If required, contact 9-1-1 or the authorized emergency number, reassure the individual, remove and shield the person from any onlookers, inquire as to whether there are any other injuries, and so forth.
The postictal phase, or time of recovery following the seizure, starts when the episode comes to a close. While some people bounce back right away, it could take others minutes or even hours to feel like themselves again.
Each person's recovery from a tonic-clonic seizure takes a varied amount of time. Some people feel well within an hour or two, while others may not feel normal for several days.
As soon as the seizure stops and the victim regains consciousness, stay by their side. When it's over, assist the person in finding a secure seat. Tell them what occurred in simple words once they are awake and able to speak. Soothe the individual and maintain composure.
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a patient is receiving pharmacologic therapy with ursodeoxycholic acid or chenodeoxycholic-cholic acid for treatment of small gallstones. the patient asks the nurse how long the therapy will take to dissolve the stones. what is the best answer the nurse can give?
A patient is receiving pharmacologic therapy with ursodeoxycholic acid or chenodeoxycholic-cholic acid for the treatment of small gallstones. The patient asks the nurse how long the therapy will take to dissolve the stones. The best answer the nurse can give is: "It takes about 6-12 months of therapy for the stones to be completely dissolved."
What are gallstones?A hardened deposit in the fluid of the gallbladder, a tiny organ located under the liver. Gallstones are deposits of digestive fluid that have calcified.
Gallstones can range in size and quantity, and they can produce symptoms or not. People who have symptoms frequently need their gallbladders removed. Gallstones that do not produce symptoms are typically not treated.
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the night nurse has reported to the day nurse that a client has not had a bowel movement in 2 consecutive days. what actions should the day nurse take?
The actions that the nurse should take for a client has not had a bowel movement in 2 consecutive days is to write a prescription to initiate "Bowel Protocol" per standing order and offer the client 120 mL prune juice (Options 1 and 2).
What is the bowel protocol?The bowel protocol refers to a care program aimed at improving the health of the digestive system by promoting the excretion of waste products.
Therefore, with this data, we can see that the bowel protocol promotes the excretion in the digestive system in order to avoid constipation as in this case, which may also include the use of dietary fiber and prune juices.
Complete question:
The night nurse has reported to the day nurse that a client has not had a bowel movement in 2 consecutive days. what actions should the day nurse take?
Select all that apply
1. Write prescription to initiate "Bowel Protocol" per standing order.
2. Offer client 120 mL prune juice.
3. Give Milk of Magnesia (MOM) 30 mL.
4. Administer bisacodyl suppository.
5. Provide sodium phosphate enema.
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a client with urinary incontinence asks the nurse for suggestions about managing this condition. which suggestion would be
Making sure to eat enough fiber to prevent constipation is the appropriate suggestion.
What is Urinary incontinence?
Urinary incontinence means a person leaks urine by accident. While it can happen to anyone, urinary incontinence, also known as overactive bladder, is more common in older people, especially women. Bladder control issues can be embarrassing and cause people to avoid their normal activities.
What is the main cause of urinary incontinence?
Incontinence can happen for many reasons, including urinary tract infections, vaginal infections or irritation, or constipation. Some medications can cause bladder control problems that last a short time. When incontinence lasts longer, it may be due to: Weak bladder or pelvic floor muscles.
What happens if urinary incontinence is left untreated?
If left untreated, UI can lead to sleep loss, depression, anxiety, and loss of interest in sex. It might be a good idea to see your doctor if your condition is causing you to: Frequently urinate (8 or more times per day) and Feel tired from incontinence-related sleep loss.
Thus, option A Make sure to eat enough fiber to prevent constipation is the correct answer.
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the nurse is caring for a client with acute myeloid leukemia (aml) with high uric acid levels. what medication does the nurse anticipate administering that will prevent crystallization of uric acid and stone formation?
The nurse plans to provide the allopurinol (Zyloprim) drug, which will stop uric acid from crystallizing causing stone formation.
How serious is myeloid leukemia?Even though AML is a dangerous condition, chemotherapy, together with or without a myeloid or stem cell transplant, can be used to treat and frequently cure it. It's critical to keep in mind that estimates represent the survival for those with AML.
What is the deadliest form of leukemia?The percentage of AML patients who will still be surviving five years following diagnosis is 29.5%. Although it can arise in other types of cells, leukemia is a malignancy that typically attacks white blood cells.
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how can professionals demonstrate leadership in promoting health, physical activity, and fitness related to body diversity?
Being physically fit improves mental stamina and endurance, both of which an effective leader had to have. A healthy professional motivates his employees to exercise, be more energetic, and be less prone to illness.
What is the significance of excellence in keeping your body fit and healthy?
It improves respiratory, cardiovascular, and overall health. Staying active can also assist you in maintaining a healthy weight, and lower your risk of type 2 diabetes, heart disease, and some cancers.
The following are some strategies for increasing physical activity.
Active Routes to Commonplace DestinationsPrograms for Schools and YouthSocial Assistance.Prompts to Promote Physical ActivityAccess to Physical Activity LocationsCampaigns Across the CommunityIndividual Assistance.Access that is equitable and inclusive.Therefore, Being physically fit improves mental stamina and endurance, which both an effective leader must have.
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before beginning work on a culturally diverse hospital unit, the nurse should perform which action first?
Before starting work on a culturally various medical institution unit, the nurse have to enhance self-focus of one's personal biases first.
An critical first step earlier than mastering approximately different cultures is an focus of one’s personal beliefs, biases, values and cultural practices. This self-information and mirrored image will aid you in developing a exercise surroundings this is touchy and adaptive to patients' cultural differences.
Part of our dedication to diversity, fairness and inclusion is to reinforce nurse’s focus and competence of culturally secure and touchy care. This consists of integrating accountabilities that includes the Ontario Human Rights Code and suggestions withinside the Truth and Reconciliation Commission Report into our entry-stage capabilities and nursing exercise requirements and guidelines.
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At what age can an infant start to eat rice cereal mixed with breast milk or formula?.
a pregnant women calls the clinic to report a small amount of painless vaginal bleeding. what response by the nurse is best?
A pregnant women calls the clinic to report a small amount of painless vaginal bleeding and the response by the nurse is "Please come in now for an evaluation by your health care provider."
Bleeding and recognizing from the channel throughout maternity are common. Up to one out of four (up to 25%) of all pregnant girls have some bleeding or recognizing throughout their maternity. Injury and recognizing in maternity do not continually mean there is a drawback, however they will be an indication of miscarriage or different serious complications.
Light bleeding, usually mixed with secretion, close to the tip of maternity may be an indication that labor is beginning. This vaginal discharge is pink or bloody and is understood as bloody show. Causes shown here are normally related to this symptom. Work along with your doctor or different health care provider for an accurate diagnosis.
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why must human cancer research often use an observational method when controlled studies could yield more definite results?
It is clearly unethical to force cancer-causing or cancer-curing behaviors on test subjects, so researchers can only observe what behaviors occurred during the study.
What is cancer?
Cancer is simply an abnormal cell growth in the body. Every person has the potential to develop cancer from birth. It is not something that one can "catch" like an infection or even a cold. Growth may become out of control when a cell's or a group of cells' programming is compromised. Chronic irritability, tobacco, smoke, as well as dust, radioactive substances, maturity level, sex, race, and heredity are a few of the variables that can change the code. We need to be aware of factors we can control even though many of these factors are beyond our control. Cancer prevention is undoubtedly preferable to cancer treatment.
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ith quite fluent, spontaneous speech, yet an inability to repeat statements made by the examiner, and an ability to follow instructions provided by the examiner. this patient may be suffering from:
An ability to follow instructions provided by the examiner. this patient may be suffering from Conduction Aphasia.
Conduction aphasia is a type of aphasia in which the main impairment is the inability to repeat words or sentences. Less of your other linguistic abilities are affected (or not at all). Also known as associative aphasia. Conduction aphasia frequently has little impact on a person's capacity for reading, writing, speaking, or understanding spoken words.
Conduction aphasia is characterized by normal comprehension and fluent speech, but it also includes a surprising inability to repeat a phrase. The relevant lesion is located in the arcuate fasciculus that connects the Wernicke and Broca areas. Global aphasia, which affects all facets of language, is brought on by large frontal lobe lesions.
Conduction aphasics are conscious of their errors and will work to correct them.
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a client is preparing for a surgical procedure is taking corticosteroids for crohn’s disease. what is most important for the nurse to monitor during the operative experience with the client?
A client is preparing for a surgical procedure is taking corticosteroids for Crohn’s disease and adrenal insufficiency is most important for the nurse to monitor during the operative experience with the client.
Corticosteroids are a category of steroid hormones that are created within the endocrine of vertebrates, further because the artificial analogues of those hormones. Corticosteroids are principally accustomed cut back inflammation and suppress the system. they are accustomed treat conditions like: respiratory illness. coryza and pollinosis.
Primary adrenal insufficiency is most frequently caused once your system attacks your healthy adrenal glands by mistake. alternative causes might include cancer. Adrenal glands manufacture inadequate amounts of the secretion adrenal cortical steroid and typically mineralocorticoid, too. once the body is beneath stress, this deficiency of adrenal cortical steroid may end up during a life threatening.
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A client with asthma is prescribed a short acting beta-adrenergic (SABA) for quick relief. Which of the following is the most likely drug to be prescribed?
a. Ipratropium bromide
b. Fluticasone propionate
c. Ipratropium bromide and albuterol sulfate
d. Albuterol
A client with asthma is prescribed a short acting beta-adrenergic (SABA) for quick relief and the most likely drug to be prescribed is d. Albuterol.
SABA medications belong to a category of medication called bronchodilators. They relax the little muscles in your cartilaginous tube tubes (airways) to assist dilate, or open them, creating it easier for you to breathe. Also, if you've got excess secretion in your airways, SABAs will assist you cough it up additional freely.
Albuterol is a sort of drug known as a short-acting medicine. It provides relief from associate respiratory disease by quiet the graceful muscles in your airways. it has always dotty a metered dose dispenser (ProAir HFA, Proventil HFA, others).
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when completing a baseline assessment of a client with depression, which diagnostic tests would the nurse anticipate?
Back depression inventory (BDI) shoul be taken to diagnose depression.
Widely used process to diagnose depression is the back depression inventory(BDI). It is used to measure behavioral manifestation and severity of depression. This inventory contains 21 self report items which include multiple choice response. It can be used for 13 to 80 ages people. There is no certain test for depression. A blood test can be done identify the cause of depression. A doctor can treat depression by physical examination and a personal interview asking you personal questions like other symptoms, patients habits like eating habits and sleeping habits. And asked about their feelings. depression should be treated by personal diagnostic process.
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a sure sign that labor is only hours or days away is a. contractions in the upper part of the uterus. b. the bloody show. c. lightening. d. frequent urination.
Asbestos fibers cause a cancer called mesothelioma in humans. The fibers kill cells that line lung tissue by causing programmed-cell death. When cells die this way, they release a chemical, hmg1, which causes an inflammatory response in other cells. During this inflammatory response, cells release chemicals that promote tumor growth. What conclusion can you draw about the chemicals released in the inflammatory response?.
The conclusion that we can draw about the chemicals released in the inflammatory response is that HMG1 acts as a mediator of acute lung inflammation that might leads to lung cancer, such as mesothelioma. The presence of HMG1 causes cells to release certain chemicals that promote tumor growth.
Asbestos Fibers and MesotheliomaAsbestos is a crystalline category of naturally occurring silicate fibers. These fibers are only visible under a microscope. Asbestos harms lung tissue cells by inducing programmed cell death. When cells die in this way, they produce HMG1 (high mobility group proteins 1) that promotes an inflammatory reaction in other cells. Cells release substances that stimulate tumor development during this inflammatory reaction. In humans, asbestos fibers cause mesothelioma, a type of cancer. Mesothelioma is typically lethal. These asbestos-related diseases do not show themselves immediately but may appear 20 to 50 years after exposure.
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at birth, the infant has dry, cracked skin, absence of vernix, lack of subcutaneous fat, fingernail extending beyond the fingertips, and poor skin turgor. based on these findings, how would the nurse would classify this neonate?
The nurse would classify this neonate as the post term neonate.
Babies that are born postterm are those who are 294 days, or 42 weeks, past the commencement of the last menstrual cycle. Postterm newborns have higher rates of morbidity and mortality as compared to term babies.
A postterm baby may seem malnourished and have flaky, peeling, dry skin, particularly if the placenta's function was seriously hampered. There are long fingernails and toenails. The umbilical cord and nails may have a green tint if meconium is present in the amniotic fluid.
It is unknown why some women carry their pregnancies for longer than others. It commonly happens as a result of incorrect conception time.
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the nursing instructor is observing a nursing student suctioning a client through a tracheostomy tube. which observation by the nursing instructor indicates an action by the student requiring the need for further instruction?
Suction the ET tube is the observation by the nursing instructor indicates an action by the student requiring the need for further instruction.
Endotracheal suctioning (ETS) is a crucial treatment in critical care units. It requires cleaning the patient's artificial airway of pulmonary secretions.
By covering the thumb hole and inserting a Yankauer catheter, suction may be applied. Yankauer should continue to move while the catheter is moved in a circular motion from the gum line to the throat. encourage the sufferer to cough. The oral mucosa is protected from the suction of the catheter, which otherwise might traumatize the tissues.
In order to remove secretions and reduce the risk of pneumonia, ETT suctioning is generally performed every one to two hours (13). However, due to the serious risks and detrimental effects, suctioning is now only advised when necessary, according to some research.
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why are aids drugs like combivir so expensive?
AIDS drugs like Combivir are so expensive because of the Market power of producers.
With the introduction of new drugs like Combivir around the middle of the 1990s, AIDS death rates began to dramatically decrease. The new drugs are great, but they are expensive, and the reason they are expensive is not that they cost a lot to make. Production costs per pill are actually quite low.
For instance, the active ingredients of Combivir can be purchased for approximately $240 on this international generic market, whereas GlaxoSmithKline, the largest manufacturer of HIV medications in the world, sells the drug for approximately $7,000 annually in the United States. A Bombay, India-based manufacturer called Cipla Ltd. claims to be selling a finished generic version of Combivir for just $275.
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which symptom would the nurse expect to be relieved if a patient has beneficial effects from famotidine?
Heartburn due acid indigestion or sour stomach is expected to be relieved if a patient has beneficial effects from famotidine.
What causes heartburn?When stomach acid backs up into the tube that transports food from your mouth to your stomach, heartburn results (esophagus). The lower esophageal sphincter, a muscle band at the base of the oesophagus, typically relaxes when food is eaten, allowing food and liquid to pass into the stomach.
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a client with a left arm fracture supported in a cast complains of loss of sensation in the left fingers. the nursing assessment identifies pallor in the distal portion of the arm, poor capillary refill, and a diminished left radial pulse. on the basis of these findings, the nurse would take which as a priority action?
A lacerated, contused, thrombosed, or severed artery may have caused arterial damage in the patient with pallor, sluggish capillary refill, weaker or lost pulse, and loss of feeling or motion in the distal limb. These symptoms might also appear when a cast is too tight. Whatever the reason, the nurse immediately alerts the registered nurse, who will get in touch with the healthcare practitioner. Emergency treatment is required, which may entail removing the restrictive bandage, reducing the fracture, or performing surgery to make the area whole.
What is capillary?
Smallest among blood arteries are capillaries. They function to deliver oxygenated blood from the arteries to the body's tissues and to feed deoxygenated blood back into the veins. In the circulatory system, the capillaries play a crucial role. basically between the veins and arteries.
There are three varieties of capillary: fenestrated, discontinuous, and continuous.
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the nurse is receiving report on a client with aki. what should the nurse follow up on first? potassium value of 5.0 meq/l patient refused fingerstick blood glucose crackles throughout lung fields patient reports itching skin
The action that the nurse follows up on the first after receiving a report on a client with AKI is that potassium value of 5.0 meq/l. Thus, the correct option for this question is A.
What is AKI?AKI stands for Acute Kidney Injury. It may be characterized as an abrupt reduction in kidney function, resulting in the retention of urea and other nitrogenous waste products and in the dysregulation of extracellular volume and electrolytes.
According to the options given, an electrolyte of potassium which has a normal value of 5.0 meq/l must be first determined by the nurse in order to deliver the evidence of the report that the patient is able to control the level of electrolyte in the blood or not.
Therefore, the action that the nurse follows up on the first after receiving a report on a client with AKI is that potassium value of 5.0 meq/l. Thus, the correct option for this question is A.
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reuben, an obese 55-year-old man, experiences chest pain. he is rushed to an emergency room in a hospital where he describes his pain as a feeling of heavy pressure or tightness in the chest along with shortness of breath. reuben is most likely suffering from a(n) .
Reuben is feeling heavy pressure or tightness in the chest along with shortness of breath. Reuben is most likely suffering from asthma. Asthma is related to breathing problems.
What is asthma?Asthma is a condition in which a patient feels suffocated due to decreased oxygen availability in the body. Asthma causes the airways to become clogged with mucus, narrowing the passage of the trachea.This allows less air to reach the lungs. The body exerts pressure on the lungs in order to bring more air into them. The lungs are affected, and the chest feels tight. In time, the fluid may fill the lungs and lead to serious lung failure.
Hence, Reuben is most likely suffering from asthma. Due to this shortness in breathing is seen.
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a community health nurse is providing dressing changes for an older adult woman who has a chronic venous ulcer. when choosing a wound management strategy for this patient, what principle should guide the nurse's care regimen?
Exudate from the wound bed has to be quickly removed is the principle should guide the nurse's care regimen.
Venous ulcers are a chronic, fatal illness that induce agony, anxiety, social isolation, and hopelessness. They can take up to 12 weeks to cure. It has been discovered that after 26 weeks, only around half of ulcers heal despite being the first-line therapy for simple venous ulcers. Debridement is thought to be essential for developing healthy tissue and subsequent healing because venous ulcers develop in a continual accumulation of devitalized, necrotic tissue. Currently, there are six methods of debridement: surgical, which entails the removal of tissue by a surgeon; sharp, which entails the removal of tissue with a sterile scalpel, scissors, or both; mechanical, which entails the removal of tissue using washing solutions, whirlpool therapy, wet-to-dry dressings, and lavage; and sterile, which entails the removal of tissue using sterile instruments.
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a nurse is caring for a client whose spouse died more than 4 years ago. what assessment question will the nurse ask to determine if the client is experiencing abnormal grief?
Have you given all of your spouse's clothes yet, is asked to determine if the client having abnormal grief.
What is abnormal grief?The nurse can tell if a client is experiencing abnormal grief by asking questions to find out if they have kept the deceased's room and possessions intact.
Have described physical symptoms that resemble those the person had before passing away, and have spoken about the deceased as if they were still alive.
Therefore, on the anniversary of a loved one's passing, crying is a common grief reaction.
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a client scheduled for hip replacement surgery did not have enough time to have autologous donations completed. the nurse knows that which action will be performed if the client requires blood during the surgery?
The greatest thing a nurse can do is pre-arrange blood from the blood bank for the emergency as the patient didn't have enough time to get autologous donations performed.
Patients who might require blood are asked to donate their blood, which can then be used before or after surgery.
After passing many tests to determine its eligibility, if the blood is not suitable for use, it is given to another patient.
Autologous blood donations are those made by individuals for their benefit, such as before surgery. Autologous Donation Requirements. For autologous contributions, a Red Cross Special Collections Order form that acts as a prescription for this service must be signed by your doctor.
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how does the new, modern definition of "nature" (nature2) solve the problem of errors from our senses?
Human outside sensation is based totally on the senses organs of the eyes, ears, pores and skin, vestibular gadget, nostril, and mouth, which make a contribution, respectively, to the sensory perceptions of imaginative and prescient, hearing, touch, spatial orientation, odor, and flavor.
The senses that shield the character from outside and internal perturbations through a contact shipping of facts to the brain include the five senses, the proprioception, and the seventh sense—immune input. The peripheral immune cells detect microorganisms and deliver the information to the brain.
Maximum of these acquainted with the matter say there are between 14 and 20, depending on how you define a feel. possibly the best definition is: a experience is a channel through which your frame can take a look at itself or the out of doors global. you're acquainted with the large 5: imaginative and prescient, hearing, smell, contact, and flavor.
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the nurse is explaining to the client that at rest, the body uses energy that is included in the basal metabolic rate (bmr). what is the bmr?
Answer:
Considerable amount of energy is required by the body to perform all the chemical reaction even when a person is at complete rest. This minimum level of energy required to exist is called BMR which accounts for about 50-70% of the daily energy expenditure in most sedentary persons.
Usual method for determining BMR is to measure the rate of oxygen utilisation over a given period of time
Maximum BMR is accounted for by essential activities of the central nervous system, heart, kidneys, and other organs, the variation in BMR among different person is related to mainly to different amount of skeletal muscle and body size.
Some factors that influence BMR:
Thyroid hormone increases metabolic rateMale sex hormone increases metabolic rateGrowth hormone increases metabolic rateFever increases metabolic rateSleep decreases metabolic rateMalnutrition decreases metabolic rateConditions to be maintained during BMR measurement:
The person must not have eaten food for at least 12 hours.The BMR is determined after a night of restful sleep.No strenuous activity is performed for at least 1 hour before the test All psychic and physical factors that causes excitement must be eliminated.The temperature of the air must be comfortable and must be between 68 & 80°F.No physical activity is permitted during the test.client involved in a motor vehicle crash presents to the emergency department with severe internal bleeding. the client is severely hypotensive and unresponsive. the nurse anticipates that which intravenous (iv) solution will most likely be prescribed
5% dextrose in lactated Ringer's intravenous (iv) solution will most likely be prescribed.
Intravenous Nutritional Products are the drug class that includes Lactated Ringers in 5% Dextrose. As a source of calories, electrolytes, and water, Lactated Ringer's and 5% Dextrose Injection, USP administered intravenously is beneficial.130 mEq sodium, 4 mEq potassium, 2.7 mEq calcium, 109 mEq chloride, and 28 mEq lactate are the ionic concentrations in one liter. (Calculated) the osmolarity is 525 mOsmol/L.
Ringer's lactate is generally utilized in a forceful increase in intravascular volume from blood loss or burn injuries; However, in many clinical circumstances, Ringer's lactate is an excellent fluid for aggressive fluid replacement.
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(complete question)
A client involved in a motor vehicle crash presents to the emergency department with severe internal bleeding. The client is severely hypotensive and unresponsive. Does the nurse anticipate that which intravenous (IV) solution will most likely be prescribed to increase intravascular volume, replace immediate blood loss volume, and increase blood pressure?
a 19 year old college student presents to student health services with a 2-day history of mildly diffuse abdominal pain, low grade temp, and mild nausea. he was out drinking with his friends over the weekend and ate pizza and wings. during your exam you ask the patient to lie on his or her left side while the right thigh is flexed backward, and you elicit left lower quadrant pain. what is the name of this sign
During your exam you ask the patient to lie on his or her left side while the right thigh is flexed backward, and you elicit left lower quadrant pain. The name of this sign is Rovsing sign.
The patient is likely experiencing appendicitis, which is characterized by pain in the lower right quadrant of the abdomen. The pain is typically worse when the patient lies on their left side and flexes their right thigh backward. This is known as the Rovsing sign.
Appendicitis is a serious condition that requires prompt medical treatment. If left untreated, the appendix can rupture and cause potentially life-threatening infection. With Rovsing’s sign, the doctor will press on the lower right side of the abdomen. This will often cause pain in the lower left side of the abdomen. This is because the pressure on the right side can cause the inflamed appendix to push on the left side of the abdomen.
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which manifestation would be obeserved in an individual wiht graves disease quizlt diplopia bradycardia exophthalmos cold intolerence pretibial myxedema
Exophthalmos, myxedema, and acropachy are all symptoms of Exophthalmos myxedema acropachy (EMA) syndrome, a rare syndrome associated with hypertcardiotrophia. EMA occurs in less than 1% of patients with hyperthyreosis. We presented a case of EMA and discussed its diagnosis and treatment.
What Is Exophthalmos Myxedema Acropachy Syndrome ?Graves' disease is an autoimmune thyroid disorder with distinct peripheral manifestations. Ophthalmopathy is the most common clinical finding in 30% of patients, followed by dermopathy (pretibial myxedema) in 4% and thyroid acropachy in 1%. Less than 1% of patients have the triad of exophthalmos, pretibial myxedema, and acropachy. A case of Graves' disease with the clinical triad of eye disease, dermopathy, and acropachy is presented.
Exophthalmos myxedema acropachy syndrome (EMA) is a rare syndrome associated with hyperthyreosis that includes exorbitism, myxedema, and acropachy (hypertrophic osteoarthropathy).
EMA is affected by an auto-immune disease, but the cause is unknown. Concurrent concurrence with Graves' ophthalmopathy is 30% in hyperthyreosis patients, approximately 4% in myxedema patients, and 1% in acropachy patients, whereas concurrent concurrence with all three manifestations is much less than 1%. . Males are more likely than females to suffer from EMA, with a gender ratio of 3.4: 1. EMA has only been reported on a few occasions so far.
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