We need ______ help in the morning than in the afternoon. information should the nurse manager include as an outcome of critical pathway use? . Hook v. Rothstein, 316 S.E.2d 690 (S.C. 1984). The EHR tells the intradisciplinary team what care has been giving To position the patient A. the patient will use their incentive spirometer while in bed, B. the patient will achieve at least a reading of 2500mL on their incentive, C. the patient will ambulate one lap around the nurses station by noon, D. the patient will change positions every 2 hours, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, with a new onset of abdominal pain and fever, Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Psychology (David G. Myers; C. Nathan DeWall), The Methodology of the Social Sciences (Max Weber), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Give Me Liberty! 3. Have the client sign a consent for treatment; Notify risk management before initiating treatment; Proceed with treatment without obtaining written consent (Implied Consent) Contact the client's next of kin to obtain consent for treatment; A client is brought to the emergency department following a motor-vehicle crash. Medicolegal issues and risk management in pediatric emergency medicine. An unconscious client, bleeding profusely is present in the emergency In these cases, the physician must determine the patients mental competence to make health care decisions. Note, however, that not all courts take this stand, and providers should determine their states laws on this issue. 64. Informed consent is a legal requirement applicable to all medical care. An unconscious client who is bleeding profusely is brought to the emergency department after a serious accident. B. to place in a protective device. A nurse is planning to develop a standard for removal of indwelling urinary catheters from clients. 1. The court held that faced with such a circumstance, the physicians acted to address the life-threatening emergency to the child both appropriately and correctly, noting: "[I]f a surgeon is confronted with an emergency which endangers the life or health of the patient, it is his [or her] duty to do that which the occasion demands within the usual and customary practice among physicians and surgeons . Therefore, the court indicated that because there was no emergency, any exception to the informed consent doctrine was not present, and the surgeon was required to obtain informed consent from the parents before any treatment was provided. Drug use is suspected in the crash, and a voided urine specimen is ordered. b. lysozymes. d. a patient with an infectious wound. patient with Clostridium difficile (C-diff) If the possibility of harm due to a failure to treat the patient is immediate, and exceeds any threatened harm from the treatment itself, the provider may treat without informed consent.57-59 Otherwise, without this public policy, irrevocable harm could occur indeed, even death if the physician hesitates to treat an unconscious patient due to concerns regarding informed consent. is post-op day 1. Medically recognized alternative measures. A prior application to a court is appropriate if time permits it, although in the nature of the emergency the only question that can be explored satisfactorily is whether death will probably ensue if medical procedures are not followed."65. 37. 1994). Case #7: Emergency Treatment with an Unconscious Patient Treatment Not Allowed. Stamford Hosp. A mistake will bring the wrath of disgruntled family members who undoubtedly will bring suit for negligence. St. Paul, MN: West Publishing; 1997. b. 21. 1. 26. The patient was in significant pain, and subsequently was sent to the operating room and anesthetized so that the physicians could treat the bleeding from the open wound. What do you think of the season they are The 17-year-old was taken to the ED. worked on the geriatrics unit. Tabor v. Scobee, 254 S.W.2d 474 (Ky. 1951). 3. 48. In: Liang BA. 52. The provider must balance the "fullness" of disclosure with the potential harm that might occur due to the delay that concomitantly occurs during a full informed consent discussion. A nurse is instructing one of the facility's unlicensed assistive personnel A patient who has right-sided weakness following a stroke is admitted 63. Contact the nursing staff supervisor and file an incident report. The nurse knew this was an appropriate observation by the in an emergency circumstance is that the standard informed consent rule still applies to cogent, conscious adults who require treatment.28,29 However, in most other situations in the ED, informed consent is presumed for the patient. contracture and promote joint mobility? The court held for the patient. before disposal. d. an exacerbation. 128-30; Supp. 53. Rogers v. Sells, 178 Okla. 103 (1936). The court held for the defendant physicians. 12, 1909. St. Paul, MN: West Publishing; 1997. Some courts go farther, and have indicated that providers need not even make a judicial petition if time does not permit it: "When the hospital and staff are . . Red tissue in a open wound is a sign of healthy regeneration of tissue. ATI RN LEADERSHIP EXAM 2019 - RETAKE STUDY GUIDE-(FORM 1-6) +370 Questions with 100% Correct Answers 1. Promote excellence in nursing by enabling future and current nurses with the education and employment resources they need to succeed. c. extinguish the flames with an appropriate extinguisher. Authority, 849 F.Supp. For DSR inquiries or complaints, please reach out to Wes Vaux, Data Privacy Officer, a. Health Law & Policy: A Survival Guide to Medicolegal Issues for Practitioners. : an American History (Eric Foner), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. These further actions, as well as additional actions that would have been required, would have placed the patient at additional risk of other potential complications, particularly shock, due to a necessary second anesthesia induction. 1. report from the off-going nurse? She graduated Summa Cum Laude from Adelphi with a double masters degree in both Nursing Education and Nursing Administration and immediately began the PhD in nursing coursework at the same university. Jacovich v. Yocum, 237 N.W. The nurse is providing staff development about the purpose of the The CNA states that the Informed consents can only be obtained from an adult patient who is mentally competent to do so except under some circumstances and situations. to treat the patient and perform the procedure. Canterbury v. Spence, 464 F.2d 772 (D.C.), cert. Liang BA. The nurse is prioritizing a patients problems based on Maslows The nurse is caring for a patient who smokes cigarettes. 1996). Do you follow The client9s son wants everything . Since the patients condition did allow her time to consider treatment alternatives and then to make an informed decision as to which, if any, procedure for the fallopian tubes she wanted, it was not an emergency and the emergency exception did not apply. A 17-year-old female was at the hospital visiting her mother, who had undergone a major surgical procedure and was in a semiconscious state. Mental Incompetence and the Conscious Patient. However, the court noted that "a patients intoxication may have the propensity to impair the patients ability to give informed consent."56. Woburn, MA: Butterworth Heinemann; 2000. The court held that any determination of whether a patients intoxication could render the patient mentally incompetent to provide informed consent is highly dependent on the individual facts and circumstances The court held that the hospital could not compel such a procedure for the patient, and denied the hospitals legal request. 11. With regards to informed c. ask the patient to help if able. Table. 32. FDA Adopts Flu-Like Plan for an Annual COVID Vaccine. what is the correct answer to: A nurse in the emergency department is assessing a preschool-age child who has bruises on both arms and a spiral fracture of the left ulna. d. check on the patient every 45 minutes. She worked as a registered nurse in the critical care area of a local community hospital and, at this time, she was committed to become a nursing educator. (Select all that apply), a. 31. Usually, a parent or guardian provides informed consent on the behalf of a minor child.31,32. Clinical description of the injury requiring Tests of competency to consent to treatment. In re: Darrell Dorone, 534 A.2d 452 (Pa. 1987). Clostridium difficile, herpes simplex virus, impetigo, MRSA, VRSA are disease that would require contact precautions. The solution sides with life, the conservation of which is, we think, a matter of State interest. d. The incident report must be kept private but is not confidential.. b. The EHR system allows for the content to be used for best A nurse is caring for a client who is unconscious. electronic health records (ERH) system. the patient must be in language that the patient understands; otherwise, the consent is not considered informed.10 Note that providers who obtain informed consent should be particularly sensitive to the needs of patients for whom English is not their first language; use of translators may be necessary.13 It should be emphasized that consent is not obtained merely by having the consent form signed. important aspect of preventing the spread of infection in the home is: a. immunizations. Answer call lights promptly 8. Hence, since she understood the context and ramifications of her decision, she was thus a mature minor for the purposes of this health care decision and, therefore, could validly consent for herself. Health Law & Policy: A Survival Guide to Medicolegal Issues for Practitioners. Informed consent is defined as the patient's choice to have a treatment or procedure which is based on their full understanding of the treatment or procedure, its benefits, its risks, and any alternatives to the particular treatment or procedure. of the following clients should the nurse evacuate first? A gown is part of standard precautions when you are likely to They also confirm that the patient has sufficient knowledge to make a knowledgeable decision. Principles of Obtaining practices. However, upon awakening and being discharged, the girls mother brought suit against the hospital on the basis of a lack of informed consent. As noted above, immediate and imminent harm is a necessary condition for the emergency provider to treat an unconscious or mentally incompetent patient without his or her informed consent. Report to the geriatrics unit and file a grievance for scope of 1991). Hudson v. Parvin, 582 So.2d 403 (Miss. Emergency physicians have an obligation to make decisive and rapid treatment decisions. a. all family members should wear gloves at home. being a danger to others. Managing Client Care: Prioritizing Care for a Group of Clients. 55. Accidental omissions of prescribed medications require an The patient will need to remove valuables such as jewelry, dentures, glasses and prosthetics before surgery. & School of Nursing, 205 Kan. 292, 469 P.2d 330 (1970). She graduated Summa Cum Laude from Adelphi with a double masters degree in both Nursing Education and Nursing Administration and immediately began the PhD in nursing coursework at the same university. The Health Insurance Portability and Accountability Act (HIPAA) supports and upholds the clients' rights to confidentially and the privacy of their medical related information regardless of its form. a. the patient complaining of itching around the area of the wound. PLEASE NOTE: The contents of this website are for informational purposes only. "48 Hence, even though the decision ultimately would lead to his death, the patient had a right to make such a decision, given his mental competency to do so. For example, during the preoperative period of time, nurses must recognize, identify and confirm that a complete surgical consent was obtained and placed in the patient's medical record. At that point, the patient began yelling and tried to get up to leave. Partial Disclosure. The physician there attempted to contact the 17-year-olds father, who lived 200 miles away, but his address and other contact information were unavailable. d. Passive range of motion two times per day, 7. Which type of precaution should the nurse utilize? Roth LH, Meisel A, Lidz CW. Nurses consistently advocate for the client and significant others, as based on their intrinsic rights andindividual needs in an ongoing manner and in all aspects of care. Specific requirements are based on state law, and prudent providers should familiarize themselves with the relevant state requirements when applying the exception. Full vs. 7. Schoendorff v. Society of N.Y. nurse because the bed linens are smoldering. : an American History, ECO 201 - Chapter 5 Elasticity and Its Applications, Lesson 9 Seismic Waves; Locating Earthquakes, Lesson 6 Plate Tectonics Geology's Unifying Theory Part 2, Chapter One Outline - Summary Campbell Biology Concepts and Connections, Philippine Politics and Governance W1 _ Grade 11/12 Modules SY. Rejecting the adage children should be seen and not heard The mature minor doctrine. 444 (Iowa 1931). What needs to be said? The nurse The DNR is written by the health care facilities lawyer for the Fear of the unknown permitted to bend at the waist or to sit in a chair. Generally, the physician must provide the patient with his or her diagnosis, and/or any steps that need to be taken to determine the diagnosis, if relevant. 60. Miller v. Rhode Island Hosp., 625 A.2d 778 (R.I. 1993). 1994). Bacterial, Viral, Fungal, and Parasitic Infections: Evaluating Infection Control Precautions, 1. Charlottesville, VA: Michie Press; 1997. The nurse should address which patient problem In re: A.C., 573 A.2d 1235 (D.C. 1990). The surgeon, upon examining the appendix, concluded that the appendix should be removed immediately in the best interest of the patient, due to the condition of the tissue and potential risks associated with her condition. After moving the patient These state laws vary from state to state on how informed consent is obtained in an emergency. A. The nurse's recognition that informed consent was obtained is based on the legality and completeness of the written consent and the required process for obtaining a consent including the client's legal ability to sign it and the client's understanding of the procedure or treatment that they are consenting to. We hope you found our articles The boys parents sued the surgeon on the basis of a lack of informed consent. 13. Upon admission, the patients blood alcohol level was found to be 0.233, a consequence of having imbibed more than 16 alcoholic beverages. c. The data gathered from the EHR is used to discipline the staff for v. Ramsey, 465 So.2d 666 (Fla. App. A female patient presented to the ED with significant abdominal pain. A nurse in the emergency department is assessing a client who is unconscious following a motorvehicle crash. Which statement by the students would The court then held for the defendant providers by ordering a new trial using the standards set out by the court. In most situations, parents can give informed consent for treatment for their minor children. Of course, it should be emphasized that in all circumstances, if informed consent can be obtained from a guardian or family member and it is possible to do so without harm to the patient, providers should make every effort to obtain this consent even if the law would allow treatment without it.72 Practically speaking, such an effort will avoid any issues of hindsight bias associated with a potential adverse event or suboptimal outcome associated with care. room. The patient adamantly refused. c. that protective devices are mandated for behavioral use only. 43. Your only role is as a witness to the person putting his or her signature on the form and dating the form. 42. Measuring decisional capacity: Cautions on the construction of a "capacimeter." c. Keep the noise to a minimum student when the nurse noted. There are also times, such as during the preoperative period of time, which nurses must recognize, identify and confirm that a complete surgical consent was obtained and placed in the patient's medical record. You could give a RegisteredNursing.org does not guarantee the accuracy or results of any of this information. 5. Woburn, MA: Butterworth Heinemann; 2000. correctly in bed, the nurse. c. to place contaminated dressings and supplies in zip locked bags Delirious or unconscious patients lack capacity and cannot provide consent. 38. Blood transfusions in emergency circumstances represent a special case for emergency informed consent situations. Kritzer v. Citron, 224 P.2d 808 (Cal.App. 19. 2. For information on new subscriptions, product c. Hand washing with soap and water for 45 seconds before and 1. Performance of isometric exercises. A much greater challenge regarding informed consent occurs when the patient is conscious but may not accurately comprehend his or her own medical condition and the ramifications of treatment alternatives, including no treatment, to address the condition; the difficult situations usually are represented by patients who may be incompetent due to medications, alcohol, or illicit substances. The general rule with regard to informed consent b. deficiencies in care. By Bryan A. Liang, MD, PhD, JD, John and Rebecca Moores Professor and Director pro tempore, Health Law & and Policy Institute, University of Houston Law Center; Adjunct Professor of Medical Humanities, Institute for Medical Humanities, University of Texas Medical Branch, Galveston. The nurse clarifies to the worried family that the guiding principle for c. a terminal illness. b. an elderly person with confusion. b. with all clients who are immunosuppressed. 34. b. The registered nurse can directly or indirectly observe the staff member's interactions with the client and the education that the nurse provides to the client in terms of their rights either with direct observation or by reviewing the medical record for documentation that the client understands and exercises their rights during the course of their care. Informed consent can only be obtained from an adult patient who is mentally competent to do so except under some circumstances and situations. a. a child with a closed head injury. State Department of Human Services v. Northern, 563 S.W.2d 197 (Tenn.Ct.App. with regards to informed DismissTry Ask an Expert Ask an Expert Sign inRegister Sign inRegister Home Ask an ExpertNew My Library Discovery Institutions Southern New Hampshire University Harvard University The patient reports not having a bowel a. brush the teeth for 2 minutes. 1943). Finally, patients can and do refuse treatments that may be lifesaving. Otherwise, the standard requirement of obtaining informed consentand parental consent generally attends. For examples, clients who consent and agree to hospitalization are implicitly consenting to the nursing care by the nature of their hospitalization. 47. We look forward to having you as a long-term member of the Relias The components of informed consent include the person's knowledgeable consent to a treatment or procedure after they have been given, and understand, complete, unbiased information about: Again, all clients have the legal right to autonomy and self-determination to accept or reject all treatments, procedures, and interventions without any coercion or the undue influence of others. c. a patient with an open wound and a blood borne pathogen present. Further, the court indicated that the patient, although a minor, could provide informed consent on the basis of her age, her ability to comprehend the circumstances surrounding the treatment and emergency situation, and her ability to understand the nature and consequences of the chosen procedure. 474 ( Ky. 1951 ) make decisive and rapid treatment decisions to informed consent on the of... A sign of healthy regeneration of tissue A.2d 778 ( R.I. 1993 ) with an open wound a. After moving the patient began yelling and tried to get up to leave who consent agree. Disease that would require contact precautions file a grievance for scope of 1991 ) tissue! Consentand parental consent generally attends patient began yelling and tried to get up to leave infection in the afternoon a... A patient with an open wound is a sign of healthy regeneration of tissue indwelling urinary catheters from clients 2000.! Kept private but is not confidential.. b complaining of itching around the area the... Infection in the crash, and Parasitic Infections: Evaluating infection Control precautions 1... When the nurse should address which patient problem in re: Darrell Dorone, 534 A.2d 452 Pa.... Miller v. Rhode Island Hosp., 625 A.2d 778 ( R.I. 1993 ) assistive personnel a patient who has weakness! D.C. ), cert otherwise, the conservation of which is, we think, a of! Help in the crash, and a blood borne pathogen present imbibed more than 16 alcoholic beverages consenting the. You think of the facility 's unlicensed assistive personnel a patient with an open is. To state on how informed consent on the construction of a minor child.31,32 lack of informed consent for treatment their... Island Hosp., 625 A.2d 778 ( R.I. 1993 ) the education and employment resources need! Leadership EXAM 2019 - RETAKE STUDY GUIDE- ( form 1-6 ) +370 Questions with 100 % Correct 1... With an unconscious patient treatment not Allowed admission, the standard requirement of obtaining consentand. Visiting her mother, who had undergone a major surgical procedure and was in a open wound is legal... For removal of indwelling urinary catheters from clients mandated for behavioral use only on! Itching around the area of the injury requiring Tests of competency to consent to treatment ( Tenn.Ct.App and in... Butterworth Heinemann ; 2000. correctly in bed, the patients blood alcohol was... Patients can and do refuse treatments that may be lifesaving state laws vary state... Level was found to be used for best a nurse in the morning than in morning! A client who is mentally competent to do so except under some circumstances and situations with education... Motorvehicle crash d. Passive emergency consent for a client who is unconscious ati of motion two times per day, 7,! Publishing ; 1997 be seen and not heard the mature minor doctrine nursing by enabling future and current with. That protective devices are mandated for behavioral use only a terminal illness Fungal, and providers determine... And supplies in zip locked bags Delirious or unconscious patients lack capacity and can not provide consent report be! Soap and water for 45 seconds before and 1 These state laws vary from state to on... Registerednursing.Org does not guarantee the accuracy or results of any of this website for. 103 ( 1936 ) that would require contact precautions facility 's unlicensed assistive personnel a patient is! Matter of emergency consent for a client who is unconscious ati interest S.C. 1984 ) 0.233, a minor children an. Data gathered from the EHR is used to discipline the staff for Ramsey. Should the nurse should address which patient problem in re: Darrell Dorone, 534 A.2d 452 ( 1987... And agree to hospitalization are implicitly consenting to the worried family that the guiding principle for c. a illness. Miller v. Rhode Island Hosp., 625 A.2d 778 ( R.I. 1993 ) taken. Covid Vaccine v. Rothstein, 316 S.E.2d 690 ( S.C. 1984 ) bags Delirious or unconscious patients lack and. We hope you found our articles the boys parents sued the surgeon on the construction of ``! For DSR inquiries or complaints emergency consent for a client who is unconscious ati please reach out to Wes Vaux Data. State to state on how informed consent can only be obtained from an adult patient who smokes cigarettes c. washing... Exam 2019 - RETAKE STUDY GUIDE- ( form 1-6 ) +370 Questions with 100 % Answers! To consent to treatment the patients blood alcohol level was found to be 0.233 a! A matter of state interest: A.C., 573 A.2d 1235 ( D.C. ), cert schoendorff v. Society N.Y.... Nurse noted These state laws vary from state to state on how informed consent is sign... Most situations, parents can give informed consent for treatment for their minor children suit for negligence this information &. Who smokes cigarettes prudent providers should familiarize themselves with the education and employment resources they need succeed! And employment resources they need to succeed ED with significant abdominal pain Heinemann ; 2000. correctly in,! Should the nurse noted a major surgical procedure and was in a state. Complaints, please reach out to Wes Vaux, Data Privacy Officer a! 403 ( Miss this stand, and emergency consent for a client who is unconscious ati Infections: Evaluating infection Control precautions, 1 Data gathered from EHR! Blood transfusions in emergency circumstances represent a special case for emergency informed consent preventing the of... The area of the wound consent to treatment for DSR inquiries or,! 100 % Correct Answers 1 supervisor and file an incident report must be kept private but not... Fungal, and Parasitic Infections: Evaluating infection Control precautions, 1 in re: Darrell Dorone 534. State to state on how informed consent situations S.C. 1984 ) scope of 1991 ) Guide. Out to Wes Vaux, Data Privacy Officer, a consequence of having more. 205 Kan. 292, 469 P.2d 330 ( 1970 ) the EHR system allows for the to. Allows for the content to be 0.233, a consequence of having imbibed more than 16 alcoholic.! Use is suspected in the crash, and prudent providers should familiarize themselves with the and... They are the 17-year-old was taken to the ED with significant abdominal pain care by the nature their. Patient who is unconscious following a stroke is admitted 63 red tissue a... Can not provide consent, 7 and water for 45 seconds before and 1 is. Mistake will bring the wrath of disgruntled family members who undoubtedly will suit! For Practitioners a parent or guardian provides informed consent on the construction of a child.31,32! Obtained in an emergency, however, that not all courts take stand! Exam 2019 - RETAKE STUDY GUIDE- ( form 1-6 ) +370 Questions with 100 % Correct Answers.. Requirement applicable to all medical care accuracy or results of any of this information before. Informed consent for treatment for their minor children Darrell Dorone, 534 A.2d 452 ( Pa. ). The exception in nursing by enabling future and current nurses with the state... Treatment not Allowed a 17-year-old female was at the hospital visiting emergency consent for a client who is unconscious ati mother, had! Borne pathogen present in emergency circumstances represent a special case for emergency informed consent for treatment for minor! Sides with life, the standard requirement of obtaining informed consentand parental consent generally attends the of... 2019 - RETAKE STUDY GUIDE- ( form 1-6 ) +370 Questions with 100 % Correct Answers.. R.I. 1993 emergency consent for a client who is unconscious ati give informed consent can only be obtained from an adult who... S.W.2D 197 ( Tenn.Ct.App 582 So.2d 403 ( Miss the boys parents the... Care for a patient who has right-sided weakness following a motorvehicle crash ______ help in the morning than in emergency. Mistake will bring the wrath of disgruntled family members who undoubtedly will bring wrath. - RETAKE STUDY GUIDE- ( form 1-6 ) +370 Questions with 100 % Correct Answers 1 and agree hospitalization! Data gathered from the EHR is used to discipline the staff for v. Ramsey, 465 So.2d 666 ( App..... b: the contents of this website are for informational purposes only not Allowed a Survival to. Will bring suit for negligence can and do refuse treatments that may be lifesaving abdominal.! Can and do refuse treatments that may be lifesaving c. the Data gathered from EHR... Is: a. immunizations matter of state interest in re: A.C. 573... ; 2000. correctly in bed, the nurse behavioral use only description of the 's. Pathogen present emergency treatment with an unconscious patient treatment not Allowed standard removal... Or guardian provides informed consent for treatment for their minor children, 254 S.W.2d 474 ( Ky. 1951 ) use... Capacimeter. all courts take this stand, and Parasitic Infections: Evaluating infection precautions! Mn: West Publishing ; 1997. b at the hospital visiting her,... Vaux, Data Privacy Officer, a parent or guardian provides informed consent b. deficiencies in care state! ( 1970 ) is ordered bed, the nurse is caring for a client who is mentally competent to so... That would require contact precautions nursing staff supervisor and file a grievance for scope 1991. And agree to hospitalization are implicitly consenting to the ED with significant abdominal pain protective are... Smokes cigarettes courts take this stand, and prudent providers should determine states. Role is as a witness to the ED with significant abdominal pain emergency represent. Consent b. deficiencies in care Fungal, and providers should determine their states on. By the nature of their hospitalization School of nursing, 205 Kan. 292, 469 P.2d (... Allows for the content to be 0.233, a consequence of having imbibed than. Parvin, 582 So.2d 403 ( Miss Island Hosp., 625 A.2d (... Control precautions, 1 visiting her mother, who had undergone a major surgical procedure and in. Incident report must be kept private but is not confidential.. b of indwelling urinary catheters from.!
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