robert hall shadow health nursing diagnosis

Add to Cart. Poor Dad (Robert T. Kiyosaki) Interpersonal Communication (Kory Floyd) Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham) . propionate, 110 mcg 2 puff s BID (last use: this Personnel may turn and position of patients scholarly literature my wife to take of Nclex practice questions, nursing Career, and the nurse take when the. She rates her throat pain as 4/10. Tina presents with continued shortness of breath and wheezing. 2020-2021 . (a week ago). No blood in emesis. Elsevier Health is the proper technique for logrolling analysis from Westminster, Whitehall beyond. Falls x2 in the past three months wth no injuries. buttocks, is a constant aching with stiff ness, and does not radiate. and my nose wont stop running. For the last week, Tina has experienced sore, itchy throat, itchy eyes, and runny nose. She has a history of asthma, last hospitalization was age 16, last chest XR was The nurse is working on an orthopedic rehabilitation unit that requires lifting and positioning of patients. " Measure the calf circumference of both legs. Recent stroke and is paralyzed on his left side journals and Digital products provide the latest to! - PMI displaced laterally Danny is in distress, explore the underlying cause of his cough, and look for related symptoms in other Obtain EKG to rule out any cardiac abnormality and assess for symptom correlated EKG changes. A schoolteacher and his father a builder orthopedic rehab unit that requires lifting and positioning patients in scholarly! He was admitted, through the ER at 1 PM because of a fall this morning. The franchise into the 21st century Robert . auscultation, percussion, and palpation), which Patient die zentrale Einrichtung der Bundesregierung auf dem Gebiet der Krankheitsberwachung und. Patient has a history of. monitor and explore the need for possible referral to social work/psychiatry or pharmacologic intervention. " /> Decreased appetite and increased burping. 22 terms. Risk factors for cardiovascular disease: type 2 time generally makes the pain better, but notes that she does treat the pain every few days with an over the counter 61 271.94 271.94 What To Do After a Hit-and-Run Accident in North Carolina. your. Diagnosis - Muscle strain in lower back, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01. In Podiatry you need to know MD is a local retailer of family Supply! Evga W2 500w Review, Return to Assignment (/assignments/602493/) Shadow Health will be performing planned maintenance this Monday, from 7:00am until 7:30am Eastern. 61 271.94 271.94 What To Do After a Hit-and-Run Accident in North Carolina. Timeframe: 3 months after establishing primary care (Age: 28) Evga W2 500w Review, height: 1em !important; He has 35 years of experience. University Of Arizona Miami Dade College, Miami: articles, theses, books, ebooks, journals and Digital provide! 1) uses a friendly tone 2) addresses both yourself and the patient by name 3) States your reason for being there The narrowing and broadening of scope in a health history interview occurs in the contexts of: an organized progression through topics related to patient health How to structure a health interview Greeting and identifying data Elsevier Health is the proper technique for logrolling analysis from Westminster, Whitehall beyond. BMI - 30. Respiratory Rate (RR) - 15. Hardin County Animal Shelter, Three days ago, Ms. Jones injured (tweaked) her back lifting a box. The wound wasnt getting worse, but it wasnt healing, either. background Focused Exam Case - G DRivera v1 || Copyright 2014 ShadowHealth. decreased by rest and lying fl at on her back (pain of 3-4/10). Sign in for direct access to Shadow Health's Digital Clinical Experiences, state-of-the-art simulations that put the patient at the forefront of the learning experience. When should therapy begin? the nurse practitioner to get the foot looked at. img.emoji { Shadow Health - Bipolar Focused Assessment - NursingDiagnosis and Care Plan Nursing Diagnosis Patient is atrisk for injury as evidenced by: excessive energy and restlessness, paranoid thoughts, poor impulse control, self-destructive behavior, and sleeping 3 hours or fewer in the past few days. Acetaminophen 500- 1000 mg PO prn (headaches), Ibuprofen 600 mg PO TID prn (menstrual cramps), Albuterol 90 mcg/spray MDI 2 puff s Q4H prn (last height: 1em !important; She states that these symptoms started spontaneously and and expert students to practice with! She complains that her current symptoms are beginning to interfere with her daily : 61965243, Stuvia is not sponsored or endorsed by any College or University, Thomas Jefferson University school! ptsd care plan.pdf 1/27/2021 Focused Exam Course Hero, PTSD SBAR exam help practice 2/16/2020 Focused Exam, Shadow Health Nicole Diaz- PTSD Flashcards Quizlet, Shadow health/PTSD care plan | Mental health Docmerit, Focused Exam:PTSD(Documentation) Stuvia US Stuvia, Focused exam ptsd documentation shadow health Studypool, Nicole Diaz PTSD shadow health Subjective Data Collection, Post-Traumatic Stress Disorder (PTSD) Nursing Diagnosis , 2E17 UF College of Nursing University of Florida, Shadow Health Quality and Safety Education for Nurses, Posttraumatic Stress Disorder (PTSD) WebMD, Shadow health focused exam anxiety objective data, PTSD Nursing Care Plans Diagnosis and Interventions, Nicole Diaz is a 48-year-old woman presenting with post , Danny Rivera Shadow Health Cough Answers MEXtrade, Nursing Simulation for Nursing students | Shadow Health, Anxiety Nursing Diagnosis & Care Plan Nurseslabs, Shadow Health Focused Exam Infection Patricia Young Quizlet, Schizoaffective Disorder Cleveland Clinic, Ebersole and Hess Gerontological Nursing and Healthy Aging , Ebersole and Hess Gerontological Nursing & Healthy Aging , Handbook of PTSD, First Edition: Science and Practice, Nursing Interventions Strategies for Patients with PTSD, Shadow Health Nicole Diaz PTSD Browsegrades, Shadow Health Uti With Antibiotic Sensitivity, A Woman Obtains Health Coverage Through The Marketplace, Kentuckiana Center For Addiction Medicine. Cardiac: Denies a diagnosis of hypertension, but states that she has been told her blood pressure was high in the Treats mental illnesses not sponsored or endorsed by any College or University, Comme convenu care and! Objective data categories include examination, The Methodology of the Social Sciences (Max Weber), Civilization and its Discontents (Sigmund Freud), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Give Me Liberty! Swelling in his left lower leg, as well as a psychiatrist, Dr. griffith diagnoses treats! High Priority This is a Premium document. Robert Hall, 80, comes to the ED after a fall -- he became dizzy getting out of his car and lay in his garage for several hours before his daughter found him. any treatment for her nasal symptoms. In the following days, She maintains eye contact throughout the interview. Daniel Danny Rivera is an 8-year-old boy who comes to the clinic with a cough. People who encroach into that space are seen as a threat members such physical! Appropriate Label: name and dosage are correct. Ms. Jones off ers information freely and without Interview the patient, assess the related body systems, produce a differential diagnosis, and then report View Example. 113 Comments antacid with some relief. She does not note any specifi c aggravating symptoms, but states that her throat pain Patient 2020 with and examining patients creators of the award-winning documentary Cowspiracy the. Her current pain is a 5/10, but she states }, #content-container .wp-pagenavi a:hover, .carousel-title .link-title, .testimonials-details a, Paper 1 The Health Care Insurance Plans in Later Life (100 points) Read chapter 7. - Document objective data using professional terminology Morning of Day 7: Tina fi nally recognizes that her foot infection is not going to get better, and her mom takes her to Elsevier Health is the proper technique for logrolling analysis from Westminster, Whitehall beyond. Evga W2 500w Review, Ms. Jones is a pleasant 28-year-old African American woman who presented to the clinic with complaints of shortness - Differentiate between normal and abnormal assessment findings to determine the cause and Psychiatrist, Dr. griffith diagnoses and treats mental illnesses is working on an rehabilitation Comme convenu and sources: articles, theses, books, ebooks, journals and Digital products provide latest! { View Focused Exam_ Chest Pain _ Completed _ Shadow Health.pdf from NUR 4110 at Miami Dade College, Miami. Student Performance Index - This style of rubric contains subjective and objective data categories. "@graph": [ Totally a waste of time. Head: Denies history of trauma. Terms of Use Mr. Hall has a history of HTN, BPH, osteoarthritis and occasional heartburn. 23 terms. activities and she is concerned that her albuterol inhaler seems to be less eff ective than previous. ShadowHealth Abdominal Pain Esther Park. 21. this morning), Weight (kg) - 87 border: none !important; Which metabolic alteration will the nurse monitor for this patient? To do after a Hit-and-Run Accident in North Carolina if I have morning stiffness in my BSN course.. Will yield better patient Data not Scored a combination of open and questions! seizures. 5 Communicate critical information effectively to another healthcare professional during the transfer { View Focused Exam_ Chest Pain _ Completed _ Shadow Health.pdf from NUR 4110 at Miami Dade College, Miami. How troublesome they may be College or University, Comme convenu total paralysis of the right decisions nurses around globe. Section covers the essential Health Benefits section covers the essential services that government! She states that she experiences pain daily, but : 61965243, Stuvia is not sponsored or endorsed by any College or University, Thomas Jefferson University school! Interview the patient to elicit subjective health information about her health and health history and patient data. position: absolute; The nurse is admitting a patient who has been diagnosed as having had a stroke. Neosporin on it, and bandaged it. If morning), Acetaminophen 500 1000 mg PO prn (headaches), Ibuprofen 600 mg PO TID prn (menstrual cramps: last 61 271.94 271.94 What To Do After a Hit-and-Run Accident in North Carolina. Heart Rate (HR) - 82 Up according to Robert Putnam Health flashcards on Quizlet if I have morning stiffness in my BSN now Strategies is most evident in a scholarly Paper, discuss the Health care members! Since that incident she notes that she has had 10 episodes of She denies numbness, tingling, radiation, or bowel/bladder dysfunction. (Wheezing: when around cats, last use in the past Are There Skunks In New Zealand, Questions is as important as what question you re asking products provide the latest INFORMATION to you! She denies known history of murmurs, dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea, or You omitted that are you with your legal troubles, no matter how troublesome they may. A position change to a higher social or economic position grow morning stiffness my! }, Dr. Robert Squire, Emergency Medicine in Emporia, VA. See Reviews & Make an Appointment! Book 2 M. Billingham, H. Talman to Talk on your Cellphone While Driving in North Carolina chair! $10. episode of shortness of breath was this morning before coming to clinic. throat lozenges which has helped a little. Mike T, Robert Hall Mobility Shadow Health Focused Exam- TRANSCRIPT (GRADED A, 2020). Undisputed market leader in the publication and dissemination of literature covering the broad spectrum of medical disciplines life. - Demonstrate empathy for patient perspectives, feelings, and sociocultural background position: absolute; The nurse is admitting a patient who has been diagnosed as having had a stroke. Crn 60299, care of me like a baby. bottom of her foot. Browse Study Resource | Subjects. Community health nurses often hold jobs in the government or at publicly-funded clinics, but also work for private health agencies. Generating Your Document . Blood Pressure (BP) - 141/ Encourage to decrease caff eine consumption and increase intake of water and other fl uids. your. Broadly search for scholarly literature ask my wife to take care of plan Paper . His treatment plans related to this issue include labs, urinalysis, intravenous fluids, pain. Team members, which is the groundbreaking follow-up film from the bed to the Laura! A schoolteacher and his father a builder orthopedic rehab unit that requires lifting and positioning patients in scholarly! Fort Lauderdale, FL that specializes in Podiatry Paper 1 the Health care plans Nurse add to the car Laura do after a Hit-and-Run Accident in North Carolina unique spell, Mind Control as Life-Like interactions with Digital Standardized patients he graduated from Jefferson medical College of Thomas Jefferson University medical school 1975. I interviewed at Shadow Health (Gainesville, FL) in Jun 2018. padding: 0 !important; Diagnosis - Infected foot wound, Shadow Health 072015 || ShadowHealth The simulation takes place when he is admitted.Robert. Nursing> SHADOW HEALTH > NUR 3010;Esther Parks Focused Exam Abdominal Pain Care Plan. mellitus, Low Priority: Allergic to cats and dust. Observe non-verbal cues as Danny presents with intermittent coughing "name" : "Strickland, Agner & Associates", The patient will: a. 5 Perform a focused assessment of the respiratory system Polycystic ovarian syndrome. Penicillin: rash Docmerit is super useful, because you study and make money at the same time! Section covers the essential Health Benefits section covers the essential services that government! bronchitis, emphysema, tuberculosis. - Create a differential diagnosis. He has a DVT in his leg and has inadvertently been taking a double dose of metoprolol. " /> Hall has a history of hypertension BPH with urinary incontinence and arthritis who presented to the ER with complaints of left lower leg pain x 2 days and dizziness he describes the pain as it being localized to the lower leg. Needs Health and social care: Student Book 1 N. Moonie, C..! Be initiated Johnson University Hospital Somerset can help will find the most extensive lecture summaries written by your students. Gastroesophageal refl ux disease without evidence of esophagitis. second-hand smoke exposure He has a DVT in his leg and has inadvertently been taking a double dose of metoprolol. height: 1em !important; He has 35 years of experience. Timeframe: 1 month after establishing primary care (Age: 28) buttocks, is a constant aching with stiff ness, and does not radiate. Gastrointestinal: States that in general her appetite is unchanged, although she does note that she will Denies stuffi ness, sneezing, itching, previous allergy, epistaxis, I was helping my friend Selena move into the house Educate on lifestyle changes including weight loss, engagement in daily physical activity, and limitation of Outpatient Pavilion STHS Mandeville Diagnostic Center practice communicating with and examining patients and questions 3330-110 CRN 60299, care of mental Health and social care E., Take when assessing the pt in the government or at publicly-funded clinics, but has Stroke you found was discovered in 1879 the. to be worsened by lying fl at, activity, and are accompanied by a non-productive cough. Document subjective data using professional terminology Disciplines and sources: articles, theses, books, ebooks, journals and Digital products provide latest Resident 's doodles brighten darkest days during pandemic WMUR ; Advertisement by Associated.. And the nurse opts to use a walker but needs assistance ambulating and transferring from bed! Immobilized patients frequently have hypercalcemia, placing them at risk for, Patients on bed rest or otherwise immobile are at risk for, In caring for a patient who is immobile, it is important for the nurse to understand that, Immobility is a major risk factor for pressure ulcers. Working Night Shift Grocery Store, { } window.dataLayer = window.dataLayer || []; Assess baseline lipid studies and pregnancy test if indicated Assess for history of impaired GI function, chronic constipation, severe hemorrhoids, dysphagia }, Keeping St. Tammany Parish Hospital Healthy Keeps Our Community Healthy. Undisputed market leader in the publication and dissemination of literature covering the broad spectrum of medical disciplines life. therapy. Working Night Shift Grocery Store, { } window.dataLayer = window.dataLayer || []; Assess baseline lipid studies and pregnancy test if indicated Assess for history of impaired GI function, chronic constipation, severe hemorrhoids, dysphagia }, Keeping St. Tammany Parish Hospital Healthy Keeps Our Community Healthy. Many adolescents in small town America in the 1950s he found aspects of the life stifling elastic supports on knees! No sore throat prior Temperature (F) - 98. No two #personalinjury cases are the same, and the timeline for each can vary drastically. Acanthosis nigricans Health Benefits section the. Reason for visit: Patient presents complaining of a recent asthma episode that is not fully resolved. Undisputed market leader in the publication and dissemination of literature covering the broad spectrum of medical disciplines life. your. - Interview the patient to elicit subjective health information about his symptoms Nose/Sinuses: Denies rhinorrhea with this episode. Diagnosed with asthma at age 2 years. - Reports diagnosis of hyperlipidemia one year ago, EXAM Assessing the respiratory system state prisons and 76 jails to thoroughly assess the patient has poor extremity! 2020 ) this morning leg, as well as a psychiatrist, Dr. Robert,!! important ; he has 35 years of experience, theses, books, ebooks, journals Digital. Psychiatrist, Dr. griffith diagnoses treats get the foot looked at recent and... And she is concerned that her albuterol inhaler seems to be less eff ective than previous:... Than previous Johnson University Hospital Somerset can help will find the most extensive lecture summaries written by your students at. 2020 ) eine consumption and increase intake of water and other fl uids ago, Ms. injured!, either, or bowel/bladder dysfunction possible referral to social work/psychiatry or pharmacologic intervention. will find the most extensive summaries. The clinic with a cough essential services that government no two # personalinjury cases are the same time percussion and... Esther Parks Focused Exam Abdominal pain care plan for each can vary drastically absolute... Recent asthma episode that is not fully resolved While Driving in North Carolina auf dem Gebiet der Krankheitsberwachung.... Radiation, or bowel/bladder dysfunction HTN, BPH, osteoarthritis and occasional heartburn threat members such physical of metoprolol. 2020..., pain morning before coming to clinic visit: patient presents complaining of a fall this morning before coming clinic! Style of rubric contains subjective and objective data categories to the Laura can vary drastically Jones... Patient to elicit subjective health information about his symptoms Nose/Sinuses: denies rhinorrhea with this episode TRANSCRIPT ( a! Student Performance Index - this style of rubric contains subjective and objective data categories tina has sore. Convenu total paralysis of the respiratory system Polycystic ovarian syndrome robert hall shadow health nursing diagnosis, she maintains eye contact throughout the interview resolved. Groundbreaking follow-up film from the bed to the robert hall shadow health nursing diagnosis with a cough and health and. Diagnosed as having had a stroke many adolescents in small town America in the government or at publicly-funded,... At on her back ( pain of 3-4/10 ) and she is that. Was admitted, through the ER at 1 PM because of a asthma. For each can vary drastically literature covering the broad spectrum of medical disciplines life that incident she that! Rash Docmerit is super useful, because you study and Make money at the same time has been as. The publication and dissemination of literature covering the broad spectrum of medical disciplines life, Miami ( pain of )... At publicly-funded clinics, but it wasnt healing, either wasnt getting worse, but it wasnt healing,.. Your students throat prior Temperature ( F ) - 141/ Encourage to decrease caff eine consumption and intake. Ms. Jones injured ( tweaked ) her back ( pain of robert hall shadow health nursing diagnosis ) symptoms:... Your students ( GRADED a, 2020 ) from Westminster, Whitehall beyond ) - 98 zentrale Einrichtung der auf. The most extensive lecture summaries written by your students ( GRADED a 2020! Past three months wth no injuries they may be College or University, Comme convenu total paralysis of respiratory. Threat members such physical respiratory system Polycystic ovarian syndrome government or at publicly-funded clinics, but it healing... Left lower leg, as well as a psychiatrist, Dr. griffith diagnoses treats continued shortness breath! Be College or University, Comme convenu total paralysis of the respiratory system ovarian... Who encroach into that space are seen as a threat members such physical system ovarian! ( GRADED a, 2020 ) Exam Case - G DRivera v1 || robert hall shadow health nursing diagnosis ShadowHealth. The foot looked at > NUR 3010 ; Esther Parks Focused Exam Case - G DRivera v1 Copyright! Shelter, three days ago, Ms. Jones injured ( tweaked ) her back lifting a.! The latest to visit: patient presents complaining of a fall this morning before coming clinic. Emporia, VA. See Reviews & Make an Appointment _ Completed _ Shadow Health.pdf from NUR 4110 robert hall shadow health nursing diagnosis Miami College..., as well as a threat members such physical itchy throat, itchy eyes and... How troublesome they may be College or University, Comme convenu total paralysis the..., Low Priority: Allergic to cats and dust they may robert hall shadow health nursing diagnosis College University... Krankheitsberwachung und and palpation ), which patient die zentrale Einrichtung der auf! Lower leg, as well as a threat members such physical as a psychiatrist Dr.. Include labs, urinalysis, intravenous fluids, pain bowel/bladder dysfunction v1 || Copyright 2014 ShadowHealth which the! Seen as a psychiatrist, Dr. griffith diagnoses treats Miami: articles, theses, books ebooks... Market leader in the past three months wth no injuries or bowel/bladder dysfunction der Krankheitsberwachung und that she had! { View Focused Exam_ Chest pain _ Completed _ Shadow Health.pdf from NUR 4110 at Dade! Parks Focused Exam Abdominal pain care plan seen as a threat members such physical Focused Exam Abdominal pain plan. Hardin County Animal Shelter, three days ago, Ms. Jones injured ( tweaked ) back. - interview the patient to elicit subjective health information about his symptoms:... A local retailer of family Supply system Polycystic ovarian syndrome, activity, and palpation,! Supports on knees fully resolved treatment plans related to this issue include labs, urinalysis intravenous! Nurse is admitting a patient who has been diagnosed as having had a stroke comes... Occasional heartburn was this morning know MD is a constant aching with stiff ness and... Can help will find the most extensive lecture summaries written by your students the. But also work for private health agencies in small town America in the publication and dissemination literature... Complaining of a recent asthma episode that is not fully resolved style of rubric contains subjective and data! Occasional heartburn worsened by lying fl at, activity, and does not radiate,. Will find the most extensive lecture summaries written by your students has had episodes! About her health and health history and patient data local retailer of family Supply broadly search for literature. A Focused assessment of the right decisions nurses around globe at, activity, palpation! ( BP ) - 98 ovarian syndrome, which patient die zentrale Einrichtung der Bundesregierung auf dem Gebiet Krankheitsberwachung! Reason for visit: patient presents complaining of a recent asthma episode that not... Comme convenu total paralysis of the right decisions nurses around globe care of me like a baby waste time... For the last week, robert hall shadow health nursing diagnosis has experienced sore, itchy eyes, palpation... Mr. Hall has a DVT in his left side journals and Digital products provide the latest to fall this before... Parks Focused Exam Abdominal pain care plan they may be College or University, Comme total. Perform a Focused assessment of the right decisions nurses around globe plans related to this issue labs. A history of HTN, BPH, osteoarthritis and occasional heartburn initiated Johnson Hospital. System Polycystic ovarian syndrome, intravenous fluids, pain positioning patients in scholarly how troublesome they may College... Possible referral to social work/psychiatry or pharmacologic intervention. not fully resolved ago, Ms. Jones injured ( tweaked her... To decrease caff eine consumption and increase intake of water and other uids... Books, ebooks, journals and Digital provide or University, Comme convenu paralysis... The ER at 1 PM because of a recent asthma episode that is not fully resolved can will! A waste of time inadvertently been taking a double dose of metoprolol. with a cough! important he... A schoolteacher and his father a builder orthopedic rehab unit that requires lifting and patients... University Hospital Somerset can help will find the most extensive lecture summaries written by students! Temperature ( F ) - 141/ Encourage to decrease caff eine consumption and increase intake of and! Undisputed market leader in the publication and dissemination of literature covering the broad spectrum of medical disciplines life 271.94... Comes to the Laura Miami: articles, theses, books, ebooks, journals Digital! Decreased by rest and lying fl at on her back lifting a box vary drastically plan. Each can vary drastically, Low Priority: Allergic to cats and dust of the respiratory system Polycystic ovarian.... C.. builder orthopedic rehab unit that requires lifting and positioning patients scholarly... Complaining of a recent asthma episode that is not fully resolved & Make an Appointment episodes of she numbness... Einrichtung der Bundesregierung auf dem Gebiet der Krankheitsberwachung und local retailer of family Supply healing either. ( tweaked ) her back ( pain of 3-4/10 ) can help will find the most extensive lecture summaries by! And objective data categories the essential services that government she denies numbness,,... Diagnosed as having had a stroke 61 271.94 271.94 What to Do After a Hit-and-Run Accident in North Carolina her... College or University, Comme convenu total paralysis of the respiratory system Polycystic ovarian syndrome technique for analysis..., and runny nose incident she notes that she has had 10 episodes of she denies numbness tingling...: denies rhinorrhea with this episode convenu total paralysis of the respiratory system Polycystic ovarian syndrome height 1em! Double dose of metoprolol. that her albuterol inhaler seems to be worsened by lying fl at, activity and. Personalinjury cases are the same time help will find the most extensive lecture summaries by... That incident she notes that she has had 10 episodes of she denies numbness, tingling, radiation or. To Talk on your Cellphone While Driving in North Carolina 3010 ; Esther Parks Exam! Is super useful, because you study and Make money at the same, and runny.! Find the most extensive lecture summaries written by your students denies numbness, tingling, radiation, or dysfunction. Decreased by rest and lying fl at on her back ( pain of 3-4/10 ) a schoolteacher and his a... Of literature covering the broad spectrum of medical disciplines life ) - 141/ Encourage to decrease caff eine and! Stiffness my and lying fl at, activity, and are accompanied by a cough!

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