Internal hip fixation and an open reduction have been performed on a patient. The client will be moved to a chair for a half-hour on the second postoperative day. The nurse should walk the client through the transfer process before beginning.
To repair badly damaged bones, open reduction internal fixation (ORIF) surgery is performed. Only severe fractures that cannot be treated with a cast or splint are treated with it. These wounds typically consist of misplaced, unstable, or joint-related fractures. You will experience no pain thanks to general anaesthesia administered by an anesthesiologist. The surgeon will make a skin incision and reposition the bone to its original location. To hold the bone together, the surgeon will affix metal rods, screws, plates, or pins to it. The location and kind of the fracture determine the kind of hardware that is employed. The surgeon will next apply a bandage, seal the incision with stitches or staples, and maybe place the leg in a cast or splint.
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The complete question is:
A client has an open reduction and internal fixation of the hip. The client is to be transferred to a chair for a half hour on the second postoperative day. Before transferring the client, what should the nurse do?
Assess the strength of the affected leg.
Explain the transfer procedure step by step.
Instruct the client to bear weight evenly on both legs.
Encourage the client to keep the affected leg elevated.
the nurse recommends that, when in bed, a client who has osteoarthritis should lie in the supine or prone position. the client states that these positions are uncomfortable for the knees and hips. which action would the nurse take?
Learn with Quizlet and retain terms from flashcards such as An arthritic patient is admitted to hospital for a prospective hip replacement to be assessed.
A hospital is what?
A hospital is what? A hospital is a type of healthcare facility that offers patients professional nursing and medical services as well as medicinal supplies.
E-hospital: What is it?
e-Hospital is a workflow-based, integrated HMIS that runs on the cloud. It is a general application that covers all of a hospital's key functional areas. The e-Hospital application's patient registration module is used to schedule, confirm, and cancel appointments as well as register patients in the OPD and Trauma departments.
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a client with tetraplegia complains bitterly about the nurse's slow response to the call light and the rigidity of the therapy schedule. which interpretation of this behavior would serve as a basis for planning nursing care?
The head of the bed should be elevated by 30 degrees for patients who have had supratentorial surgery to encourage venous draining from the head.
How should the caregiver place the patient whose intraocular pressure ( iop is high and making them drowsy after a recent craniotomy?The client's head should be held in a neutral midline posture with the increased intracranial pressure. The client's neck should not be bent, extended, or rotated in any way by the nurse. It is recommended to raise the bed's head by 30 to 45 inches.
What should the nurse do to treat a patient who might have a skull fracture?Using sterile gauze, apply tight pressure to the wound. a spotless cloth. If you think there may be a skull fracture, however, avoid putting direct pressure on the wound. Awareness and respiratory patterns to watch for. Start CPR if the person is not breathing, coughing, or otherwise demonstrating indications of circulation.
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the nurse assists a client who has had a stroke affecting the left side causing difficulty moving the hand and fingers. which range-of-motion exercise(s) will the nurse use? select all that apply.
Spreading out the fingers, The nurse will employ finger range-of-motion exercises such as flexion, adduction, and abduction.
What are the 5 warning signs of a stroke?When any of these indications of a stroke arise, dial 9-1-1 right away: A strong headache with no apparent cause, numbness and weakness inside the face, arm, or leg, confusion or difficulty hearing or understanding speech, difficulty seeing out of one or both eyes, difficulty walking or feeling dizzy.
What happens to you when you have a stroke?Brain activity is lost when brain cells are destroyed. It's possible that you won't be able to perform tasks that require that section of your brain. For instance, a stroke may impair your capacity for movement, speech, eating, thinking, and remembering.
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which instruction would the nurse provide to the client with hemiparesis who is learning to ambulate with a cane?
The instruction that nurse would be given to client with hemiparesis who is learning to ambulate with a cane is to shorten the stride of the unaffected extremity. Because it will help the client to speed up the healing process.
What is hemiparesis?Hemiparesis define as weakness or the uncapable to move of one side of the body that make hard to perform everyday activities such eating, walking or dressing. The most common cause of the Hemiparesis are stroke, brain damage because of trauma, brain damage because of head injuries and brain tumors caused by cancer.
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an older adult is returned to the surgical unit after having a subtotal gastrectomy. the nurse anticipates that which dietary modification will be prescribed?
Continue with small, easily digested feedings gradually will be prescribed by the nurse to the old adult client who had subtotal gastrectomy.
In general, health care providers prevent the dumping syndrome by changing the diet after surgery. Changes may include eating smaller portions or restricting foods high in sugar. More severe cases of dumping syndrome may require medication or surgery. This aims to ensure the complete removal of the tumor by providing adequate longitudinal and circumferential resection margins. Subtotal gastrectomy is the gold standard treatment for early gastric cancer located in the distal third of the stomach. A gastrectomy is a major operation, and recovery takes a long time. You will usually stay in the hospital for 1 to 2 weeks after surgery and may be given direct intravenous nutrition until you can eat and drink again.
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a client in active labor is rushed from the emergency department to the labor and birth suite screaming, 'knock me out!' examination reveals that her cervix is dilated 9 cm and 100% effaced. which would the nurse say while trying to calm the client?
While attempting to calm the client, the nurse should warn that the drug may impair with the baby's initial breaths and to keep breathing. Hence option 'd' is correct.
What is the purpose of medication?Medicines are chemicals or substances that cure, halt, or prevent disease, lessen symptoms, or help with disease diagnosis. Doctors can now save and treat numerous diseases thanks to modern medicine.
Why is medication beneficial to you?Reduced blood pressure, the treatment of infections, and pain relief are a few examples of how drugs are beneficial. There is a chance that something unfavorable or unexpected possibly happen to you when you use a drug.
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The complete question is -
A client in active labor is rushed from the emergency department to the labor and birth suite screaming, "Knock me out!" Examination reveals that her cervix is dilated 9 cm and 100% effaced. What should the nurse say while trying to calm the client?
a) "I'll rub your back—that will help ease your pain."
b) "You'll get a shot when you reach the birthing room."
c) "I'm sure you're in pain, but try to bear with it for the baby's sake."
d) "Medication may interfere with the baby's first breaths; keep breathing."
a client experiences occasional right upper quadrant pain attributed to cholecystitis. to prevent or minimize dyspepsia, the nurse would instruct the client to avoid which food items?
An infrequent right upper quadrant ache in a client is thought to be caused by cholecystitis. Clear fluid diets are safe when used temporarily and in accordance with medical advice.
Which nutrients are required following surgery?Infection prevention requires notably high levels of vitamin D, zinc, and l - ascorbic acid After surgery, nutrient-rich beverages and smoothies can help you eat enough calories and nutrients if you don't feel like eating for a day or two. Good options include Carnation Quick Breakfast, Ensure, Boost, and Sustacal.
What falls under your purview as a nurse to guarantee the patient is receiving the proper diet?The task of making ensuring that patients' and clients' nutritional requirements are addressed falls under the purview of nurses. To promote healthy eating and hence better health outcomes, it is crucial to offer nutrition assessment and appropriate nutrition guidance.
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a nurse is caring for a client who has neutropenia resulting from chemotherapy. which precaution would be least appropriate to include when caring for this client?
The least precaution to be taken by the nurse with the client having neutropenia is checking the rectal temperatures.
Neutropenia occurs when levels of neutrophils, a type of white blood cell, are low. All white blood cells help the body fight infections, but neutrophils are important in fighting certain infections, especially those caused by bacteria. You don't know something Common causes include HIV, hepatitis, tuberculosis, sepsis, and Lyme disease. cancer:
Cancer and other blood and bone marrow diseases, including leukemia and lymphoma, can prevent the body from making enough healthy white blood cells, leading to neutropenia. Neutropenia is a common side effect of cancer or cancer treatment that patients should be aware. It is a side effect of chemotherapy.
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hat type of progress addresses issues such as public health and sanitation that affect the poorest people, which in turn improves water quality and other environmental issues? progress
Social progress improves water quality and other environmental problems by addressing problems that the poorest people face, like public health and sanitation.
Social Progress is even to tangible quality cause it is humankind's concern that ends the effect of the environment. The plan of the organic park's search helps support character conservation- and to supply the public approach to everyday advantage and outdoor games.
Public health is "the skill and cunning of hampering disease, extending growth and advancing health through the systematized exertions and cognizant selections of society, arrangements, public and private, societies and things". Sanitation mediations primarily benefit community health by lowering the predominance of pertaining to stomach pathogenic illnesses, that cause dysentery. Health benefits are fulfilled and amassed to the direct recipients of cleanliness attacks and again to their neighbors and so forth in their communities.
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What kind of repair code would be used to report a layered closure of the extensive cleaning of a heavily contaminated wound?
Answer:
Intermediate Repair
the nurse is collecting data on a newly admitted client with conversion disorder. the nurse knows which voluntary motor or sensory function deficits might be present in this client? select all that apply
The nurse is aware of any potential deficiencies in this client's voluntary motor or sensory functions.
1.Paralysis
3.Blindness
4.Paresthesia
5.Movement disorder
How does conversion disorder develop?current severe stress, or recent mental or physical trauma. having a mental illness, such as an anxiety or mood problem, dissociative disorder, or specific personality disorders. having a family member who suffers from a neurological disorder or symptoms. having a background of childhood neglect or sexual or physical abuse.
Can speech be impacted by conversion disorder?Any speech issue that is the result of one or more different psychological processes is referred to be a psychogenic speech disorder. Anxiety, depression, conversion disorders, and emotional reactions to stressful events are examples of this, although they are not the only ones.
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Complete question is:
the nurse is collecting data on a newly admitted client with conversion disorder. the nurse knows which voluntary motor or sensory function deficits might be present in this client? select all that apply
1.Paralysis
2.Incoordination
3.Blindness
4.Paresthesia
5.Movement disorder
a nurse has permission from the homebound client to educate any of the family members about providing care for the client. which family member is the most appropriate choice?
The homebound client has given the nurse permission to instruct any family members. The client is told by the nurse that giving up smoking will lower their risk of developing cancer.
Describe cancer?A very serious illness wherein cells in one area of the body begin to proliferate and develop lumps in an abnormal manner.
Cancer comes in a variety of forms. Cancer is named by the region of the body in which it first appeared and can appear anywhere in the body. For instance, even if breast cancer that originates in the breast spreads metastasizes to certain other parts of the body, it is still referred to as breast cancer.
A cancer cell is what?Solid tumours are created by the uncontrollably dividing cancer cells.
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a factory worker has presented to the occupational health nurse with a small wood splinter in his left eye. the nurse has assessed the affected eye and irrigated with warm tap water, but the splinter remains in place. what should the nurse do next?
For the factory worker with a small wood splinter in his left eye, the nurse should arrange the worker to be examined promptly by an ophthalmologist (eye specialist).
What is an ophthalmologist?An ophthalmologist is a doctor who specializes in ophthalmology. Ophthalmologists differ from optometrists in their level of training and what they can diagnose and treat.
Which doctor is best for vision?For general eye care, either an ophthalmologist or an optometrist are good options. Both can perform a comprehensive advanced eye examination. Write prescriptions for eyeglasses and contact lenses.
Who is an ophthalmologist or optician?An optician is a technician who adjusts eyeglasses, contact lenses, and other vision-correcting devices. Optometrists examine, diagnose, and treat patients' eyes. An ophthalmologist provides medical and surgical treatment of eye diseases.
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hypoxemia triggers the production of erythropoietin. erythropoietin increased the rate of erythropoiesis. this an example of ?
Negative feedback control
Hypoxemia triggers the production of erythropoietin. erythropoietin increased the rate of erythropoiesis. This an example of negative feedback.
What do you mean by negative feedback?A negative feedback mechanism, often known as negative feedback homeostasis, is a pathway that is triggered by a deviation in output and produces changes in output in the opposite direction of the initial deviation.
Also known as an inhibitory loop, a negative feedback loop allows the body to regulate itself. The process starts when there is an increase in output from a body system, which results in higher levels of certain proteins or hormones.
Another example of negative feedback is the regulation of the blood calcium level. The parathyroid glands secrete parathyroid hormone, which regulates the level of calcium in the blood. If calcium decreases, the parathyroid glands sense the decrease and secrete more parathyroid hormone.
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which information would the nurse provide when teaching parents about the nutritional needs of their 15-year-old child? select all that apply. one, some, or all responses may be correct.
When educating parents on the nutritional requirements of their 15-year-old child, the nurse would present information. Adolescents from underrepresented.
What exactly is adolescence?Between the ages of 10 and 19, adolescence is the stage of existence between childhood and adulthood. It is a distinct period in human development and crucial for setting the groundwork for long-term health.
Teenagers grow quickly in terms of their physical, cognitive, and emotional development. The period of development and growth between childhood and maturity is known as adolescence.
Any person between the ages of 10 and 19 is considered an adolescent by the World Health Organization (WHO). Pay attention to how it sounds. Concerning a disease's psychological, emotional, economic, and spiritual side effects.
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which body system effects would the nurse state as occurring due to immobility? select all that apply.
The body system effects occurring due to immobility are: (A) Increased cardiac workload; E) Increased risk for renal calculi; and F) Increased risk for electrolyte imbalance.
Immobility is defined as the condition of the body where its physical movement is limited or completely lost. The individual suffering from immobility is either partially or completely dependent on another person or equipment for the movement.
Renal calculi in simple terms are called the kidney stone. These are the hard deposits of minerals and salts that form inside the kidneys. The condition of presence of renal calculi is very painful for the person.
The given question is incomplete, the complete question is:
Which body system effects would the nurse state as occurring due to immobility? Select all that apply.
A) Increased cardiac workload
B) Increased depth of respiration
C) Increased rate of respiration
D) Decreased urinary stasis
E) Increased risk for renal calculi
F) Increased risk for electrolyte imbalance
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when educating a client about the risks of malignant melanoma, what would you know to include? (mark all that apply.)
In educating a client about malignant melanoma risk, I would include:
Immunosuppression (A)Red or light hair (C)Freckles (D)Immunosuppression: People who have a weakened immune system, either due to a medical condition or medication, have an increased risk of developing malignant melanoma. This is because the immune system plays a critical role in identifying and fighting cancer cells.
Red or light hair: People with red or light hair are more susceptible to developing malignant melanoma than those with darker hair. This is because they have less melanin, the pigment that provides some protection from the sun's harmful ultraviolet (UV) rays.
Freckles: Freckles are a common sign of sun damage, which is a major risk factor for malignant melanoma. People who have many freckles or who develop them at a young age are more likely to develop malignant melanoma than those without freckles.
Age greater than 60 and female gender are not necessarily risk factors for malignant melanoma, but fair skin, a family history of melanoma, moles, and sun exposure are some of the other key risk factors that should be taken into account when educating patients about this cancer. Early detection and regular skin exams can greatly improve the chances of a successful treatment.
This question should be provided with answer choices, which are:
A. ImmunosuppressionB. Age older than 60C. Red or light hairD. FrecklesE. Female genderThe correct answers are A, C and D.
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the nurse is providing nutrition instructions for a client who has inflammatory bowel disease of the ascending colon. which suggestion by the nurse is appropriate?
The recommendation that an ascending colon inflammatory bowel disease(IBD)patient consume scrambled eggs and applesauce
The condition in which the tissues in your digestive tract have experienced persistent (chronic) inflammation is referred to as "inflammatory bowel disease" (IBD).
Low-residue foods like eggs and applesauce result in less fecal waste, which lessens intestinal contents and pain. Calories provide you with energy, while protein aids in healing. Hot barbecued meals can hasten peristalsis, as can fatty foods. Fruit and pungent, aged cheese may irritate the intestines. Chunky peanut butter and whole wheat bread are high-residue (high-fiber) foods.
For other people, IBD is just a minor illness. Others are extremely frail due to a condition that is potentially fatal.
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a 30-year-old client tells the nurse that she would like to use a contraceptive sponge but does not know enough about its use and whether it will protect her against sexually transmitted infections (stis). which information should the nurse provide the client about using a contraceptive sponge? select all that apply.
She will be safeguarded against STDs thanks to it (stis). The nurse is approached by a 30-year-old client who says she would want to use a prophylactic sponge but is unsure it will be effective.
What precautions should use of the birth control patch take?
Among the possible negative effects of the modern contraceptive patch are: an increased risk of high blood pressure, liver cancer, gallbladder disease, heart attack, and stroke. hemorrhage or spotting that is excessive. irritated skin.
How should you apply the contraceptive patch?
Put on your first patch, then wear it for seven days. Change this patch to just a new one on day eight. After three weeks of weekly changes in this manner, there will be a week without any patches. Although it's possible that it won't always happen, you'll experience a withdrawal bleed similar to a period throughout your patch-free week.
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the nurse is checking a child for dehydration and documents that the child is moderately dehydrated. which symptoms would be noted in determining this finding? select all that apply.
Oliguria. Somewhat recessed fontanels. mucous membranes feel quite dry. Patients with mild dehydration should get oral rehydration therapy.
There are several symptoms, including nausea, vomiting, diarrhoea, fever, decreased oral intake, inability to stop further losses, decreased urine output, deteriorating into lethargy, and hypovolemic shock. Infants who are nursing should keep doing so. Drinks having a lot of sugar in them should be avoided because they can make diarrhoea worse. Age-appropriate foods can be served to kids on a regular basis in tiny portions.
Slight dehydration
The Morbidity and Mortality Weekly Report advises giving 50 to 100 millilitres of oral rehydration solution per kilogramme of body weight over the course of two to four hours to make up for the expected fluid deficit, with more oral rehydration solution given to make up for continued losses.
The complete question is:
the nurse is checking a child for dehydration and documents that the child is moderately dehydrated. which symptoms would be noted in determining this finding? select all that apply.
Oliguria
Urine output
Slightly sunken fontanels
Limit concentrated sweets
Very dry, mucous membranes
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A client's blood glucose us 23. The client is unresponsive and unable to swallow. What priority action should be taken to increase the blood glucose rapidly?
According to the research, the correct answer is Option 3. The administration of a glucagon injection is the priority action that should be taken to increase the blood glucose rapidly.
What is hypoglycemia?It is the clinical syndrome or a condition characterized by low glucose, that is, it appears in those situations in which blood glucose concentrations are below normal.
In this sense, Glucagon is a natural hormone, which has the opposite effect to that of insulin in the human body, which is used when, in cases of severe hypoglycemia, children and adults with diabetes are unable to take sugar orally. This hormone helps the liver break something called “glycogen” into glucose (sugar).
Therefore, in case of severe hypoglycemia in which the person is unable to swallow, glucagon should be administered as a subcutaneous or intramuscular injection.
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the nurse is caring for a 5-year-old in a clinic setting. the child is due for a scheduled immunization. which approach is the best for the nurse to take when administering the im injection?
The child is due for a scheduled immunization. the best for the nurse to take Allow the child to pick which arm the injection will go in.
What are the 3 types of injections?The three main routes are intradermal injection, subcutaneous injection and intramuscular injection. Each type targets a different skin layer: Subcutaneous injections are administered in the fat layer, underneath the skin. Intramuscular injections are delivered into the muscle.
What is injection and types of injection?An injection (often and usually referred to as a "shot" in US English, a "jab" in UK English, or a "jag" in Scottish English and Scots) is the act of administering a liquid, especially a drug, into a person's body using a needle and a syringe.
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you are using an aed on an 82-year-old woman in cardiac arrest. she is frail and only weighs about 105 pounds, so you should use pediatric aed pads. true or false?
No, pediatric AED cannot be used for old age people.
Automated external defibrillator pads (also known as AED electrode pads) are an important part of life-saving AED devices. These pads are placed on the bare chest of a person suspected of having a sudden cardiac arrest (SCA).
Pediatric AED pads should never be used on adult patients. Not designed to effectively shock adult cardiac arrest patients. These pads are designed for toddlers and children under 8 and under 55 pounds. Pediatric pads should be used for children under 8 years old or weighing less than 25 kg. If pediatric electrodes are not available, standard (adult) electrodes can be used. If you are using standard (adult) electrodes, do not let the electrodes touch each other.
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a cooling blanket is prescribed for a child with a fever. the nurse prepares to use the cooling blanket and would avoid which action?
The nurse prepares to use the cooling blanket and would avoid keeping the child uncovered to assist in reducing the fever.
In hotter climates or for those who become overheated while sleeping, cooling blankets may be helpful. Anecdotal testimony indicates that cooling blankets work effectively to deliver a cooler and more comfortable sleep temperature, despite the dearth of scientific research on the topic.
An acute increase in body temperature is referred to as a fever. It represents a portion of the immune system's entire reaction. Infections frequently result in fever. An painful fever may be experienced by most kids and adults. However, it typically isn't a cause for alarm.
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which information will the nurse include when teaching a client with intermittent claudication in the lower legs?
Answer:
Explanation:
When teaching a client with intermittent claudication in the lower legs, the nurse would likely include information about the causes of the condition, such as peripheral artery disease or atherosclerosis, as well as risk factors, such as smoking and diabetes. They would also likely discuss the typical symptoms of intermittent claudication, such as cramping, pain, or weakness in the legs during physical activity. They would teach the client how to manage symptoms through lifestyle changes such as exercise and diet, as well as through medications and/or other treatments such as angioplasty or bypass surgery. Additionally, the nurse would teach the client how to recognize when symptoms are becoming severe and when to seek medical attention.
julianne green is being admitted for induction of labor. the certified nurse midwife has ordered oxytocin 30 units/500 ml iv to be started at 1 milliunit/min. what will you set for the rate in ml/hr on the pump?
3 mL/hr. To figure out the pump drip rate for this client, the nurse needs perform a lot of computations. The nurse must first calculate how many milliunits there are in a volume of 1000 mL of fluid: 1000 mL with 10 units
Are flow rate and drip rate equivalent?The amount of DROPS the IV fluid is dropping at is referred to as the drip rate. So, you'd be keeping track of droplets per minute. The pace at which an IV solution enters a vein is referred to as flow rate.
How is drip per hour determined?If you just need to calculate the infusion rate, or the amount of medication to infuse each hour, divide the entire volume in mL by the total number of hours the medication was prescribed.
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the family of an older adult seeks medical attention for the client because of an increase in inappropriate responses and avoidance of social interactions. on which body area will the nurse focus when assessing the client?
Within first day of life, the infant is typically given a comprehensive physical examination by the doctor. Weight, length, and head circumference measurements are taken before the examination even begins.
What does the term "weight" mean?
However, scientists use the term "weight" specifically to refer to the impact of an object's gravity. The gravitational force that pulls an object toward the center of a huge object, such the Earth or the Moon, is measured by its weight. The weight of an object differs from its mass.
What elements influence a child's weight?
When that comes to growth (height), everything matters, including hormones, environment, age, sex, nutrition, regular exercise, health issues, and genetics.
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from a population perspective, what are three key health behaviors that can increase longevity and reduce risk of disease?
Three key health behaviors that can increase longevity and reduce disease risk are following a balanced diet, getting regular exercise, and practicing stress management.
Three key health behaviors that can increase longevity and reduce disease risk are following a balanced diet, getting regular exercise, and practicing stress management. A balanced diet includes eating a variety of fruits, vegetables, and whole grains, while limiting processed foods and foods high in saturated fat, trans fats, and added sugars. Regular exercise can improve cardiovascular health, help control blood pressure and cholesterol levels, and reduce the risk of diabetes. Stress management is important for physical and mental health, and can include activities such as yoga, deep breathing, and mindfulness. Making these behaviors part of your daily routine can help you enjoy a longer and healthier life.
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a client with a history of intolerance to fatty foods is admitted to the hospital with a sudden onset of severe right upper quadrant pain radiating to the right shoulder. what should be included in the nurse's initial focused assessment of this client?
Stools that are clay-colored indicate biliary blockage and are caused by a shortage of bile. The feces gets a deeper shade from the bile. The client's description of feces will provide the nurse with extra information and is open-ended.
What role does bile play in the body?The liver cells release bile, a greenish-yellow fluid made up of cholesterol, waste products, and bile salts, to serve two main purposes: to transport trash away. to digest fats by breaking them down.
What occurs when there is too much bile?Watery stools, urgency, and fecal incontinence are common symptoms of bile acid malabsorption (BAM), which can be brought on by an excessive amount of bile acids entering the colon. Despite the fact that BAM has been connected to diarrhea for about
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a client who has had a myocardial infarction is being discharged. the client asks the nurse when sexual activity can be resumed. which response by the nurse is correct?
The client can resume sexual activity at least between 4 and 6 weeks after the myocardial infarction (heart attack), the point at which two flights of stairs can be climbed without dyspnea.
Myocardial infarction is the death of a portion of the heart's myocardium. It is caused when the blood supply to the myocardium is cut off due to complete blockage of the supplying arterial branch. Myocardial infarction is also known as a heart attack. The client is recommended to resume activies like sexual activities, which require energy just like any other exercise, when he/she/they can climb two flights of stairs without dyspnea. Dyspnea refers to the breathing condition in which a person has difficulty breathing. One feels as if he or she is not getting enough air into their lungs. Pushing your heart to pump more blood during this stage can have negative effect on your heart and your life.
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