Because the dogs were without a nutritional supply of nitrogen, which is necessary and must be supplied through the food, the dogs were unable to live.
Magendie was so despised in Britain that Richard Martin (1754–1834) cited his experiments in the House of Commons when he proposed a measure to ban bear-baiting, which would go on to become the "Cruel Treatment of Cattle Act" of 1822, one of the earliest laws protecting animals.The Father of Modern Genetics is Gregor Mendel. In the field of science, he is well-known. He didn't get any of this credit, though, while he was still living. We'll revisit this later. A phrase using Magendie has given his experiments and inferences the highest endorsement. Magendie discovered that it produced when fed to dogs.
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correct question:
What did Magendie learn from his experiment involving the dogs and nitrogen?
1. nitrogen is nonessential in the diet
2. nitrogen is essential in the diet
3. peptides are essential in the diet
4. peptides are nonessential in the diet
a person with a spinal cord injury is experiencing loss of pain sensation in his left leg and loss of tactile sensation in his right leg. on which side of the spinal cord did his injury occur?
When a person with a spinal cord injury experiences a loss of pain sensation in his left leg and a loss of tactile sensation in his right leg, the right side of the spinal cord is affected.
What is the role of the spinal cord?The spinal cord is important for regulating different organs, carrying messages, and sending messages to motor organs, etc. The nerves that derive from the spinal cord are called the spinal nerves, and they regulate different body organs such as the muscles of the legs, etc.
Hence, when a person with a spinal cord injury experiences a loss of pain sensation in his left leg and a loss of tactile sensation in his right leg, the right side of the spinal cord is affected.
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which of the following does not increase the risk of developing osteoporosis? a. smoking cigarettes b. moderate alcohol consumption c. low dietary intake of calcium d. high caffeine consumption
Alcohol use in moderation does not increase the risk of developing osteoporosis.
B is therefore the correct option.
When bone tissue breaks down, it is known as osteoporosis. As a result, the interiors of the bones become more porous and less shock-resistant, making them thinner, weaker, and more brittle and prone to breaking. Symptoms include back pain, height decrease, hunched posture, and brittle bones.
Osteoporosis can be brought on by a variety of factors, such as smoking, drug use, sedentary lifestyles, inadequate calcium intake, and rheumatic inflammatory diseases, among others.
As a result, alcohol addiction, not moderate alcohol use, is to blame.
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Coordination of healthcare services is complicated by which of the following? (Select all that apply.)
A. Involving one or more services
Too many community resources
B. Poorly funded social programs
C. Authority for managing services
D. Too many nurses
E. Lack of healthcare systems
Coordination of healthcare services is complicated by (A) Involving one or more services and too many community resources.
Health care encompasses all fields related to medicine, including dentistry, pharmacy, midwifery, nursing, optometry, audiology, psychology, occupational therapy, physical therapy, and athletic training. It encompasses work done in the fields of public health, primary care, secondary care, and tertiary care.
Private healthcare facilities and public healthcare facilities are the two different categories of healthcare facilities.
the intentional division of patient care tasks among two or more caregivers (including the patient) in order to facilitate the efficient provision of medical care.
Making an agreement on responsibility and establishing accountability are two examples of specialised care coordination activities. sharing and communicating knowledge. assisting with care transitions.
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biologically effective radiation dose, appropriate for relating doses to effects on the human body, is the
Biologically effective radiation dose, appropriate for relating doses to effects on the human body, is the absorbed dose in gray. The biologically effective radiation dose, or the amount of radiation energy absorbed by an organism.
When studying the effects of radiation on humans, the most appropriate measure of radiation dose is the absorbed dose in Gray (Gy). Gray is a unit of measure that corresponds to the amount of energy absorbed by an organism per kilogram of tissue. It is the most accurate way of determining the amount of energy absorbed by a person, which is essential for assessing the risks associated with radiation exposure.
The primary health effects of radiation are classified as either stochastic effects or deterministic effects. Stochastic effects are long-term genetic or cellular damage, such as cancer, and are proportional to the amount of radiation dose absorbed by the organism. Deterministic effects are more immediate tissue damage, such as burns, and are not proportional to the amount of radiation dose absorbed.
The Gray is the best way of measuring the amount of radiation dose received by an organism, as it takes into account the type of radiation, its energy, and the sensitivity of the particular tissue of the organism to that radiation. It is the most accurate measure of radiation dose, and therefore the most appropriate for determining radiation effects on the human body.
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describe three (3) teaching points the nurse would provide to a client and their family regarding the treatment and transmission of tuberculosis.
It is transferred when air particles are expelled from people with pulmonary tuberculosis cough or sneeze thus reducing exposure, in common spaces, such as waiting rooms, providing tissues and surgical masks, hand-hygiene products (hand sanitizers), and trash bins.
Tuberculosis is a potentially serious infectious disease that primarily affects the lungs (TB). By releasing microscopic bacterial droplets into the air while coughing or sneezing, people can spread tuberculosis to one another. In wealthy countries, tuberculosis infections were historically rare, but they began to increase in 1985, in part because of the advent of the HIV virus, which causes AIDS. HIV weakens the immune system, preventing it from fighting against TB germs. Because of more successful control measures, tuberculosis cases in the US began to drop once more in 1993. But it still leaves room for doubt. Symptoms and indicators of active TB include coughing for three weeks or longer, blood or mucus when coughing, and fatigue. Chest pain, breathing problems, coughing pain, accidental weight loss, Reduced appetite, fatigue, nighttime sweats, and fever.
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what federal or state agency would best prevent an infectious disease outbreak to the neighboring cities and states of a small town after the town itself has been exposed with the spreads of this infectious disease?
The Centers for Disease Control and Prevention (CDC) is responsible for preventing an infectious disease outbreak to the neighboring cities and states of a small town after the town has already been exposed.
State and local health agencies work with many federal agencies, primarily those of the U.S. Department of Health and Human Services. For example, the Centers for Disease Control and Prevention (CDC) is leading efforts to control epidemic outbreaks and facilitate mass vaccinations.
What is the role of the Centers for Disease Control and Prevention (CDC)?
To inform the public and protect the health of individuals. To Promote public health and the prevention and control of disease, injury and disability through education.To notify the public and protect personal health.
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the clinic nurse reads the results of a tuberculin skin test performed on a 5-year-old child. the results indicate an area of induration measuring 8 mm. which correct interpretation should the nurse make about these results?
The nurse should interpret an area of induration measuring 8 mm on a tuberculin skin test as a positive reaction. This is because an area of induration greater than 5 mm is generally considered to be indicative of a positive reaction to the test.
Interpreting Results of Tuberculin Skin Test in a 5-Year-Old ChildThe nurse should explain to the patient and their family that the results of the tuberculin skin test indicate that the child has been exposed to tuberculosis, and they should seek further medical evaluation and treatment if necessary. The nurse should also provide information about the signs and symptoms of tuberculosis, how it is spread, and how to prevent it from spreading to others.
Since the question is not complete, here's the full task:
The clinic nurse reads the results of a tuberculin skin test performed on a 5-year-old child. The results indicate an area of induration measuring 8 mm.
Which correct interpretation should the nurse make about these results?
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a client is taking an angiotensin-converting enzyme (ace) inhibitor for the prevention of migraines. what should the nurse say if the client develops a cough?
Blood tests will be necessary to check your potassium levels and kidney function as soon as you start taking an ACE inhibitor.
Keep a written record of your blood pressure and heart rate (pulse) if you use an ACE inhibitor. Take your pulse every day to monitor your heart rate. Medication and lifestyle changes are the two approaches to regulate and maintain your heart health. Although it cannot be cured, medication can help you manage heart disease and high blood pressure. Maintaining a healthy lifestyle might enable you to use fewer medications. Visit get-healthy.heartandstroke.ca. Utilize the most recent knowledge and guidance from Heart and Stroke Foundation professionals to learn how to maintain a healthy heart. Your finest sources of information are your doctor or pharmacist.
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Bob Jones is considering contractors for his company's medical benefits, and he is reviewing health plans from two different entities. What database should he consult to compare the performance of the two health plans:
HEDIS: Healthcare effectiveness data and information set
In order to assess the efficacy of the two health plans, Bob Jones should access the HEDIS database (Healthcare effectiveness data and information set).
HEDIS is a comprehensive collection of standardized performance metrics created to give consumers and purchasers the knowledge they require to accurately compare the performance of health plans. Numerous important public health concerns, including cancer, heart disease, smoking, asthma, and diabetes, are related to HEDIS Measures.
SNPs may track improvement, highlight areas for improvement, assess the efficacy of quality improvement programs and give a set of measuring criteria that enable comparison with other plans using HEDIS performance data. Data make it possible to spot performance gaps and set reasonable development goals.
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the nurse reviews the client's serum calcium level and notes that the level is 8.0 mg/dl (2.0 mmol/l). the nurse understands that which condition would cause this serum calcium level?
The normal serum calcium level is 8.6 to 10.0 mg/dL. A client w/a serum calcium level of 8.0 mgdL is experiencing hypocalcemia.
A blood test called serum calcium measures the level of calcium in the blood. In order to detect or track bone diseases or problems of calcium control, serum calcium is frequently tested (diseases of the parathyroid gland or kidneys).
The acceptable range for blood calcium levels at UCLA is between 8.6 and 10.3 mg/dL. The body employs hormones to control blood calcium levels in order to keep them at a normal level. The way a thermostat operates is comparable to how calcium levels in our blood are normally regulated.
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a woman with an inflammatory skin disorder has begun taking prednisone in an effort to control the signs and symptoms of her disease. the nurse who is providing care for this client should prioritize which potential nursing diagnoses in the organization of the client's care?
The potential nursing diagnosis in the organisation of the client's care is fluid volume excess.
What is inflammatory skin disorder?Inflammatory skin disorder is a type of disorder that affects the surface or the peripheral part of the skin which leaves the individual devastated because of change in the physiology of their skin.
The clinical manifestations observed in individuals with inflammatory skin disorder include the following:
may be smooth or scaly.may itch, burn, or sting.may be flat or raised.skin redness.warmth in the affected area.blisters or pimples.The drug used for the effective treatment of inflammatory skin disorder is prednisone which is a corticosteroids that has the side effect of excessive fluid volume.
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the nurse is preparing to administer suvorexant to a client as ordered. the nurse should question the client receiving this dose and contact the primary care provider first if which findings were noted on the assessment? select all that apply.
The nurse is getting ready to provide a client suvorexant as directed. The key factors contributing to the patient's apparent lethargy are a considerable drop in blood pressure and a respiration rate below 10 breaths per minute.
It's possible for Suvorexant to become a habit. Misuse can result in overdose, addiction, or death. The drug should be kept out of the reach of others. Suvorexant shouldn't be taken shortly after or with meals. Taking it on an empty stomach will make it work more quickly. Suvorexant, a dual orexin receptor agonist, is now authorized in Japan and the United States to treat insomnia. The first drug to be licensed for the treatment of sleep problems in Alzheimer's disease was svorexant ( company press release ; FDA prescribing information ). Suvorexant is ingested orally.
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for an aerobic exercise such as a latin dance class, which measurement would you use to confirm that you are working at 70% to 90% of your maximal heart rate for improved cardiorespiratory fitness?
Target heart rate confirm that you are working at 70% to 90% of your maximal heart rate for improved cardiorespiratory fitness.
The number of beats per minute serves as a proxy for the average heart rate. Each person's heart rate variability can be influenced by a variety of factors, including physical activity and the body's demand for oxygen absorption. This frequency can be mechanically or manually determined using the arterial pulse. The most common reason for heart rate changes is exercise. The most popular technique for advising aerobic exercise is heart rate, which establishes a training zone using a percentage. The heart rate can be utilized to evaluate whether the heart is beating at 70% to 90% of its maximal heart rate when engaging in an aerobic exercise like Latin dancing.
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the nurse is planning to get a client out of bed for the first time after having a total hip arthroplasty (tha). what specific actions would the nurse take? select all that apply
The nurse is planning to get a client out of bed for the first time after having a total hip arthroplasty (THA). The specific actions would the nurse take are:
1. Place a gait belt on the client.
2.If stretch bands are used, reinforce the correct use.
3.Observe for any signs/symptoms of dizziness the first time the client gets out of bed.
4.After the client sits on the side of the bed, remind the client to stand on the unaffected leg.
What do you mean by total hip arthroplasty (THA)?Hip replacement is a surgical technique in which a prosthetic implant, or hip prosthesis, is used to replace the hip joint. An entire hip replacement or a partial hip replacement can be performed during hip replacement surgery. Orthopaedic joint replacement procedures are typically performed to treat hip fractures or the pain associated with arthritis. In contrast to hemiarthroplasty, which often just replaces the femoral head, total hip replacement (also known as THA) involves replacing the acetabulum as well. One of the most frequent orthopaedic procedures is a hip replacement, yet patient satisfaction varies greatly.
Thus from above conclusion we can say that the nurse is planning to get a client out of bed for the first time after having a total hip arthroplasty (THA). The specific actions would the nurse take are:
1. Place a gait belt on the client.
2.If stretch bands are used, reinforce the correct use.
3.Observe for any signs/symptoms of dizziness the first time the client gets out of bed.
4.After the client sits on the side of the bed, remind the client to stand on the unaffected leg.
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which drug is most effective in reducing most major types of dyslipidemia in patients at risk or who have already developed cad?
Statins – One of the most well researched families of pharmaceuticals, statins are the most widely prescribed medication for decreasing LDL cholesterol. These medicines work best at preventing coronary heart disease, heart attacks, strokes, and mortality.
What is the preferred medication for dyslipidemia?The recommended medications are statins and fibrates. In addition to its positive pleiotropic effects, such as lowering fibrinogen and plasma viscosity, fibrates address a number of defects in lipoprotein metabolism.
Which medication is appropriate for treating hyperlipidemia?The U.S. Food and Drug Administration has given the go-ahead for the use of cholestyramine, clofibrate, nicotinic acid, sodium dextrothyroxine, and beta-sitosterol as treatments for hyperlipidemia.
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a child diagnosed with adrenal insufficiency takes po hydrocortisone daily. the client is followed regularly by a nurse, who assesses the child every 3 months. what assessment data should the nurse prioritize during these assessments?
Height and weight of the child. Addison's disease, also known as adrenal insufficiency, is a rare ailment that arises when the body does not produce enough of specific hormones.
In Addison's disease, the adrenal glands produce insufficient cortisol and, in many cases, insufficient aldosterone. Adrena crisis is the most severe consequence of adrenal insufficiency. Adrenaline crises can be fatal if not addressed immediately. During times of physical stress, such as illness, serious injury, or surgery, your body requires significantly more cortisol than usual. Primary adrenal insufficiency is most commonly caused by your immune system mistakenly attacking your healthy adrenal glands.
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the rate of relapse among people with problems such as substance abuse, depression, and sexual offending is very high. which of the following is most likely to reduce the relapse rate?
Cognitive-behavioral therapies are most likely to lower the recurrence rate in people with issues including substance misuse, depression, and sexual offense, all of which have very high relapse rates.
What defines depression?Depression is a prevalent mental illness. According to estimates, the condition affects 5% of adults worldwide. Its defining characteristics are constant sadness as well as a lack of enthusiasm in formerly gratifying or happy activities. Additionally, it may impair appetite and sleep. Concentration problems and fatigue are frequent. Everybody is different in how they are affected by depression, which has a wide variety of symptoms. The signs include crying a lot, feeling depressed and hopeless, and losing interest in previously enjoyed activities. It's also typical for persons with depression to experience anxiety symptoms.
What happens during a depression?In times of depression, the unemployment rate soars to double digits and consumer demand plummets. Businesses often cut production or shut down facilities to make up for this, and investment activity declines. GDP and other indicators of economic activity consequently undergo severe reductions.
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a nurse is caring for a patient who is receiving lovastatin. which assessment by the nurse would indicate that there is possible damage to the patient's skeletal muscle as a result of the drug therapy?
The assessment by the nurse would indicate that there is possible damage to the patient's skeletal muscle as a result of the drug therapy in brownish-colored urine.
Keep in mind that your doctor has recommended this medicine because they believe it will help you more than it will harm you. Many users of this medicine report no significant negative effects. A very tiny percentage of lovastatin users may have minor disorientation or memory issues.
Rarely, this medicine may result in liver issues. If you have any liver-related symptoms, such as persistent nausea or vomiting, yellowing of the skin or eyes, dark urine, or stomach or abdominal discomfort, call your doctor straight once.
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the licensed practitioner orders 500 mg of amoxicillin three times daily for a patient. how much of the medication should the patient take at each dose?
The patient is prescribed 500 mg of amoxicillin three times per day by the qualified healthcare provider. At each dose, the patient should take 250-500mg of the drug.
what is amoxicillin?
Several different bacterial infections are treated with amoxicillin. The antibiotic in question is similar to penicillin. It functions by halting bacterial growth. With this medication, only bacterial illnesses are treated. Additionally, amoxicillin is combined with other drugs to treat and prevent the recurrence of stomach/intestinal ulcers brought on by the bacteria H. pylori.
Amoxicillin capsules should be taken three times day at a dosage of 250 mg to 500 mg. For children, the dosage might be decreased.
Attempt to distribute the doses equally throughout the day. The first thing in the morning, mid-afternoon, and right before night if you take it three times a day.
Amoxicillin capsules should be consumed whole together with water. Never eat them or break them. Children and those who struggle to swallow capsules can get amoxicillin as a liquid.
Your pharmacist will typically provide extra liquid amoxicillin for you if you or your child needs it. A plastic syringe or spoon will be sent with the medication to assist you in measuring the proper dosage, Request one from your pharmacist if you don't already have one. There are 125mg and 250mg dosages of amoxicillin liquid available.
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a patient in severe pulmonary edema is being intubated by the respiratory therapist. what priority action by the nurse will assist in the confirmation of tube placement in the proper position in the trachea?
The nurse's priority will be to call for a chest x-ray to establish that the tube is in the correct location in the trachea.
The two techniques for determining NG tube location are as follows:
NG aspirate pH measurement using pH indicator paperA chest X-rayA chest X-ray can be utilized to confirm the secure insertion of an NG tube if pH monitoring of the NG accidentally ingest is not possible.
An X-ray of the chest should show the lower diaphragm and the higher esophagus.
The NG tube needs to stay in the midline to the diaphragm level. The carina should be divided by the NG tube. The left hemidiaphragm should be below the tip of the NG tube, which should be visible. The NG tube's tip should extend around 10 cm past the GOJ.Learn more about tube placement in the trachea at
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a patient is diagnosed with a malignant gastric tumor in the distal portion of the stomach. which surgical intervention would the nurse expect this patient will be offered?
Gastric resection remains the preferred surgical treatment option for many diseases of the stomach, including malignancy, peptic ulcer disease, and bariatric procedures.
Gastric cancer is a condition in which malignant (cancer) cells grow in the stomach lining. The chance of acquiring gastric cancer can be influenced by age, food, and stomach condition. Indigestion and stomach discomfort or pain are symptoms of gastric cancer.
Adenocarcinomas. The majority of stomach malignancies (90–95%) are adenocarcinomas. These malignancies arise from gland cells in the stomach's innermost lining (the mucosa). When you are diagnosed with stomach cancer (or gastric cancer), it is nearly invariably an adenocarcinoma.
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a client recently received lip and tongue piercings and subsequently developed a superinfection of candidiasis from the antibacterial mouthwash. what would the nurse recommend for this client?
For a client received lip and tongue piercings and subsequently developed a superinfection of candidiasis the nurse would recommend Use salt water or an antifungal mouthwash.
If the antibacterial mouthwash results in a superinfection of candidiasis, the client can switch to salt water or an antifungal mouthwash. It is not advised to use a hard-bristled toothbrush; a soft-bristled toothbrush should be used instead. The patient should rinse her mouth with salt water or an antifungal mouthwash for 30 to 60 seconds after eating. While cleansing helps to cleanse the pierced tract, moving the jewelry near the piercing back and forth does not fix the issue. After eating, the patient should rinse her mouth for 30 to 60 seconds with salt water or an antifungal mouthwash.
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what drug would the nurse expect to administer to a client with acquired immunodeficiency syndrome who has developed cachexia?
Megestrol acetate would client with acquired immunodeficiency syndrome who has developed cachexia
the parents of a school-age child tell the nurse that their child is tall, broad, and very active in sports, so they are planning to enroll the child for strenuous competitive athletics. which is the best response from the nurse?
The youngster is not yet ready for such activities. Although the school-aged youngster may appear large and muscular, due to their age, they may not be ready for physically demanding sports activities.
Despite the child's potential enthusiasm in the sport, it's possible that they aren't physically prepared for it. Because the child is developing and won't be too exhausted to partake in various physical activities, the child doesn't require longer stretches of relaxation. This is an inappropriate reaction from the nurse because the youngster may or may not pursue a career in sports based on his or her passion and ability in the sport.
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a nurse is, preparing to administer a client's scheduled beta-adrenergic blocker. the nurse, is aware that the client is receiving this medication for the treatment of hypertension. the nurse has addressed which right of safe medication administration?
a nurse is, preparing to administer a client's scheduled beta-adrenergic blocker, a medication for the treatment of hypertension. the nurse has addressed about Right Reason of safe medication administration
Drugs that lower blood pressure are referred to as beta blockers or beta-adrenergic blocking medicines. Epinephrine, often known as adrenaline, is a hormone that beta blockers act by inhibiting. Blood pressure is lowered by beta blockers because they make the heart pulse more gradually and gently. In order to increase blood flow, beta blockers also aid in artery and vein dilation. While some beta blockers primarily influence the heart, others influence the heart and blood vessels. Based on your medical problems, your doctor will decide which beta blocker is appropriate for you.
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the clinic nurse is reinforcing instructions to an adolescent with type 1 diabetes about administration of insulin. which statements by the adolescent indicate the need for further teaching? select all that apply.
instructions to an adolescent with type 1 diabetes: Use one major site for the morning injection and another site for the evening injection for 2 to 3 weeks before changing major sites.
type 1 Diabetes , also referred to as juvenile diabetes or insulin-dependent diabetes, is a chronic illness. Little to no insulin is produced by the pancreas in this situation. The hormone insulin is used by the body to let glucose (sugar) into cells where it can be used to make energy. Type 1 diabetes may be brought on by numerous elements, including viruses and genetics. Despite typically developing in childhood or adolescence, type 1 diabetes can sometimes strike adults. Type 1 diabetes still has no cure, despite extensive research. The goal of treatment is to control blood sugar levels with the use of insulin, food, and lifestyle changes in order to avoid problems.
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a client with a phobia will be treated for the condition using a behavior modification technique known as systematic desensitization. the nurse describes the components of this form of therapy to the client and reinforces which client instruction?
Systematic desensitization must include these three essential elements: Fear hierarchy is first, followed by relaxation exercises and reciprocal inhibition.
Exposure treatment in the form of systematic desensitization aids people in addressing a range of mental health issues. Systematic desensitization employs reverse counter-conditioning to evoke a different response in order to unlearn the maladaptive response to a circumstance or object (relaxation). The three steps of systematic desensitization are as follows: the client first creates an anxiety hierarchy (a prioritized list of anxiety-inducing stimuli); the client is then instructed in deep muscle relaxation; and finally, the client attempts to work through the hierarchy while practicing remaining calm while imagining each stimulus.
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excessive use of mobile devices is linked to and may affect all of the following in children?
a client is receiving an ssri. the nurse would inform the client that the full benefits of the drug may not occur for which time period?
When a client is receiving an SSRI, the nurse will let them know that it can take up to 4 weeks for all of the advantages of the drug to kick in.
What is a drug ?
A substance that has been approved by a pharmacopoeia or formulary. a drug that is meant to be used in the treatment, diagnosis, mitigation, or prevention of disease. a material intended to change the body's composition or any of its functions that is not food.
Before you start to feel the affects of SSRIs, it often takes 2 to 4 weeks. When you first begin taking SSRIs, you'll have regular appointments with your doctor. You should let them know if you don't feel any better after 4 to 6 weeks of the drug. Feeling agitated, jittery, or worried are typical adverse effects of selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs),having a sick feeling. bloating and stomach pains.
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Which of the following would NOT be good advice to offer someone who is selecting a calcium supplement?
Answer
Select a calcium carbonate supplement as it contains the most calcium per dose.
Your body cannot absorb more than 500 mg at any given time.
Look for a calcium supplement that is labeled "lead free."
Take your calcium supplement on an empty stomach to increase absorption.
Take your calcium supplement on an empty stomach to increase absorption.
Answer:
Your body cannot absorb more than 500 mg at any given time.
Explanation:
Your body cannot absorb more than 500 mg at any given time.
This is not good advice because the body can actually absorb more than 500 mg of calcium at a time. The amount of calcium that the body can absorb at one time varies and depends on several factors, including the form of the calcium supplement and the individual's age and health status. It is generally recommended to spread out calcium intake throughout the day rather than taking a large dose all at once.