A 28-year-old purchaser with a history of endometriosis presents to the emergency department with intense stomach pain and nausea and vomiting.
The patron also reviews her periods are irregular with the remaining one being 2 months in the past. Palpate the fundus, and test fetal coronary heart rate.
Endometriosis frequently involves the pelvic tissue and might envelop the ovaries and fallopian tubes. it can affect close by organs, collectively with the bowel and bladder. So at some point of the menstrual cycle, or length, this tissue responds to hormones, and due to its region, frequently results in ache.
Even in extreme cases of endometriosis, maximum may be treated with laparoscopic surgical treatment. In laparoscopic surgical treatment, your fitness care provider inserts a slim viewing device (laparoscope) thru a small incision close to your navel and inserts units to get rid of endometrial tissue through every different small incision.
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you are a doctor and one of your patients has a stent inserted following heart catheterization. plavix (generic name is clopidogrel) is a very commonly prescribed cardiological medication after this procedure. which genetic profile would make them less like to receive benefit from this medication?
There will be less of an antiplatelet effect from clopidogrel (Plavix) in people who have the CYP2C19 PM phenotype because CYP2C19 cannot activate it.
Clopidogrel must be transformed by the CYP2C19 enzyme into an active metabolite in order to be effective. Those with two CYP2C19 genes with loss-of-function are referred to as CYP2C19 poor metabolizers. Because clopidogrel cannot be activated by CYP2C19 in those who have the CYP2C19 PM phenotype, there will be less of an antiplatelet effect from the medication.
With acute coronary syndrome (ACS), atherosclerotic vascular disease, and other conditions, clopidogrel (marketed under the name Plavix) lowers the risk of myocardial infarction (MI) and stroke.
Since CYP2C19 cannot activate clopidogrel in people who have the CYP2C19 PM phenotype, there will be a reduced antiplatelet effect from the drug.
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the nurse is administering a medication to a client with hyperthyroidism to block the production of thyroid hormone. the client is not a candidate for surgical intervention at this time. what medication should the nurse administer to the client?
Antithyroid glucose like propylthiouracil(PTU) and methimazoleare.
Antithyroid drugs, such as propylthiouracil(PTU) and methimazoleare given to block the production of thyroid hormone preoperatively or for long-term treatment for clients who are not candidates for surgery or radiation treatment. Levothyroxine (Synthroid) would increase the level of thyroid and be contraindicated in this client. Spironolactone (Aldactone) is a diuretic and does not have the action of blocking production of thyroid hormone and neither does propranolol (Inderal), which is a beta-blocker.
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if a person routinely takes antianxiety medication for an extended period of time, what is the most debilitating symptom likely experienced if the person stops taking the drug?
The most debilitating symptom that a person likely will experience after stopping to take antianxiety medication after taking it for an extended period of time is intense anxiety.
Antianxiety medications are the type of medications that help reduce anxiety symptoms, such as extreme fear, worry, and panic attacks. While feeling anxious every now and then is a normal human response, feeling it too much or too often can be a sign of a disorder and may debilitate the victim from performing daily tasks and socializing. That's why antianxiety drugs tend to be taken for an extended period of time.
When someone quits using antianxiety drug, within a day or two, they may feel various withdrawal symptoms, such as intense anxiety, insomnia, or vivid dreams. These will fade gradually over time, from several weeks to several months.
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a patient is having a problem with wound healing. the nurse assesses the patient's tray and finds that only 25% of all meals are eaten. the nurse helps the patient understand that protein intake is important for what reason? select all that apply.
It is necessary for maintaining and growing bodily tissues, as well as for both of these. Only dietary sources can provide essential amino acids, which are necessary for repair.
What about proteins?A structure composed of amino acidsThe body needs proteins to operate rightly.They serve as the structure blocks for several fleshly factors, including the skin, hair, and enzymes, cytokines, and antibodies.Living effects include chemical motes called proteins.They perform several different tasks, similar as organizing, transportation, and defense.A protein can have up to four different structural situations and is made up of chains of amino acids.examples of particular proteins are collagen, insulin, and ant fraternity.An essential element of a balanced diet is protein.Amino acids are the chemical" structure blocks" that make up proteins.Amino acids are used by your body to produce hormones, enzymes, and to make and repair muscles and bones.They may be employed as a source of energy as well.Protein is present in every mortal cell. An amino acid chain makes up the abecedarian structure block of proteins.In order for your body to repair damaged cells and produce new bones , you need protein in your diet.Children, teenagers, and expectant women all need protein for healthy growth and development.Learn more about proteins here:
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the risk of which lower-extremity injury was decreased in female basketball athletes who participated in a 5-week balance training program that improved landing movement mechanics?
The risk of an anterior cruciate ligament injury in female basketball players who underwent a 5-week balancing training program that enhanced landing movement mechanics was reduced.
Overstretching or rupture of the knee's anterior cruciate ligament (ACL) is an anterior cruciate ligament injury. A single tear might be either partial or whole. The knee is a flexor joint that is formed by the ligaments connecting the large lower leg bone (tibia) and the large upper leg bone (femur).
The majority of patients claim to have had a sudden "pop" and felt their knee "give out" beneath them at the time of injury. Other signs and symptoms include stiffness, discomfort, edema, loss or reduction in range of motion, and trouble walking.
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a nurse is caring for a client who started tpn two days ago previously. the client reports increased frequent thirst, dry mouth, and avoiding frequently. which is the nurses most appropriate action?
The nurse's most appropriate action would be to assess the client's electrolyte levels, as increased thirst and dry mouth can be a sign of electrolyte imbalance.
What is TPN?
TPN stands for Total Parenteral Nutrition, which is a type of nutrition that is given to patients intravenously instead of through the digestive tract. It is mostly used for people who are unable to get adequate nutrition through regular diet. TPN is a combination of proteins, carbohydrates, fats, vitamins, and minerals that are delivered directly into a vein to provide nourishment and hydration.
The nurse should also ask the client about any other symptoms they may be experiencing, such as nausea or fatigue. The nurse should also provide the client with extra fluids and oral care, as well as encourage them to drink fluids throughout the day.
What do you mean by Electrolytes?
Electrolytes are basically minerals in the body that carry an electric charge. They are responsible for a number of essential bodily functions, such as regulating the body's hydration levels, muscle contractions, and nerve signaling. Examples of electrolytes include sodium, potassium, calcium, chloride, and magnesium.
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the nurse is caring for a client who is diagnosed with type ii diabetes. which treatment option does the nurse expect to provide education for in regards to this diagnosis?
The treatment option that the nurse expects to provide education for in regard to this diagnosis is Diet and exercise.
Type 2 diabetes develops when the pancreas, a large gland located behind the stomach, is unable to create enough insulin to regulate blood glucose levels or when the body's cells don't react appropriately to the insulin that is produced.
It is brought on by issues with the hormone or molecule called insulin in the body. It frequently correlates with being overweight or inactive, as well as with a family history of type 2 diabetes.
Type 2 diabetes is characterized by improper insulin use by the body. And while some people can regulate their blood glucose (blood sugar) levels with healthy nutrition and exercise, others might require medication or insulin to do so.
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Grading of tumors depends upon the following except
at birth, a xy patient that has a mutation in the gene coding for the enzyme 5-alpha reductase will exhibit
At birth, a XY patient with a mutation in the gene coding for the enzyme 5-alpha reductase will exhibit ambiguous genitalia.
What is Mutation?
Mutation is the process of changing or altering the genetic material of an organism. It can be caused by various factors, such as exposure to radiation, chemicals, or viruses, or even by mistakes that occur during DNA replication. Mutation can lead to changes in the organism's physical characteristics, as well as changes in its behavior.
In the case of the XY patient, this enzyme is responsible for converting testosterone to dihydrotestosterone, which is necessary for the normal development of male sexual organs. Without this enzyme, the body cannot produce enough dihydrotestosterone and male sexual organs do not develop normally. The result is atypical external genitalia that can appear to be both male and female. In addition, the patient may also have an underdeveloped prostate and underdeveloped male secondary sex characteristics, such as facial hair and a deep voice.
What is Ambiguous genitalia?
Ambiguous genitalia is a condition in which an infant's external genitals do not have the typical appearance of either a boy or girl. In some cases, ambiguous genitalia may be a sign of an underlying medical condition, such as an intersex disorder or a chromosomal abnormality. Treatment for ambiguous genitalia typically involves the use of hormone therapy, surgery, and sometimes psychological therapy.
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an elderly patient who is a customer at your pharmacy is being admitted to the hospital. the patient is having difficulty remembering what medications they take at home. the hospital pharmacist completing the medication reconciliation calls your pharmacy to ask for a list of medications the patient is taking and the prescriber names for each med. what should you do in order to stay compliant with hipaa?
Give the pharmacist the information they've requested. To obtain the patient's permission, ask them to speak with her.
What behavior qualifies as a technical safeguard?HIPAA specifies technical protections for needs related to access controls, data in motion, and data at rest. A covered entity must put in place technological policies and procedures that limit access to PHI data storage systems to those who have been authorized access rights.
What is covered by the HIPAA security rule?All personally identifiable health information that a covered entity electronically generates, acquires, retains, or transmits is protected by the Security Rule. "Electronic Protected Health Information" is what this data is called (e-PHI). 3 PHI that is transmitted verbally or in writing is not covered by the Security Rule.
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a client at 27 weeks' gestation is admitted to the obstetric unit after reporting headaches and edema of her hands. review of the prenatal notes reveals blood pressure consistently above 136/90 mm hg. the nurse anticipates the health care provider will prescribe magnesium sulfate to accomplish which primary goal?
The primary goal is to prevent maternal seizures.
What is the importance of magnesium sulphate during pregnancy?
Since it is known that some newborns who receive magnesium sulfate (MgS04) during pregnancy can be protected from developing cerebral palsy, it is given to pregnant women whose babies will be delivered between 24 and 30 weeks of pregnancy. Pregnant women who get magnesium sulfate have an eclampsia risk that is more than halved, perhaps lowering the chance of maternal death during the perinatal period.
Hence the answer is, the healthcare provider's primary goal is to prevent maternal seizures.
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a client with chronic kidney disease reports generalized bone pain and tenderness. which assessment finding would alert the nurse to an increased potential for the development of spontaneous bone fractures? elevated serum creatinine hyperphosphatemia hyperkalemia elevated urea and nitrogen
A client with chronic kidney disease reports generalized bone pain and tenderness and hyperphosphatemia would alert the nurse to an increased potential for the development of spontaneous bone fractures.
A bone fracture is complete or partial break during a bone. Treatment usually involves resetting the bone in situ and immobilising it during a forged or splint to convey it time to heal. Sometimes, surgery with rods, plates and screws could also be needed.
Hyperphosphatemia is a condition within which you have got an excessive amount of phosphate in your blood. Causes embrace advanced chronic nephrosis, glandular disorder and metabolic and carbon dioxide acidosis. Hyperphosphatemia does not have symptoms. Treatment includes creating changes to your diet, medications and chemical analysis
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Among u. S. Children, which deficiency is widely prevalent due to inadequate intakes and may necessitate supplementation?.
The deficiency which is widely prevalent among u. S. Children due to inadequate intakes and may necessitate supplementation is Vitamin D deficiency.
What is vitamin D?It is a type of secosteroids.It is fat soluble vitamin.it is important in intestinal absorption forcalciummagnesiumphosphateAll the above three are important for building bone.
Necessitate supplementation :Necessitate supplementation is the necessary supplementation of the required for being fit and healthy. These supplements enhance our regular diet for healthy nutrition .
Hence, The deficiency which is widely prevalent among u. S. Children due to inadequate intakes and may necessitate supplementation is Vitamin D deficiency.
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a student nurse is caring for a client with iron deficiency anemia who is newly prescribed ferrous sulfate. which action by the student nurse requires the supervising nurse to intervene?
The nurse assesses a client during suctioning.
Anemia outcomes from a loss of pink blood cells or dysfunctional pink blood cells in the frame. This results in reduced oxygen flow to the frame's organs. symptoms might also consist of fatigue, pores and skin pallor, shortness of breath, lightheadedness, dizziness, or a fast heartbeat.
Treatment depends on the underlying diagnosis. Iron supplements may be used for iron deficiency. nutrition B dietary supplements are perhaps used for low nutrition degrees. Blood transfusions can be used for blood loss. medicinal drugs to set off blood formation may be used if the frame’s blood production is decreased.
Anemia is a condition in which you lack sufficient wholesome red blood cells to carry good enough oxygen in your frame's tissues. Having anemia, also called low hemoglobin, could make you experience being worn out and susceptible. there are many styles of anemia, every with its own cause.
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a client who plays football for a local high school is seeing the health care provider for treatment of athlete's foot. what does the nurse anticipate the health care provider to order?
The nurse anticipate the health care provider to order antifungal.
Antifungals are drugs that kill or stop the increase of fungi (the plural of fungus) that cause infections. They may be additionally known as antimycotic marketers.
Weakened immune system. Travel to an surroundings with excessive fungi. Outbreak of fungi because of adjustments within the surroundings, which includes production. Advent of latest fungi to an environment.
If left absolutely untreated, your stubborn fungal skin contamination may also purpose a few or the alternative sort of everlasting damage and in some cases your fungal infection may also sooner or later result in demise.
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a nurse is caring for a newborn who was diagnosed with an imperforate anus. assessment reveals drooling, copious bubbles of mucus in mouth, rattling respirations, and abdominal distention. during feeding, the newborn coughs and becomes cyanotic. which action by the nurse would be appropriate?
The nurse would make sure that the newborn should receive intravenous hydration.
Intravenous hydration allows your body to soak up nutrients and fluids while not wishing on the systema digestorium. It creates less waste than drinking fluids, and your body will retain a lot of of the nutrients it wants.
Imperforate anus is a inherent (present from birth) defect during which the gap to the anus is missing or blocked. birth defect might occur in many forms. Most infants with birth defect can would like surgery to mend the matter. a standard repair could be a posterior mesial anorectoplasty (PSARP). It's done once the doctor is aware of the placement of the organs within the abdomen and wherever the body part ends.
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a client has received discharge education post extracapsular cataract surgery. which statement made by the client indicates to the nurse that further teaching is needed?
A client has received discharge education post extracapsular cataract surgery. Case your eyesight acuity deteriorates, then get in touch with the surgeon. With acetaminophen, made by the client indicates to nurse, thing is needed.
Currently, the most popular method of cataract surgery in the developing world is extracapsular cataract extraction with an intraocular lens implant (ECCE + IOL). Extracapsular cataract extraction (ECCE) involves removing the cortex and nucleus of the lens while keeping the posterior lens capsule intact. A posterior chamber intraocular lens (IOL) implant is then placed into the capsular bag. This is the greatest approach optically speaking because it returns normal vision with the least amount of distortion or magnification. Better visual correction following surgery leads to earlier intervention because it is possible to act earlier.10,24,25. IOLs of excellent grade are now available for less than each. The disadvantages of ECCE + IOL include the need for an operating microscope and the preservation of the posterior capsule, which may opacify and compromise vision years after cataract surgery. The cataract is removed during small-incision ECCE + IOL surgery through a self-sealing tunnel incision near the limbus.
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a staff nurse expresses frustration that a native american patient always has several family members at the bedside. which action by the charge nurse is most appropriate?
A staff nurse expresses frustration that a native American-affected person always has several own family members at the bedside which motion via the fee nurse is most suitable.
We represented American HomePatient as a co-recommend in its sale to Lincare Holdings Inc., a U.S. subsidiary of the Linde organization. The transaction closed on February 2, 2016, with an undisclosed purchase rate.
In psychology, frustration is a common emotional reaction to competition, related to anger, annoyance, and disappointment. Frustration arises from the perceived resistance to the achievement of a man or woman's will or goal and is possible to increase while a will or intention is denied or blocked.
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discussion board question: review the scenario below and answer following questions: which units are overstaffed and which are understaffed?of those units that are overstaffed, what will you do with the unneeded staff?how will you staff units that are understaffed? will an outside agency or mandatory overtime methods be used?how did staffing mix and patient classification system (pcs) acuity levels factor into your decisions?what safeguards can you build into the staffing plan for unanticipated admissions or changes in patient acuity during the shift?
Yes hospitals can force employees to work mandatory overtime. Employers can also terminate an employee for refusal to work the mandated overtime.
which units are overstaffed and which are understaffed? The ICU unit is understaffed The Pediatrics unit is overstaffed The Obstetrics unit is understaffThe medical floor is overstaffedThe Surgical Floor is well staffed what will you do with the unneeded staff?The unneeded staff can be shifted to the units of ICU where 2 staff members are required . Also, these unneeded staff can be eliminated from the hospitals.
How did staffing mix and patient classification system (pcs) acuity levels factor into your decisions?Although data comparisons with other organizations are not possible, a healthcare institution can create its own PCAS that is unique to that company. If the organization already has a Staffing and Scheduling System, the newly formed PCAS may be connected with the additional functionalities of the existing staffing system.
what safeguards can you build into the staffing plan for unanticipated admissions or changes in patient acuity during the shift?We can use agency nurses and travel nurses typically employed by an external nursing broker for unanticipated admissions or changes in patient acuity during the shift.
What is hospital staff management ?The process by which healthcare providers effectively and efficiently administer everything from patient registration to appointment scheduling, document management, consultation management, lab management, drug safety, report generation, staff management, outpatient management, and so much more is known as hospital management.
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you have a 38-year-old patient who has fainted. following your local protocol, you use a pulse oximeter to determine the spo2. you attach the device to the patient's finger; it gives you a reading of 91 percent. what does that reading indicate?
The pulse oximeter indicates a reading of 91%. Therefore, the reading shows that the patient has mild hypoxia.
Hypoxia means a lack of oxygen in the blood. Pulse oximeter is a device that is used to measure the saturation of oxygen in the blood. A healthy person will definitely show a SpO₂ level between 95% to 100%. If the oximeter shows an oxygen level below 95% in the blood, the person will have hypoxia.
Therefore, in this case, the reading indicates mild hypoxia.
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what is the term that refers to the extent to which a nutrient is absorbed in the gastrointestinal tract?
a client who has rheumatoid arthritis has begun treatment with anakinra and has received the first injection. what finding would indicate that the primary health care provider (phcp) needs to be notified and that the medication would be discontinued?
White blood cell count of 12,000 mm3 (12 × 109/L) and temperature of 99.9º F (37.7º C.
What do you mean by the term Rheumatoid Arthritis?
Rheumatoid arthritis is a chronic autoimmune disorder that causes inflammation of the joints. It is a progressive condition that can lead to permanent joint damage and deformity if left untreated. Symptoms of rheumatoid arthritis include joint pain, swelling, and stiffness. Other symptoms can include fever, fatigue, and loss of appetite. Treatment typically includes medications, lifestyle changes, and physical therapy.
Leukocytosis and a slight temperature elevation can indicate an infection in a client on a biological response modifier. These findings warrant primary health care provider notification and possible discontinuation of the medication. Irritation and erythema are common and can be decreased by rotating the injection sites. Arthritic medications often are given with other medications, such as a tumor necrosis factor inhibitor. Arthritic symptoms often do not lessen early in the treatment.
What is Anakinra?
Anakinra is a medication used to reduce inflammation and pain caused by rheumatoid arthritis. It is a type of drug known as a recombinant human interleukin-1 receptor antagonist, and it works by blocking the action of a substance in the body called interleukin-1 (IL-1), which is involved in the inflammation and joint damage caused by rheumatoid arthritis.
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If you were exposed to a drug that inhibited aquaporin function, you would expect to produce….
Answer:
lots of dilute urine
Explanation:
On average, the brain loses ______ percent of its weight between the ages of 20 and 90.
Answer:
5-10%
Explanation:
the nurse is reinforcing teaching to a pregnant woman about the physiological effects and hormonal changes that occur during pregnancy. the woman asks the nurse about the purpose of estrogen. the nurse bases the response on which purpose of estrogen?
The nurse bases the response on the purpose that the client is wearing knee-high hose.
What is estrogen?
One of the key hormones used for sex in women is oestrogen. It is necessary for a number of bodily processes, including puberty, the menstrual cycle, pregnancy, bone density, and others. Oestrogen levels fluctuate during the course of the menstrual cycle and decrease after menopause. Your risk of blood clots and stroke can increase if you consume too much oestrogen.
Estrogen is necessary for bone, cardiovascular, and reproductive health. However, a surplus of oestrogen may exacerbate conditions that harm your reproductive system and lead to irregular menstrual cycles.
Therefore, The nurse bases the response on the purpose that the client is wearing knee-high hose.
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a patient with a clotting disorder is prescribed an anticoagulant and asks you to explain the purpose of anticoagulant therapy. what is your best response?
Anticoagulants are the medicines which are used to treat clotting disorder as these prevent new clot formation.
What is an anticoagulant?
Anticoagulants are medicines which help prevent blood clots. These medicines are given to people who are at a high risk of getting blood clots, to reduce their chances of developing serious conditions such as strokes and heart attacks. A blood clot is a seal which is created by the blood to stop bleeding from wound areas.
Anticoagulants show their effect by acting at different sites of the coagulation cascade. Some anticoagulants act directly by enzyme inhibition, while others act indirectly, by binding to the protein antithrombin or by preventing their synthesis from the liver such as vitamin K dependent factors.
Some of the most common natural anticoagulants include protein C, protein S, and antithrombin.
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know what % of global deaths and what % of global dalys are attributable to lack of hsw (and know what hsw stands for) and what health outcome is the leading contributor to hsw-attributable dalys
The burden of disease is calculated using the disability-adjusted life year (DALY). One DALY represents the loss of the equivalent of one year of full health.
What are global deaths?Three broad categories are used by epidemiologists to classify the causes of deaths:
Non-communicable diseases, or conditions that cannot be communicated from one person to another, are depicted in blue on the left. This category includes the two leading causes of death: cardiovascular disorders, such as stroke and ischemic heart disease, account for one out of every three fatalities worldwide and account for 18% of all cancer deaths.Communicable or infectious diseases—diseases brought on by a pathogen that can be transmitted from person to person—are depicted in red.You may see injuries in green. This is a fairly broad category that covers both unintentional injuries like homicides, war deaths, and su-icides as well as accidents like automobile accidents and falls from ladders or stairs.Learn more about global deaths: https://brainly.com/question/10851186
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two locations are experiencing cases of an infection: a city of 6,000,000 people with 600 cases, and a town of 6,000 with 300 cases. which scenario is likely of greater concern to epidemiologists?
A town of 6000 with 300 cases is likely to have greater concern to epidemiologists.
Because, there are no doubt less number of people but more number of cases.
What do you mean by epidemiology?
Epidemiology is the branch of medical science that investigates all the factors that determine the presence or absence of diseases and disorders. Epidemiological research helps us to understand how many people have a disease or disorder, if those numbers are changing, and how the disorder affects our society and our economy.
Many epidemiological estimates try to determine how the number of people affected by a disorder changes over time. The definition of a disorder also tends to change over time, however, making estimates more difficult. Even scientists working in the same field at the same time may not agree on the best way to measure or define a particular disorder.
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Lipoprotein
A complex that transports lipids in the lymph and blood. These consist of a central core of triglycerides and cholesterol surrounded by a shell composed of proteins, cholesterol, and phospholipids. The various types differ in size, composition, and density
Lipoprotein is a complex that carries lipids in the blood and lymph. These are made up of a triglyceride and cholesterol core in the center and a protein, cholesterol, and phospholipid shell around it. Different varieties of lipoprotein have different sizes, compositions, and densities.
Triglycerides and cholesterol, which are either ingested or created from scratch, are two types of lipids that are transported from the serum to tissues via substances called lipoproteins. Transporting lipid components in the blood is the primary purpose of lipoproteins. Complex particles called lipoproteins carry fat to and from different cells in the body's organs. Students may be familiar with HDL (good cholesterol) and LDL (bad cholesterol) as examples of lipoproteins.
It appears that the proper response, which is lipoprotein, has been provided along with the question.
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a nurse is assessing a client with bipolar disorder. the client tells the nurse that the family health care provider prescribed lithium. which symptom would indicate that the client is developing lithium toxicity?
Lithium toxicity is characterised by blood levels of lithium that are greater than 1.5 mmol/L. Disorientation and confusion falling and having poor balance diarrhoea and/or vomiting.
what is define Lithium toxicity ?
The result of having too much lithium is a condition known as lithium toxicity or lithium overdose. A tremor, heightened reflexes, difficulty walking, renal issues, and an altered state of awareness are possible symptoms. After levels return to normal, certain symptoms might last for a year. One potential complication is serotonin syndrome.
Lithium toxicity can result from high intake or low excretion. Overconsumption might be an acident or a sucide attempt. Dehydration from vomiting, diarrhoea, a low-sodium diet, or renal issues can all lead to decreased excretion. Symptoms are often used to make the diagnosis, which is then confirmed by a lithium level of at least 1.2 mEq/L.
Lithium toxicity is characterised by blood levels of lithium that are greater than 1.5 mmol/L. Disorientation and confusion falling and having poor balance diarrhoea and/or vomiting.
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