the mothers physiologic needs, there is the additional need to provide the building blocks for optimal growth of the baby. All this construction requires energy and oxygen as the fuel that helps drive the engine. Oxygen in the air that we breathe is delivered to the cells of the body by haemoglobin, a protein molecule found in red blood cells. When the blood lacks level of healthy red blood cells or haemoglobin it leads to a condition called anaemia. The main part of red blood cells is haemoglobin that binds to oxygen. If red blood cells is too few or the haemoglobin is abnormal or low , the cells in the body will not get enough oxygen. The body goes through significant changes when a woman is pregnant. Anaemia is a common disorder in pregnancy, which affect 20 to 60% of the pregnant women. About 20 to 30% of blood increases in the body, which increases the supply of iron and vitamins which are required in the production of haemoglobin. Most of the mothers lack adequate amount of iron during the second and third trimester of pregnancy. A mild anaemia is normal during pregnancy due to increase in the blood volume, but however a severe anaemia can put the baby at high risk of iron deficiency later in infancy. There are different types of anaemia that can develop during pregnancy such as fotal-deficiency anaemia vitamin B12, deficiency anaemia and iron deficiency anaemia. According to Cashion Alden, Perry (2009) In pregnancy, ladies need extra folate to make the red blood cells to transport oxygen to tissues throughout the body. Folate deficiency can directly contribute to certain types of birth defects. Folate-deficiency anaemia, folate which is also called folic acid, is a type of vitamin which is needed for the body to produce new cells, including healthy red blood cells. Iron-deficiency anaemia is when the body does not have enough iron to produce adequate amounts of haemoglobin, and is the most common cause of anaemia in pregnancy. To form healthy red blood cells the body needs vitamin B12 from her diet, the body would not be able to produce enough healthy red blood cells. Ladies who do not eat meat, poultry, dairy products, and eggs have a risk of vitamin B12 deficiency, which can lead to birth defects. Severe or anaemia which is untreated can lead to preterm or low-birth-weight baby, postpartum depression, baby with a serious birth defect of spine or brain, prenatal mortality or maternal death. . Some of the symptoms of anaemia during pregnancy are pale skin, lips and nail, feeling tired or weak, dizziness, shortness of breath, and rapid heartbeat. Antenatal care refers to care given to a pregnant woman from the time of conception is confirmed until the beginning of labor. Risk factors for anaemia in pregnancy can be woman pregnant with more than one child, two pregnancies close together, vomiting a lot because of morning sickness, teenager who is pregnant, not eating enough foods that are rich in iron and heavy periods before became pregnant In nursing process Assessment is the first stage in which nurse carries out a complete and holistic nursing assessment. Normal ward routine of nursing care procedures in antenatal unit at booking and important nursing focus areas is followed. Antenatal booking appointment, which provides the midwife with the valuable background information. The subjective and objective data is collected. The purpose of the visit is to bring together the woman to the maternity service. The information is shared between the mother and the midwife in- order to discuss, plan and implement care for duration of the pregnancy, the birth and postnatal period. During my attachment in antenatal clinic a mother came in for antenatal booking. Collecting her personal history, she is Mrs X, Indian married female. Her date of birth is 22th January, and is now 23 years old. , she is a high school graduate, is able to read and write and follow instructions, able to maintain eye to eye contact and is married to a 25 years old taxi driver named Mr Y. She is staying with her husband, his parents, two brother’s and a sister. They live in a wooden house near the copra mill. The mother is from Waibula but lives with relatives in Namara. Her emergency contacts were of her husband xxxxxxx and cousin sister xxxxxxx. Her family history, Mrs X mother is diabetic and her sister had twins. Mothers medical history was occasionally complains of migraine, and heavy menstrual bleeding. The husband and his elder brother are driving taxi and also they do a casual job in the timber mill. Mrs last normal menstrual period was on 25th of September 2012, her expec ted date of delivery is on the 7th of January 2013. She missed her period for two months. There was no gynaecological history present. Starting with her examinations, the height is 6 feet and 4 inches (1.65m) and is 66 kilograms. The urine test was normal, blood pressure was 80/40mmHg, temperature of 37.5 °C,pulse rate: 114 bpm, respiratory rate: 28 bpm skin: (+) pallor, (-) jaundice, (-) cyanosis, head:, EENT: pale palpebral conjunctiva, negative cervical lymp adenpathy chest, lungs: symmetrical chest expansion, (-) retractions heart: adynamic precordium, tachycardia, (-) thrills, (-) murmur abdomen: globular, soft, normal and active bowel sounds, non-tender extremities: pale nail beds, cold upper and lower extremities (-) cyanosis, weak peripheral pulsesneurological: No found neurological deficits rectal exam: No haemorrhoids, no fissures, no masses, palpated, no tenderness, intact rectal vault, good sphincter tone. In the blood test, the full blood count was done and was low an d proven to be anaemic. In order to ensure that the outcome of the pregnancy is the best for mother and baby, a routine is undertaken which is embraced by the term â€Å" antenatal care†. Fraser and Copper (2009) stated â€Å" the aims of antenatal care is to monitor the progress of pregnancy to .maternal and fetal health, developing a partnership with the woman, providing a holistic approach to the woman’s care that meets her individual needs, promoting an awareness of her public health issues for the woman and her family, exchanging information with the woman and her family, enabling them to make informed choices about pregnancy and birth, being an advocate for the woman and her family during her pregnancy, supporting her right to choose care appropriate for her own needs and those of her family, recognizing complications of pregnancy and appropriately referring woman to the obstetric team or relevant health professionals or other organizations, facilitating the wom an and her family in preparing to meet the demands of birth, making a birth plan, facilitating the woman to make an informed choice about methods of feeding and giving appropriate and sensitive advice to support her decision and offering parenthood education within a planned programme or an individual basis†.(P.g 265). During booking the mothers blood was sent in the laboratory for tests. The haemoglobin level 12g/dL or if it is the haematocrit less than 30% in a pregnant woman. Then it proves that the woman is anaemic. Mrs X haemoglobin level was 8.7g/dL and hemocrit was 25% , so it proved that she is anaemic. It is the risk to the mother and the fetus., So the nursing problem was diagnosed to Mrs X that she was suffering from Iron Deficiency Anaemia. Fraser et al. (2009) stated â€Å" iron deficiency anaemia is the most common hematologic disorder in pregnancy, it affects approximately 15% to 25% of pregnant woman, depending on the ethnic and socioeconomic groups being studied†.(P.g 872). After the diagnosis of iron deficiency anaemia Mrs X was referred to the doctor. The body produces more blood to support the growth of the body. The existence of a hematologic abnormally increases the pregnant women’s risk for developing more complication such as infection or preterm delivery If the mother not getting enough iron or certain other nutrients, the body might not be able to produce the amount of red blood cells it needs to make this additional blood. Taylor, Lillies, Lemone Lynn (2011) stated â€Å" carbohydrates, protein and fats are potential sources of energy for the body†.(P.g 1158). Mrs X presented with symptoms of pale skin, lips and nails, feeling tired or weak, dizziness, shortness of breath, rapid heart rate and trouble concentrating. It is very important to assess the wellbeing of the fetus. This was done by checking the fetal movement and listening to the fetal heart sound using a fetal cardio graph machine. The bloods were performed to see the changes that may indicate worsening of anaemia. The nurses has its own independent role scope of practice to ensure that the mother and fetus are healthy. The nurses role in managing the pregnant woman in this case of Mrs X are as follows. Nurses can be councillor, collaborator and advocator. The role of the nurse at first step will be taking or monitoring vital signs of the mother and thefetal heart rate. To assess the fetal heart rate, fetal heart sound and fetal kick count was monitored. Urine check is another important role of nurse in monitoring an anaemic mother. The mother will be asked to bring along a urine sample for glucose and protein level. In early pregnancy if protein level will be high it can be sign of problems including urinary tract infection, a kidney disorder , high blood pressure or diabetes. If in later pregnancy protein of high level is found is sign of pre-eclampsia. Taking of height and weight measurements is another role of a nurse, also to work out body mass index. Potter, Perry, Stockert Hill (2013) st ated â€Å" body mass index (BMI) measures weight corrected for height and serves as an alternative to traditional height-weight relationships†.(P.g 56). Since the nurse knows the diagnosis of Mrs Mrs Xshe can advise on what kind of foods to consume .She was advised to take foods that are rich in iron examples are red meat, egg yolks, dark leafy vegetables, dried fruit, iron-enriched cereals, grains, chicken giblets, beans, lentils, and liver. Establishment of quiet and peaceful environment to promote rest. During her hospitalization Mrs X was served with full diet. The nurse also taught to the woman on correct positioning while resting.The nurses also did health education with the husband on health. Nurses need to follow the physicians orders in giving the prescribed medications on time.They also advised on personal hygiene. In antenatal care the nurse needs to collaborate with other health care professionals, such as dietician, the obstetric, doctor, haematologists and physiotherapist. To enablepeople to make informed and practical choices about food and lifestyle in health and disease, the role of a dietician comes in, dietetics is the interpretation and communication of nutrition science. The role of a dietician was to prepare a food guideline for Mrs X. Obstetric team works with patients who are wanting to become to become pregnant, is pregnant or have recently delivered. The obstetricnurse have plenty roles in managing an anaemic mother. Mrs Narayan was admitted, reviewed, history taken, vaginal examination, fetal heart tones, and duration and intensity of contractions was done by an obstetric nurse. Paediatrician doctoradvised on healthy and successful delivery of Mrs Narayan, also advised on diet and medication compliance. Paediatrician doctor also took blood and urine test. The roleof midwife is to provide pregnancy care to woman during pregnancy and during birth. The midwife took Mrs X medical history and explained in detail the limitations and risks associated with pregnancy while being anaemic. The midwifealso checked urine for protein and heart beats for the developing baby. Health education was also provided by the midwife. The doctor was also responsible to prescribe medications, examination and to consider delivery if the condition of mother gets worse and fetus gets distressed. The physiotherapist taught Mrs X on exercise that was helpful to her. There are rationales behind the nurses independent roles in ensuring the well-being of the mother and the fetus. As stated earlier monitoring of vital signs, it is very important because to see if Mrs X condition is stable or not. Also same for the fetal heart rate and fetal sounds to see if everything is normal or not. Monitoring fetal heart rate and fetal sound to ensure that the fetus is not distressed. Urine checkis also important factor, it is done by the nurses to see if the glucose and protein level is normal or requires attention. Taking of height and weight is also important to see if mother is healthy and gaining weight since she is pregnant.Also to calculate the body mass index of the mother. The nurse providing health education on her diet, encouraging her to take iron rich foods to prevent or stop Mrs X from getting anaemic. The nurse administers medication as prescribed by the doctors to make Mrs X to improve on her health.Personal hygiene is really important because th e way mother keeps her self affects or reflects the fetus as well. There are rationales behind the professionals collaborative roles in establishing or giving quality care to the pregnant mother. Taking of history from the mother is to know whether she had any past medical problems, such as gynaecological issues or any surgeries that can hinder her present pregnancy. Doctors or paediatricians take samples of blood to see if mother is seriously anaemic or requires attention, or to see if there could be any complications.The rationale of doctors doing vaginal examination is to see cervical dilation or any complications which can arise. Counselling by the doctors of having proper diet or dieticians, to improve the condition of the mother and avoiding complications. Obstetric team was to ensure that if emergency develops there could be urgent need to conduct delivery in caesarean section, because they have knowledge on when and how to conduct delivery in emergency situation. Doctors presenting medication to increase iron level in the blood. Physiotherap ist needed to educate mother on exercise to help her in delivery. During the end of the antenatal clinic, the strengths and weakness of Mrs X was found and identified, it was recorded in evaluation. Mrs X was adjusted to what the plan was ruled out for her. Her strengths were that she followed her diet to what the dieticians planned for her. The health education was really effective to her and her husband supported on her diet and growing fetus. The family support was also there and she was in happy environment, free of fear and anxiety. Mrs X also took her tablets on time and gained weight. Another blood test was done and was found out that her haemoglobin level was normal. The benefitsof maternal iron supplementation on these outcomes are unclear, even for woman who develop anaemia during pregnancy. There is vivid evidence that maternal iron deficiencyanaemia increases the risk of preterm delivery and low birth weight. Iron supplementsimprove the iron status of the mother during pregnancy and during the postpartum period, even in woman who enter pregnancy with reasonable iron stores. Through my point of view, the mass of evidence supports the practice of routine iron supplementation during pregnancy, even though iron is most common and important for woman who have anaemia. ( Approx: 2443 words.) Reference Potter, P, A., Perry, A, G., Stockert, P, A., Hill, A, M. (2013). Fundamentals Of Nursing (8th ed.). United States Of America: Mosby. Fraser, D, M., Copper, M, A. (2009). Myles: Textbook for midwives (15th ed.). Edinburgh: Churchill Livingstone. Lowdermilk, D, L., Perry, S, E., Cashion, K., Alden, K, R. (2012). Maternity Women’s Health Care ( 10th ed.). United States Of America: Mosby. Taylor, C, R., Lillis, C., Lemone, P., Lynn, P. (2011). Fundammentals Of Nursing: The art and science of nursing care (7th ed.). Philadelphia: Lippincott. Reeder, S, J., Martin, L, L., Martin, L, L. (1997). Maternity Nursing: Family, newborns, and women’s health care (18th ed.). Philadelphia: Lippincott. 1