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The Joint Commission (TJC) is an

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independent, not-for-profit group in the US that accredits hospitals and other health care- related agencies

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Recent National patent safety goals

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identify patents correctly, improve staff communication, uses meds safely, uses alarms safely, prevent infection, identify pt. safety risks, prevent mistakes in surgeries

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unintentional injuries are often reffered to as

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accidents

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National patient safety goals are reevaluated every

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year

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safety risks in health care agencies include

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falls and the use of restraints

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physical restraints

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mechanical or physical devise, such as material or equipment attached to patients body used to restrict movement

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chemical restraints

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medication that is administered to a patent to control behavior

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examples of physical restraints

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wrist or ankle restraint, jacket or vest and side rails

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fall related injuries have

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increased with restraints

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other safety risks in health care agencies include

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medication errors, radiation exposure, resistant microorganisms, procedural errors

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excessive radiation exposure can cause injury to many body systems including the

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gastro tract, skin, and reproductive organs

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six rights of medication

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the right drug, right dose, right time, right patient, right route, right documentation

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example of procedural error

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failure to properly identify a patent when entering a room to give medication

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most 3 frequently used tools for the assessment of fall risk in hospital settings are

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John hopkins Hopsital fall assessment tool, the morse fall scale, and hendrich 11 fall risk model

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assessment of fall risks includes

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personal factors inconteience, unsteady gait and environmental factors like tubes drains and floor surfaces

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John hopkins hops. fall assessment tool

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seven item tool, used nationally easy and quick

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morse fall scale

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six item fall risk assessment tool, acute and long term , takes 3 minutes

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hendrich 11 fall risk model

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eight factor used in acute care settings

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most common nursing diagnoses directly associated with safety concerns include

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risk for injury, risk for falls, risk for poisoning, risk for infection, risk for aspiration

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illnesses that create safety concerns might include

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MRSA infection, hypothermia, and needle-stick related disease

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nursing diagnoses realted to safety

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risk for injury, risk for falls, risk for poisoning

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Falls

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events in which an individual unintentionally and through the force of gravity drops to ground

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fall interventions

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keeping call light , keeping used items close to patients, making hourly rounds to check on pts, keeping pts. who are at high risk falling in rooms close to nurses station

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alternatives to phys. restraints

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orient to pts. surroundings, use pressure, ensure alarms and sensors are properly placed, encourage family and significant others to spend time with patient

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examples of common reasons for use of physical restraints

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immobilize an extremity, to prevent harmful patent behavior, to allow treatment or procedures to proceed without patent interferance

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when helping a dependent patient with oral care, the nurse or UAP always uses

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gloves

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ADLs

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bathing, mouth care, grooming, tolieting, dressing, eatinf

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maceration

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breakdown of skin caused by fluid and infection caused by breeding microorganisms

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avoid massaging

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reddening areas on skin

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a partial bed bath is performed when only

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part of body is washed

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others need perinal care after

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using bedpan

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partial bed bath may be necessary with

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dry skin

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patients who are ambulatory may prefer to wash while

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standing or sitting in fromt of bath or sink

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sitz baths

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baths for soaking patients perineal area

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perineal care is particularly important for patents who are

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dependent or incontinent or those who have a urinary catherter

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soaking feet of a diabetic patient is

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contraindicated bc they have decreased ability to heal

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petrissage provides

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stimulation to the deep muscle tissue

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the effleurage cycle is reacted

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several times

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unconscious patients are at risk for

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aspirations

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therapeutic touch

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holding patents hand touching shoulder can pro dive comfort and alleviate pain

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gestures may be most effective when used with people who have

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limited hearing

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SBAR

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situation, background, assessment, and recommendation

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situation

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what is happening now

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background

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what led up to this situation

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assessment

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what is the identified problem concern or need

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recommendtion

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what actions or interventions should be initiated to alleviate problem

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using SBAR format when documenting patient progress notes

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increases the clarity of shared information for legal purposes

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SBAR is used to

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to report to a health care provider a situation that requires immediate action, to define the elements of a handoff of a patient from one caregiver to another, such as during transfers from one unit to another or during shift report, and in quality improvement reports

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SBAR is often used by nursing as a

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handoff tool and as a structured method for all communications between providers

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phases of the nurse patient helping relationshi[

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orientation or introductory working or termination

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factors affecting timing of patent communication

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pain or anxiety, location and distractions, safe practice alert

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talking with pts at

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eye level enhances coommunication

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therapeutic communication

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SOLER

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S

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sit if possible

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O

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open stance

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L

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listener lean

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E

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Eye contact without staring

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R

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relaxion

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family members should

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NOT be used as interpreters of specific medical information

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visually impaired patients use

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anticipatory communication, analog clock, large print braille, audio, e books, gentle contact

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fidelity

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keeping promises or agreements

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justice

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concept of acting fairly and equitably

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nonmaleficence

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avoiding harm

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responsibiltiy

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being dependable and reliable

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veracity

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being truthful

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advance directives

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living will, durable power of attorney, health care proxy

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first line of defense

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normal flora

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second line of defense

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inflammation

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third line of defense

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immune response

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never recap a

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dirty or used needle

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PPE (personal protective equpiment

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is the equipment that health care personnel use to protect against spread of infection

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examples of PPE

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gloves, masks, goggles face shields, gowns caps and shoe coverings

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using ppe protects self and others when

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caring for pts on isolation precautions and caring for pts when any contact with blood or boyd fluids may be expected

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medical asepsis is often referred to as

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clean technique

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surgical asepsis or

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sterile techiniwue

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braden scale

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pts risk for comprised skin integrity

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pts should ambulate at least

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3 times a day

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electrolytes are

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charged substances used to conduct electrical impulses across cells

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tonicity refers to

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the level of osmotic pressure of a solution

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urine is formed in the kidney in the

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nephron

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urinary incontience is the inability to

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control the passage of urine

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urinary retention is the inability of the bladder to

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empty

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suspected pt with urinary retention

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small amounts of urine voided two to three times per hour

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wipe

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front to back to prevent UTIs

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80% of UTIs are the result of

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cathererixation

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C diff is a

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bacterium that causes diarrhea

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C diff can lead to

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life threatening inflammation of colon

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stools that are dry and hard

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constipation

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enema

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introductions of solutions into rectum and sigmoid colon via the anus

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a test performed to visualize inflamed tissue , ulcers, and abnormal growths in the anus is

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colonoscopy

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ostomy

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refers to the surgically created opening in the gastro, urinary, or respiratory organs,

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the major nutrients often reffered to as

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macronutrients

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minerals and vitamins are referred to as

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micronutrients

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water soluble vitamins

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C, B

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Fat soluble vitamins

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A, D e k

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Enteral feeding or

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tube feeding

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Morphology

answer

obese patents after surgery or anorexic pateints

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