Since drinking alcohol might exacerbate a concussion, it's crucial to keep a close eye at any change in his health. In order to rule out whatever brain injury, a CT scan as well as MRI should also be performed.
Describe MRI.A procedure that uses radio waves, a powerful magnets, and a computer to produce a series of exact photographs of various areas inside the body. A contrast agent, such as gadolinium, may be injected into a vein to enhance the visibility of the tissues and organs in the image.
What distinguishes an MRI from a CT scan?Through the fast series of X-ray images taken during a CT scan, an image of a area being scanned is created. An MRI uses strong magnetic fields to create images of the inside of the body. A CT scan is typically the first imaging technique of choice. MRIs are useful for certain illnesses that a CT scan can't quite detect.
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the nurse should carefully screen a client who insists on using only oral contraceptive pills (ocps) for which contraindication?
Oral contraceptive pills can cause a variety of side effects, including high blood pressure, headaches, nausea, and a risk of clots and stroke.
Oral contraceptive pills (OCPs) are a commonly used form of contraception, but they can also cause a variety of side effects. They can increase blood pressure and can cause headaches, nausea, and breast tenderness. There is also a risk of blood clots and stroke, so it is important for the nurse to carefully screen a client who insists on using this form of contraception. Contraindications to using OCPs include smoking or a history of blood clots, high blood pressure, or certain medical conditions, such as diabetes or depression. Furthermore, OCPs can also interact with certain medications and herbal remedies, so it is important to ask the client about their medical history and any current medications they are taking before beginning the medication.
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High blood pressure, migraines, nausea, blood clot risk, and stroke are just a few of the negative effects that oral contraceptives might have.
Despite being a widely used method of contraception, oral contraceptive pills (OCPs) have a number of potential negative effects. In addition to raising blood pressure, they can also result in headaches, dizziness, and sore breasts.
The nurse must carefully examine a client who insists on using this method of contraception because there is a risk of blood clots and stroke as well. Smoking, a history of blood clots, high blood pressure, or certain medical disorders, such as diabetes or depression, are also reasons to avoid using OCPs.
Before starting the medicine, it's vital to question the client about their medical history and any current medications they're taking because OCPs can also interfere with some prescription drugs and herbal supplements.
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a class of student nurses are discussing the digestion of fat. the nurses recognize that approximately how much of consumed fat is absorbed in the duodenum and jejunum?
95% fat (lipids) is absorbed in the duodenum and jejunum.
Lipids (commonly known as fats) are large molecules (biomolecules) that are generally insoluble in water. Lipids, like carbohydrates and protein, are broken down into small components for absorption. Duodenum and Jejunum are parts of the small intestine where lipid digestion takes place. There, bile salts emulsify these lipid molecules and digestive enzymes break them down into smaller molecules called fatty acids . Long-chain fatty acids form a large lipoprotein structure called a chylomicron that transports fats through the lymph system. Lipids constitute structures in cells, especially the plasma membrane. The quasi-fluid nature of plasma membrane is due to the presence of lipids only.
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select a health care setting other than a hospital. what would you expect the similarities to be between the role of the health information manager in a hospital and in one of the other health care settings? what would you expect the differences to be?
The responsibility of the health information manager in a hospital or other place of healthcare is Self-Contained Ambulatory Care
What is Ambulatory care?
Ambulatory care, also known as outpatient care, is medical care delivered on an outpatient basis and includes services for diagnosis, observation, consultation, treatment, intervention, and rehabilitation. Even when delivered outside of hospitals, this treatment may involve cutting-edge medical equipment and techniques.The term "ambulatory care sensitive conditions" (ACSC) refers to medical illnesses like diabetes or chronic obstructive pulmonary disease when getting the right ambulatory treatment might delay or eliminate the requirement for hospitalization (or inpatient care).Numerous medical investigations, treatments, and preventative care can be carried out on an outpatient basis, including minor surgical and medical operations, the majority of dental services, dermatology services, and many types of diagnostic procedures.To learn more about Ambulatory care refer to:
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many laws address patient privacy and confidentiality. what other resources address the provider's responsibility for keeping health information private?
The professional code of ethics will address the provider's responsibility to keep health information private.
HIPAA Security Rule. The HIPAA Privacy Rule protects PHI, while the Security Rule protects a subset of the information covered by the Privacy Rule. This subset includes all personally identifiable health information that an affected entity creates, receives, maintains, or transmits in electronic form. Federal law, the Privacy Regulation, gives you rights to your health information and sets rules and restrictions on who can view and receive your health information. The Privacy Rule applies to all types of health information protected from individuals, whether electronic, written or oral. HIPAA security rules require three types of safeguards: management, physics, and technology.
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A nurse is providing discharge teaching to a client who has a new prescription for furosemide twice daily. The nurse should include which of the following instructions in the teaching? 1. Take the second dose at bedtime 2. Increase intake of potassium-rich foods. 3. Obtain your weight weekly. 4. Monitor for muscle weakness. 5. Dangle your legs from the side of the bed before standing.
Correct answer is option (2). Increase intake of potassium-rich foods.
The nurse need to inform that "they need go drink mil with each dose of medicine" To lessen gastric irritation, the patient should take furosemide with food or milk.
Additional information: -Due to fluid loss brought on by furosemide's diuretic effect, the patient taking the drug is at an increased risk of hypotension.
-Furosemide has a diuretic effect that causes potassium to be excreted through the kidneys, which puts the patient at an increased risk for potassium loss. The client needs to eat more foods high in potassium.
-To prevent nocturia-related sleep disturbances, the client should take each dose of medication in the morning.
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The above question is incomplete. Check below the complete question -
A nurse is providing discharge teaching to a client who has a new prescription for furosemide twice daily. The nurse should include which of the following instructions in the teaching?
1. Take the second dose at bedtime
2. Increase intake of potassium-rich foods.
3. Obtain your weight weekly.
4. Monitor for muscle weakness.
5. Dangle your legs from the side of the bed before standing.
a 4-year-old child weighing 33 1b (15 kg) has a prescription to receive 100 ml/kg per 24 hours for the first 10 kg and then 50 ml/kg per 24 hours for the next 10 kg. which parental statement would the nurse recognize as correctly reflecting the child's recommended daily fluid intake?
The parental statement that nurse would identify as correctly reflecting child`s recommended daily fluid intake is "Ten 4-oz (120-mL) servings is required.
Why do need fluid intake ?Drinking enough water every day is very important for many reasons: It regulates body temperature, keeps joints lubricated, fights infections, nourishes cells and maintains organ function. Staying hydrated also improves sleep quality, cognition, and mood.
How much liquid should be drink per day?The American Academy of Medicine suggests daily fluid intake to be adequate for healthy men and women at about 13 and 9 cups, respectively. 1 cup is 8 ounces. People who are physically active or exposed to very warm weather may need more fluid. The recommended total daily fluid intake is 3,000 ml for men and 2,200 ml for women. Increasing fluid intake has no compelling health benefits, except perhaps to prevent (recurring) kidney stones.
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for which reason would the nurse check for cerumen in a patient's ear canal before measuring tympanic membrane temperature
A nurse should check for cerumen in a patient's ear canal before measuring tympanic membrane temperature to ensure an accurate reading.
A nurse should check for cerumen in a patient's ear canal before measuring tympanic membrane temperature in order to ensure an accurate reading. Cerumen, or earwax, can prevent a thermometer from getting an accurate reading. It is important to remove any earwax present before taking a temperature reading in order to get an accurate reading, otherwise the thermometer may provide an artificially high reading. For this reason, a nurse should always check for and remove any cerumen in a patient's ear canal before taking a tympanic membrane temperature.
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the medical term for the study of the stomach and intestines is . a. gastroenterology b. entergastrology c. gastrology d. oncology
Option a. gastroenterology is the medical term for the study of the stomach and intestines.
The medical specialty known as gastroenterology is dedicated to treating problems with the digestive system. Gastroenterologists, or GI doctors occasionally, are medical professionals who focus on the field of gastroenterology. Gastroenterologists often treat gastrointestinal bleeding, irritable bowel syndrome, peptic ulcer disease, biliary tract illness, pancreatitis, colon polyps, dietary issues, and many other disorders.
The digestive system includes the gastrointestinal tract (oesophagus, stomach, small intestine, large intestine, rectum, and anus), as well as the pancreas, liver, bile ducts, and gallbladder. A gastroenterologist is a professional with knowledge of the diseases that affect the digestive system.
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a client with hypothermia is brought to the emergency department. which treatment would the nurse anticipate?
The care that the nurse will anticipate for a client who is experiencing hypothermia is to warm the client's respiratory tract by giving warmed oxygen through a mask and tube and giving an infusion containing warmed saline solution.
What is hypothermia?Hypothermia is a condition when the body temperature drops below 35oC. As a result, the heart and other vital organs fail to function. If not treated immediately, hypothermia can cause cardiac arrest, respiratory system disorders, and even death. Hypothermia occurs when the heat produced by the body is not as much heat lost.
Treatment that can be carried out by nurses to clients who experience hypothermia is to provide oxygen that has been warmed, provide an infusion containing warmed saline solution, and flow a warm solution to pass through, and warm several organs of the body.
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what is a good reason not to use distracters when administering maxillary facial anesthesia? group of answer choices the clinician needs her fingers for retraction of the upper lip. pulpal anesthesia may be blocked. movement may cause the anesthetic not to be placed at the target area. all options listed.
The use of distractors during the administration of maxillofacial anesthesia should be avoided since movement may result in the anesthetic not being applied to the intended location.
The most crucial method of pain control in oral and maxillofacial surgery is local anesthetic (LA). Safe and efficient LA not only allows patients to receive high-quality care, but also helps patients feel less anxious when they visit the clinic. The success of LA is greatly influenced by the selection of local anesthetic and injection techniques. Common local anesthetics used in oral and maxillofacial surgery currently belong to the class of amides and are injected into patients' bodies mostly through block or infiltration anesthesia. Additionally, the level of technique used by the operators, the patient's subjective psychology, and anatomical variations in the craniofacial structure all significantly affect LA in dental clinics.
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when a client expresses anxiety about an upcoming surgical procedure, which action would the nurse take first to help decrease anxiety?
Take the client's vital signs and ask questions about the source of the anxiety.
The nurse would begin by taking the client's vital signs and determining the source of the concern. When a client is anxious, it is usual for them to have a higher pulse rate, thus a comprehensive history and physical are not necessary. Although an anxiolytic or preoperative sleep aid may be beneficial, it should not be the nurse's first action.
Anxiety is characterised by feelings of fear, dread, and unease. It may cause you to sweat, feel agitated and anxious, and have a racing heart. You may have anxiety when confronted with a challenging situation at work, before taking a test, or before making an important choice.
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describe the tree (in general terms) draw a quick sketch of the tree. does there appear to be a relationship between the patient and victim sequences?
Relationship between the patient and victim primarily emphasizes the unfavorable parts of the individual's experience, whereas "patient" denotes a connection in which the nurse gives the patient with care.
What function does the notion of a second victim serve in the medical field?Providing assistance to second victims might lessen psychological pain (Arndt, 1994). Because failing to support employees would cause health care organizations to lose all credibility and respect, which will eventually have a negative impact on their culture (Denham, 2007).
Which stages of the second victim's recovery are they in order?A stage-by-stage natural history of the second victim phenomena was established through our investigation. This includes responding to turmoil and accidents, having intrusive reflections, and regaining one's integrity.
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which parental behavior indicates to the nurse that additional teaching about gastrostomy button care is needed?
Parents not being able to demonstrate proper gastrostomy button care techniques indicates to the nurse that additional teaching is needed.
Parents not being able to demonstrate proper gastrostomy button care techniques, such as cleaning the button and changing the dressing, indicates to the nurse that additional teaching is needed. The nurse should assess the family's understanding of the procedure and the child's condition before proceeding with teaching the family about gastrostomy button care. It is important for the nurse to explain the details of the procedure, its potential risks and benefits, and how to properly care for the button. Additionally, the nurse should assess the family's ability to take on the responsibility of caring for the child. If the nurse believes that the family is unable to provide the necessary care for the child, they should refer the family to a social worker for assistance. With the right guidance and education, the family will be able to provide the necessary care for the child with a gastrostomy button.
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The appropriate magnification for a manual RBC cell count using a hemocytometer is which of the following?
A. 10X
B. 100X (Oil)
C. 40X (Dry)
D. 4X
When using a hemocytometer to manually count RBCs, the proper magnification is C) 40X. (Dry).
A microscope slide that has been specially created to allow cell counting is known as a hemocytometer. The middle of the slide has a sink, and a grid has been drawn around it. In the sink, a drop of a cell culture is put. The researcher uses the grid to manually count the number of cells in a particular area while examining the sample under a microscope. The sink has a predetermined depth. As a result, the concentration of the cells and the volume of the counted culture can both be determined.
Using a magnification of 40X allows us to see individual sells within the grid and count them distinctly as well. Each cell will appear clearly at high magnification as there is high contrast in image and cell appear larger in size as well.
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which response would the nurse provide to a perimenopausal woman who asks about complementary treatment options for hot flashes?
Take estrogens is the response that the nurse would provide to a perimenopausal woman who asks about complementary treatment options for hot flashes.
Taking estrogen is the safest and most efficient way to ease the discomfort of hot flashes, but doing so has hazards. The advantages may outweigh the hazards if oestrogen is prescribed for you and you begin taking it within ten years of your last period or before the age of 60.
The abrupt sensation of warmth in the upper body known as a hot flash is typically most acute across the face, and chest. You might blush as your skin turns red. Sweating might also result from it. You could become chilly if you shed quite so much body heat.
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a new nurse employed at a community hospital is reading the organization's mission statement. the new nurse understands that this statement:
The new nurse realises that this statement summarizes the organization plans to accomplish
Patients who already have autonomy are able to make their own decisions. This implies that nurses must ensure that patients have all of the information they need to make an informed decision regarding their medical treatment. The nurses have no influence on the patient's decision. In terms of medical competence, nurses should deliver treatment that prevents or reduces danger. This attitude would prevent a nurse from delivering negligent care to a patient.
A nurse showing this philosophy would avoid providing negligent treatment to a patient. The Code applies to all sorts of nurses, including researchers, managers, staff nurses, or public health nurses. At times, nurses may need to handle ethical dilemmas as a team, as the most difficult decisions should not be taken by a single individual.
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the nurse is providing care for an elderly client who has a percutaneous endoscopic gastrostomy (peg) feeding tube and is receiving continuous feeding. which interventions should the nurse include when providing care?
The senior consumer has a higher chance of developing hyperglycemia than hypoglycemia. This is because some enteral feeding formulations have a high carb load.
Without diabetes, what causes hypoglycemia?The causes of low blood sugar (hypoglycemia) among non-diabetics include some drugs, excessive alcohol consumption, hypothyroidism, complications from weight-loss surgery, liver or renal issues, anorexia nervosa, pancreatic issues, and certain genetic abnormalities.
What results in hypoglycemia?Blood Sugar Low Reasons excessive insulin consumption inadequate carbohydrate intake in relation to insulin dosage. when you should take your insulin. physical activity frequency and duration.
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the nurse is caring for a woman in the labor room. the primary health care provider prescribes an oxytocic medication for the woman to augment her labor. which finding indicates a need to discontinue the oxytocic medication?
Program for Perinatal Education. A guide for advanced midwives on labor and delivery. Prenatal Care. assisting both mother and her unborn child during labor.
Which nursing intervention should be given top priority for a pregnant patient with dystocia?nursing intervention should be given top priority while treating a pregnant client with dystocia Monitoring the heartbeat of the fetus is the most important nursing intervention for the a pregnant female with dystocia since fluctuations may indicate fetal distress.
Which procedure would the nurse carry out to increase security for a client in labor and a fetus with such a prolapsed cord?Put the customer in Trendelenburg's place. Justification: Prompt measures are made to reduce cord compression and boost fetal oxygenation when cord prolapse occurs. Positioning the mother with her hips lower.
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while observing a 13-month-old and her parents in the playroom of the hospital unit, the nurse notes that the toddler is using her index finger to point towards a toy. what should the nurse say to the parents?
Your daughter is using age-appropriate fine motor skills by pointing with her index finger. The child should be able to feed herself finger foods and point to things with her index finger by the time she is 12 to 15 months old.
Which toy ought a nurse to provide for a little child to play with in the hospital playroom?Blocks are a great toy option for toddlers who are just starting their imaginative play. Blocks can be used in any way by kids, encouraging imaginative play.
What factor should be taken into account first while designing the playroom?The most significant element is space planning. There must be enough room for both storage and activities. You can think of using a combination of built-in storage and ready-made cabinets and shelves that are within your child's reach and accessibility.
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a 2-year-old toddler holds his breath until passing out when he wants something the parent does not want him to have. the nurse would decide whether these temper tantrums are a form of seizure based on the fact that:
Up to 5% of kids go through breath-holding episodes. They might continue till a kid was 6 years old and may start as early as six years. Two years old is when breath-holding spells are most common. Breath
What does being able to breathe mean?
1: Breathing: Breathing is simple. I briefly ran out of breath. 2: air that the lungs take in or expend Take a deep breath. I could see my breath since it's so cold. Dad muttered, "Don't screw this up for me."
What does breathing via your nose entail?
Consistently inhale through your nose. The word for breath is /bre/. The oxygen that you inhale and exhale is known as a breath.
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while dealing with her flu symptoms at home, the woman was careful to drink large amounts of water. how would this effect her fluid and electrolyte balance?
If the body has too much or not enough water, it may develop an electrolyte imbalance. Electrolytes are minerals that are present in all parts of the body, including the blood and tissues. The electrical charge they carry is implied by their name.
The body needs electrolytes, which are minerals, to: the water is evenly distributed, carry nutrients into cells and remove waste, enabling neurons to communicate will help muscles to efficiently relax and contract, maintain the heart and the brain working
Humans consume electrolytes in their diet and beverages. The preservation of electrolyte balance is assisted by the liver and kidneys. If a person eats a variety of foods and drinks enough water, electrolytes frequently remain at the proper amounts.
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a client with cholecystitis is placed on a low-fat, high-protein diet. which nutrient would the nurse teach the client to include in this diet? quizle
An individual with cholecystitis is put on a low-fat, high-protein diet and is advised to drink skim milk.
One tablespoon (15 mL) of fats and oils per meal, such as butter, margarine, mayonnaise, and salad dressing, is the maximum. Consume low amounts of high-fat foods like chocolate, whole milk, ice cream, processed cheese, and egg yolks. Every day, consume yoghurt, cheese, nonfat or low-fat milk, or other milk products. Cheeses should have less than 5 grammes of fat per ounce, so check the labels. Try yoghurt, cream cheese, or sour cream without added fat. Don't eat pasta with cream sauces or cream soups.
Bile can build up and result in cholecystitis if something prevents the gallbladder from emptying. Foods high in fat should be avoided if you have cholecystitis. Fried foods, canned fish, processed meats, full-fat dairy products, baked goods, fast food, and the majority of packaged snack foods fall under this category.
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the nurse is caring for a client who has been physically restrained due to extremely aggressive and violent behavior. while conducting the client assessment, which finding(s) will lead the nurse to remove with restraints temporarily? select all that apply.
While conducting the client assessment, Removing the restraints will facilitate blood supply will lead the nurse to remove with restraints temporarily.
When a patient is in restrains the position of the restrain should be checked how often?Before using restraints, the health care professional should be conversant with the restraining device. A five-person team is also ideal for restraining an aggressive patient. Each person will be in charge of one extremity, with the patient's head being supervised and positioned by the fifth person. Every 30 minutes, the nurse must review the restraints. Restraint reassessment and care include neurovascular assessment (circulation to hands, fingers, feet, and toes), skin assessment (bruising of restrained area), and addressing a patient's activities of daily life such as toileting, feeding, and drinking. These interventions must be properly documented on the patient's chart.
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a 20-year-old client seen in the emergency department reports frequent 'skipped heart beats, and the nurse notes frequent premature ventricular complexes (pvcs) on the cardiac monitor. which action would the nurse take first?
PVCs in 20-year-olds are frequently caused by the use of stimulants, such as methamphetamine or caffeine-containing drinks. PVCs may lead to ventricular tachycardia.
What is the origin of methamphetamine?This drug is used to treat ADHD, or attention deficit hyperactivity disorder. It functions by altering the quantities of particular chemical compounds in the brain. Methamphetamine is a member of the stimulant drug category.
Which substance do athletes use?Stimulants. In order to combat exhaustion and improve alertness, athletes may utilize stimulants, which quicken the central nervous system. Along with nicotine and caffeine, they also include amphetamines, cocaine, ecstasy, and methylphenidate (Ritalin).
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the nurse is planning a dietary menu for a client with heart failure who is being treated with digoxin and furosemide. which would be the best dinner choice from the daily menu?
2–3 pound weight increase in a short period of time Prior to giving the patient a diuretic like furosemide, the nurse evaluates the patient's potassium level according to recent lab test findings.
Which posture does the nurse put the patient in before a pericardiocentesis?A semirecumbent position with the patient at a 30- to 45-degree tilt is ideal. The anterior chest wall and the heart are more closely aligned in this configuration.
Where should a nurse position a patient who has coronary artery disease (CAD)?If possible, ask the patient to bend forward or place them so they are lying on their left side. When auscultating the heart sounds, it's typical to hear lung noises.
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an infant who weighs 12 1b 4 oz (5.6 kg) is receiving 8 oz (240 ml) of full-strength formula, 20 kcal/fl oz every 4 hours between 8:00 am and midnight. in light of the recommended caloric intake of 108 kcal/kg/day, which would the nurse conclude about the amount of formula ingested?
In light of the recommended caloric intake, the nurse should conclude exceeds recommended requirements about the amount of formula ingested.
What are caloric in food?The energy content of food and drink is measured in calories. When we eat or drink more calories than we consume, our body stores the excess as body fat. This can lead to weight gain over time.
What is good calorie intake?In general, the recommended daily caloric intake is 2,000 calories for women and 2,500 calories for men.
How many calories should eat to lose weight?To lose at least 1 pound a week, get at least 30 minutes of physical activity most days and aim to reduce your daily calorie intake by at least 500 calories. However, caloric intake should not drop below 1,200 for women and 1,500 for men per day unless under medical supervision.
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A 5-month-old infant who weighs 12 lb 4 oz (5.6 kg) is receiving 8 oz (240 mL) of full-strength formula 20 kcal/fl oz every 4 hours between 8:00 AM and midnight. In light of the recommended caloric intake of 108 kcal/kg/day, what does the nurse conclude about the amount of formula ingested?
the nurse provides instructions to a client with rheumatoid arthritis about joint exercises that are important to prevent deformity and reduce pain. which statement by the client indicates the need for further instruction?
The nurse counsels a patient having rheumatoid on joint exercises that really are essential for avoiding deformity and minimizing pain. Which customer testimonial supports the
What is the source of pain?
Pain is an unpleasant feeling that is typically triggered by powerful or damaging stimuli. A World Association for the Research of Hurt defines pain as "a unpleasant emotional and sensory induced equal equal, and approaching, those connected with actual or possible cellular damage."
What physiologically produces pain?
physiology of pain. Although some pain is objective, the majority has a physiological basis and is connected to tissue damage. However, not all tissues respond to harm in the same manner. For instance, despite the fact that skin may burn,
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what of the contraindications to the administration of misoprostol (cytotec) for treatment of a postpartum hemorrhage?
Hypersensitivity to prostaglandin is the contraindications to the administration of misoprostol (cytotec) for treatment of a postpartum hemorrhage.
In people who have previously experienced an allergic response or intolerance to prostaglandin, misoprostol is contraindicated. Regarding the negative consequences associated with misoprostol during pregnancy, those who are at danger for gastric ulcers as a result of NSAID use and are expecting baby should avoid using it.
A synthetic prostaglandin called misoprostol is used to deliver the baby, produce an abortion, treat postpartum haemorrhage brought on by insufficient uterine contraction, and diagnose and reduce stomach and duodenal ulcers. Misoprostol is given orally in order to prevent stomach ulcers.
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A type of shock that includes brain trauma that results in depression of the vasomotor center is cardiogenic.
a. True
b. False
A type of shock that involves brain trauma leading to depression of the vasomotor center is cardiogenic is b) a false statement
Cardiogenic shock occurs when the heart cannot pump the amount of blood the body needs. Even if you don't have a heart attack, it can also occur if any of these problems occur and heart function suddenly declines. Cardiogenic shock is a type of circulatory shock resulting from severe impairment of ventricular pump function rather than vascular or volume abnormalities. Cardiogenic shock has four stages.
Early, compensatory, progressive, refractory. In the early stages, there is a decrease in cardiac output without clinical symptoms.
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Proper Central Service workflow is important to help ensure safety and appropriate processing of souled materials. Which of the follow illustrates the proper one-way flow?
A. Decontamination, Clean Processing, Sterile Storage
B. Clean Processing, Sterile Storage, Decontamination
C. Decontamination, Sterile Storage, Clean Processing
D. Sterile Storage, Decontamination, Sterile Processing