Answer:
When a nurse arrives on shift and finds the patient having a seizure, the appropriate action to be taken is to protect the patient from further injury by guiding the patient's movements and provide appropriate care to prevent complications such as aspiration or head injury.
What is a seizure?
A seizure is a sudden change in behavior, movement, sensation, or awareness caused by abnormal electrical activity in the brain. A seizure can be convulsive, nonconvulsive, or both, depending on the type and severity of the seizure.
What are the steps to take when a patient is having a seizure?
Remain calm and remain with the patient during the seizure:
Do not leave the patient alone, it is important that you remain calm and reassure the patient that they will be okay.
Gently guide the patient to the floor or bed:
It is important to guide the patient to the ground or bed to prevent injury. If you cannot move the patient, place pillows or soft items around the patient to prevent injury.
Loose clothing around the neck:
The nurse should loosen any clothing around the patient's neck to allow the patient to breathe properly.
Protect the patient from injury:
Ensure the patient's safety by removing any sharp objects or items that can harm the patient while they are having the seizure. Use side rails to prevent the patient from falling off the bed.
Place the patient on their side:
This will prevent the patient from aspirating if they vomit or have any other secretions.
Perform suctioning if necessary:
This will prevent the patient from choking on their secretions.
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a school nurse is concerned that an increased number of students are reporting allergic symptoms after eating. on which factor should the nurse prioritize for a well-developed foreground question?
The nurse should prioritize identifying the source of the allergic reactions as the well-developed foreground question.
Allergic reactions are the body's response to a normally harmless substance, such as pollen or food. The body's immune system mistakenly recognizes the substance as harmful and releases chemicals, such as histamine, which cause the symptoms of an allergic reaction. Common signs and symptoms of an allergic reaction include sneezing, runny nose, itchy and watery eyes, itching, hives, and swelling. In severe cases, an allergic reaction can lead to anaphylaxis, a life-threatening condition that requires immediate medical attention.
Identifying the source of the allergic reactions is critical for the nurse to develop an effective plan for addressing the issue. The nurse should consider factors such as the student's diet, the environment, and the food that is served at the school.
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a client with type 2 diabetes is scheduled for surgery. for which potential complication(s) will the nurse plan care for this client? select all that apply.
For a client with type 2 diabetes scheduled for surgery, the nurse should plan care for potential complications such as hyperglycemia, hypoglycemia, infection, and delayed wound healing.
Type 2 diabetes is a disease that causes blood sugar levels to rise due to abnormalities in the body's ability to use the hormone insulin. Type 2 diabetes is the most common type of diabetes.
Hyperglycemia occurs when blood glucose levels are higher than normal. Hypoglycemia is when blood glucose levels are lower than normal. An infection can occur during or after surgery and can cause additional risks. Delayed wound healing can also be an issue for individuals with diabetes, as their bodies may not respond as quickly to healing processes.
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if a nurse quits his job telling his supervisor that he will not be back at work the fillowing morning. The supervisor tells he has to complete the entire month or it will he patient abandonment. Is this true or false?
an elderly client who is hypotensive has been admitted to the nursing unit for fluid replacement therapy. what intravenous solution would the nurse expect to administer?
The nurse would expect to administer a 0.9% sodium chloride (normal saline) intravenous solution to the hypotensive elderly client for fluid replacement therapy.
what is normal saline?Normal saline is the most commonly used intravenous fluid for hypotension, as it helps restore normal fluid balance and correct electrolyte imbalances. Normal saline is an isotonic solution that is composed of sodium chloride and water, and has a near-neutral pH. It is a safe, effective and inexpensive solution for fluid replacement therapy and is readily available in most healthcare facilities.
Normal saline works by restoring fluid volume and improving cardiac output and blood pressure. This action is achieved by increasing circulating blood volume and decreasing cardiac afterload. It also helps correct electrolyte imbalances, such as sodium and potassium levels, and assists in restoring acid-base balance. Moreover, it helps increase organ perfusion and tissue oxygenation, thus improving overall patient health.
Normal saline is administered intravenously and is slowly infused to avoid overhydration or fluid overload. The usual adult dose is 250 to 500 ml of 0.9% sodium chloride over 30 to 60 minutes. The nurse should also monitor the patient’s vital signs and fluid balance during and after the infusion, as well as watch for signs of fluid overload.
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which instruction would the nurse give a uap to perform while caring for a cleint prescribed captopril
The nurse should instruct the Unlicensed Assistive Personnel (UAP) to give the client captopril as prescribed, and monitor for side effects, such as dizziness, lightheadedness, and cough.
Captopril is an ACE inhibitor, which means it is used to treat hypertension and heart failure. As a result, it has some potential side effects that the nurse must educate the UAP on. The nurse would instruct the UAP to report any signs of adverse effects such as hypotension (low blood pressure), angioedema (swelling of the face and throat), or hyperkalemia (elevated potassium levels) to them as soon as possible.
Aside from monitoring the client for side effects, the nurse might also teach the UAP how to take the client's vital signs, including blood pressure, and how to assist the client with activities of daily living, such as bathing, eating, and toileting. Additionally, the nurse could instruct the UAP on how to promote restful sleep for the client, such as by limiting unnecessary noise and ensuring the client is comfortable.
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which complication would the nurse anticipate finding during the assessment of a client admitted with a diagnosis of severe procidentia
The nurse would anticipate finding complications such as ulcerations when assessing a client with a diagnosis of severe procidentia.
Procidentia, or uterine prolapse, occurs when the uterus slips out of its normal position in the pelvic cavity and descends towards or into the vaginal canal. It can happen to women of any age but is most common in postmenopausal women and those who have had multiple pregnancies. Symptoms may include feeling a heaviness in the pelvic area, pain in the lower back, or discomfort with intercourse. If the prolapse is severe enough, the uterus may be visible outside of the vagina.
If it is mild, pelvic floor exercises may be enough to strengthen the muscles and ligaments around the uterus, while more severe cases may require surgery. It is important to seek medical advice if you have any symptoms of uterine prolapse. If left untreated, uterine prolapse can lead to more serious problems such as urinary or fecal incontinence, urinary tract infections, and bleeding.
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auscultation of a 23-year-old client's lungs reveals an audible wheeze. what pathological phenomenon underlies wheezing?
The pathological phenomenon underlying wheezing is "narrowing or partial obstruction of an airway passage", causing turbulent airflow that produces a high-pitched whistling sound during breathing. Thus, Option D is correct.
Wheezing is a common symptom of respiratory diseases such as asthma, chronic obstructive pulmonary disease (COPD), bronchitis, or pneumonia. It occurs when the air passages become narrowed, inflamed, or obstructed, making it difficult for air to flow freely in and out of the lungs. As a result, the person may experience shortness of breath, chest tightness, coughing, and wheezing.
Wheezing can be heard through a stethoscope during auscultation and is a key diagnostic feature of many respiratory conditions. Treatment for wheezing depends on the underlying cause and may include bronchodilators, corticosteroids, or other medications to relieve inflammation and open up the airways.
This question should be provided with answer choices, which are:
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which ntervention would help the nurse communicate with patient swith varying degress of hearing losss
Answer: The different interventions to help the nurse communicate with patients with varying degrees of hearing loss are alternative communication methods, patient-centered communication and face-to-face communication.
There are different interventions to help the nurse communicate with patients with varying degrees of hearing loss.
One of the interventions is through the use of alternative communication methods.
Alterative communication methods include writing or typing down the message, using sign language, or using assistive devices such as text messaging, communication boards or picture cards. The use of technology can also help nurses to communicate with patients with hearing loss.
Some of these technologies include cochlear implants, hearing aids and captioned phones. The nurse can also use some techniques to enhance communication.
One such technique is face-to-face communication.
In this approach, the nurse speaks directly to the patient in a well-lit area and facing the patient directly. This technique also involves using clear and concise sentences that are easy to understand. The nurse can also use visual cues such as facial expressions, body language and gestures to enhance communication.
The use of interpreters can also help nurses to communicate with patients with hearing loss. Interpreters can be family members, friends or professional interpreters. They help to relay the message from the nurse to the patient and vice versa.
The nurse can also use patient-centered communication to enhance communication with patients with hearing loss. In this approach, the nurse listens carefully to the patient, acknowledges their feelings and concerns and then responds appropriately. This approach helps to build trust and respect between the nurse and the patient.
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a patient is prescribed both a diuretic and a dobutamine in teh immediate post op period. what adverse druge reactions will the prescriber consider as possible?
The prescriber should consider potential adverse drug reactions when prescribing a diuretic and dobutamine in the immediate postoperative period. These may include hypotension, tachycardia, dysrhythmias, cardiac arrhythmias, electrolyte imbalances, pulmonary edema, nausea and vomiting.
Hypotension is a common adverse effect of diuretics, and is more likely when the patient has hypovolemia or is on concurrent antihypertensive therapy. Tachycardia, dysrhythmias, and cardiac arrhythmias can occur with both diuretics and dobutamine. Electrolyte imbalances, such as hypokalemia, hypomagnesemia, and hypernatremia can occur with diuretics, while dobutamine may cause hypocalcemia, hypophosphatemia, and hypomagnesemia. Pulmonary edema is a potential adverse reaction to dobutamine. Nausea and vomiting are possible with both drugs.
Therefore, when prescribing a diuretic and dobutamine in the immediate postoperative period, the prescriber should consider these potential adverse drug reactions and take appropriate precautions. It is important to monitor the patient's vital signs, electrolytes, and renal function to ensure the safety and efficacy of the medications.
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which statements made by a toddler-age client during a health maintenance visit indicate preoperational magical thinking? select all that apply. one, some, or all
The question refers to the preoperational stage of cognitive development in toddlers including:
- "If I wish hard enough, I can make the medicine not taste bad."
- "If I get enough rest, I won't get sick."
- "If I'm good enough, I won't need to take a bath."
These statements illustrate the child's belief that they can directly affect the outcome of their circumstances through wishing, resting, and good behavior. This type of thinking is a normal part of cognitive development for toddlers, as it allows them to make sense of the world around them. As the child matures, they will move away from magical thinking and develop the capacity for logical reasoning and problem-solving.
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the nurse is caring for a client with laryngitis. which interventions would the nurse implement? select all that apply.
The nurse should implement the following interventions for a client with laryngitis:
RestHumidificationAntibioticsAnalgesicsGarglingBy following these interventions, the nurse can help to reduce the symptoms of laryngitis and promote healing.
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vitamin a deficiency is a major problem in developing countries; it is responsible for 367 deaths a day linked to what illness?
The major illness linked to vitamin A deficiency is measles, which is responsible for 367 deaths a day in developing countries.
Measles is a highly contagious infection caused by the measles virus. It is spread through the air via coughing and sneezing, or contact with an infected person’s saliva or mucus. Symptoms of measles include a runny nose, red eyes, a cough, a fever, and a rash.
If left untreated, measles can lead to complications such as blindness, encephalitis, or pneumonia. Vitamin A deficiency has been linked to a weakened immune system, meaning people with vitamin A deficiency are more likely to contract measles and suffer serious complications. Vitamin A is also essential for growth, normal vision, and protection from infections. Therefore, vitamin A deficiency can have serious consequences for individuals’ health and well-being.
In conclusion, vitamin A deficiency is a major problem in developing countries and is responsible for 367 deaths a day linked to measles. Eating a balanced diet and taking supplements can help to reduce the risk of vitamin A deficiency and its associated health risks.
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the nurse caring for a newborn checks the record to note clinical findings that occurred last shift. which finding related to the renal system would be of increased significance and require further action?
The finding of increased significance related to the renal system that would require further action is increased levels of creatinine in the infant's urine. Creatinine is an important indicator of kidney function. If it is found to be elevated, then additional tests and treatments may be necessary to identify and address the underlying cause.
The renal system, also known as the urinary system, is responsible for filtering waste products from the blood and eliminating them from the body through urine. The kidneys, ureters, bladder, and urethra are the main organs of the renal system. If a nurse caring for a newborn is checking the record to note clinical findings that occurred last shift and comes across something related to the renal system, it could be of increased significance and require further action if it indicates a potential problem with the baby's kidney function or urine output.
Some examples of findings that could be of increased significance and require further action include:
Decreased urine output or no urine output
Swelling or tenderness in the area of the kidneys or bladder
Blood in the urine
Difficulty urinating or abnormal urination patterns
High levels of protein or other substances in the urine
If any of these findings are noted, the nurse should report them to the healthcare provider immediately for further evaluation and treatment.
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which test requires the patient to place his or her own hand in the middle of the abdomen while the physician performs the test?
Answer: to test for Ascites
How do we protect a patient's privacy, and how do we verify the patient's identity? Explain HIPAA.
Answer:
To protect a patient's privacy, healthcare providers and organizations must comply with the Health Insurance Portability and Accountability Act (HIPAA), which establishes national standards for protecting individuals' medical records and personal health information.
To verify a patient's identity, healthcare providers may require them to provide a government-issued ID or other form of identification that includes their name, date of birth, and other identifying information. Healthcare providers may also use electronic health record (EHR) systems to verify patient identity by matching the information entered into the system with the patient's personal information on file.
I hope this answers your question.
a client who is legally blind must undergo a colonoscopy. the nurse is helping the healthcare provider obtain informed consent. when obtaining informed consent from a client who is visually impaired, the nurse should take which step?
When obtaining informed consent from a client who is visually impaired, the nurse should take which step: The nurse must read the informed consent form, explain the procedure in easy-to-understand terms, and answer any questions the patient may have to ensure that they understand the information provided.
Informed consent is a legal and ethical necessity that must be obtained before any medical treatment is provided to the patient. It's a way for medical professionals to get permission from a patient before providing them with treatment, medications, or surgical procedures.
Informed consent is crucial since it ensures that patients understand the risks, benefits, and alternatives available to them when receiving treatment.
Some of the considerations to make when obtaining informed consent from a visually impaired patient include: Utilizing sensory aids such as audio tapes or Braille-reading materials.
Explain the purpose of the procedure in simple terms.
Making eye contact and employing proper body language to convey empathy. Talk in a calm and clear tone. Ask the patient if they have any questions and provide additional information if necessary.
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for ct of the foot, when the patient is positioned with knees bent, feet flat on the scan table, and the gantry is angled perpendicular to the subtalar joint, data are acquired directly in which plane?
For the CT Scan of the foot, when the patient is positioned with knees bent, feet flat on the scan table, and the gantry is angled perpendicular to the subtalar joint, data are acquired directly in the axial plane.
When the patient is positioned with knees bent, feet flat on the scan table, and the gantry is angled perpendicular to the subtalar joint, data are acquired directly in the coronal plane during CT of the foot. Computed tomography (CT) scans, also known as CAT (computed axial tomography) scans, are a kind of X-ray test that generates detailed cross-sectional images of the body. CT scans are used to investigate the internal structures of a body. CT scans can detect subtle differences in tissue densities in the body because they provide more detailed and detailed images than regular X-rays.
During a CT scan, you are positioned on a table that slides into a doughnut-shaped opening in the scanner. Inside the scanner, an X-ray tube rotates around you, capturing pictures of the area being studied from a range of different angles. A computer combines these images to create cross-sectional pictures of your body.
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most researchers believe that the number-one candidate for an anti-alzheimer's strategy is: intellectual stimulation. a healthy diet. exercise. microdosing psychotropic medication.
Most researchers believe that a healthy diet, is the number-one candidate for an anti-Alzheimer's strategy. Therefore option A is correct.
Multiple studies and scientific evidence suggest that maintaining a nutritious diet, particularly one that is rich in fruits, vegetables, whole grains, lean proteins, and healthy fats, can have a positive impact on brain health and reduce the risk of developing Alzheimer's disease.
A healthy diet, such as the Mediterranean or DASH (Dietary Approaches to Stop Hypertension) diet, has been associated with a lower incidence of cognitive decline and Alzheimer's disease.
These diets emphasize consuming antioxidant-rich foods, reducing inflammation, and promoting overall cardiovascular health, which are all factors that can support brain function and reduce the risk of cognitive decline.
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the nurse is reviewing drugs prescribed for the management of peptic ulcer disease (pud) with a group of new colleagues. which cell should the nurse explain is inhibited by drugs used to reduce gastric acid secretion?
The cells that are inhibited by drugs used to reduce gastric acid secretion in the management of peptic ulcer disease (PUD) are parietal cells, which produce gastric acid in the stomach.
Peptic ulcer disease (PUD) is a condition caused by the erosion of the lining of the stomach, small intestine, or esophagus. Symptoms include abdominal pain, heartburn, nausea, bloating, and indigestion.
The most common cause of PUD is an infection with the bacterium Helicobacter pylori, but certain medications such as non-steroidal anti-inflammatory drugs (NSAIDs) can also lead to its development. Treatment for PUD may include antacids, antibiotics, proton pump inhibitors, and in severe cases, surgery.
Prevention is key and includes avoiding irritants such as alcohol and tobacco, eating healthy foods, and reducing stress.
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Paternity Testing While Pregnant: How Can You Get a DNA Test Before Giving Birth?
Paternity testing while pregnant is a way to determine the biological father of your unborn child. It can be done by collecting a sample of the mother’s blood, which contains fetal DNA that can be used to identify the father.
This can be done as early as eight weeks after conception, and the results of the test can be available in as little as two weeks. The test requires a swab of the mother’s cheek for DNA analysis, and the father’s sample can be collected in a variety of ways, such as a buccal swab or a blood sample.
The accuracy of the test is typically over 99.9%. If you are considering paternity testing while pregnant, it is important to discuss your options with your doctor or midwife to ensure that the process is safe for you and your baby.
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the health care provider orders the insertion of a single lumen nasogastric tube. when gathering the equipment for the insertion, what will the nurse select?
The nurse should select the following equipment when gathering for the insertion of a single lumen nasogastric tube: Single lumen nasogastric tube is a flexible tube that is passed through the nose or mouth, down the esophagus and into the stomach.
It is commonly used to feed and medicate patients who are unable to swallow or to remove substances from the stomach. The nurse should select the following equipment when gathering for the insertion of a single lumen nasogastric tube: Sterile gloves Lubricating jelly Sterile container or package containing the nasogastric tube Syringe and stethoscope.
Water-soluble lubricant Tissue Paper tape to secure the tube Measure to verify the length of insertion A syringe should also be available to inject air into the tube to confirm the proper placement of the tube in the stomach. The following terms are used in the answer: lumen nasogastric tube.
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after surgery to create an ileal conduit, a client is admitted to the postanesthesia care unit. which clinical finding during the first hour of the postoperative period would the nurse report to the primary health care provider?
Answer: The mental health practitioner should help to involve the client's care to address anxiety related to changes in body image.
During an ileal conduit procedure, a surgeon creates a brand new tube from a part of the intestine that enables the kidneys to empty and urine to exit the body through a tiny low opening called a stoma.
After the surgery, urine will result in the kidneys, through the ureters and ileal conduit, and out of the stoma. One must wear a urostomy pouching (bag) system (appliance) over the stoma to catch and hold the urine.
This surgery usually takes about 3 to six hours. A change in body image is one of the main disadvantages of this surgery.
Explanation:
the nurse is participating in a quality improvement process related to improving care for clients at risk for skin breakdown. which best describes the purpose of this process?
The purpose of this quality improvement process is to ensure that clients at risk for skin breakdown receive the highest level of care possible. This can be accomplished through activities such as regularly monitoring skin integrity, implementing preventive measures, and using the appropriate dressing and topical treatments.
The purpose of the quality improvement process in which the nurse is participating in relation to improving care for clients at risk for skin breakdown is to identify the problem, assess the causes, and establish strategies for improvement. Quality improvement is a systematic method that recognizes that there is always room for development, in which an organization tries to increase the quality of its goods, services, or procedures.
There are three key steps in the quality improvement process: identifying the problem, assessing the causes, and developing strategies for improvement. The goal is to develop high-quality products, services, or procedures that meet customer needs and are delivered on schedule, on budget, and with the desired level of quality.
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5. the nurse is educating a client with a seizure disorder. what nutritional approach for seizure management would be beneficial for this client
A beneficial nutritional approach for seizure management is to eat a diet that is low in fat. This will help to reduce the frequency and intensity of seizures.
A seizure disorder can be managed effectively through the adoption of a nutritional diet. Eating a balanced diet that is high in protein, low in carbohydrates, and rich in essential vitamins and minerals is key to maintaining a healthy lifestyle for those with a seizure disorder. Foods high in B vitamins, such as meat, dairy, eggs, fish, and green vegetables, are beneficial in managing seizures. Consuming foods rich in antioxidants, such as berries, can help reduce the number of seizures a person has.
Eating a balanced diet, limiting processed and sugary foods, and consuming plenty of fluids can help a person with a seizure disorder manage their symptoms and maintain a healthy lifestyle.
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the nursing initial assessment upon admission documents the presence of a decubitus ulcer. there is no mention of the decubitus ulcer in the physician documentation until several days after admission. the present on admission (poa) indicator is
The POA indicator is "no" when the nursing initial assessment upon admission documents the presence of a decubitus ulcer, but there is no mention of the decubitus ulcer in the physician documentation until several days after admission.
POA stands for Present on Admission. This means that a patient's ailment was present when they were admitted to a hospital. There are two different POA indicators used to classify a patient's condition: present at the time of admission (Y), and not present at the time of admission (N).
In this scenario, the POA indicator is "no." When the nursing initial assessment upon admission documents the presence of a decubitus ulcer, but there is no mention of the decubitus ulcer in the physician documentation until several days after admission, it means that the ulcer was not present when the patient was admitted to the hospital.
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the nurse teaching the patient with allergic rhinitis that antihistamines are not effective in reducing which symptom?
The nurse is teaching the patient with allergic rhinitis that antihistamines are not effective in reducing nasal congestion. Nasal congestion is a symptom of allergic rhinitis and is caused by inflammation of the nasal passages.
Allergic rhinitis is an inflammation of the nasal passages that can cause a range of symptoms, including nasal congestion. Antihistamines are medications used to reduce the effects of histamine, a chemical released by the body's immune system in response to an allergen. While antihistamines can be effective in reducing itching, sneezing, and runny nose, they are not effective in reducing nasal congestion. This is because antihistamines work by blocking the effects of histamine and not by reducing the inflammation that causes the congestion.
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your medical patient seen today needs long term hemodialysis services. you telephone for authorization to get verbal approval. four important items to obtain are?
It is important to obtain verbal authorization when a medical patient needs long-term hemodialysis services. The four important items to obtain during this process are:
Name of the patientMedical diagnosisProcedures and services requestedName of the person giving authorizationThe name of the patient is needed in order to verify their identity and to ensure that the correct patient is receiving the correct services. The medical diagnosis is necessary to explain why the patient needs hemodialysis services and to ensure that the services being provided are appropriate and necessary for their condition. The procedures and services requested should be outlined in detail to provide the authorizing person with a clear understanding of what is being requested. Lastly, the name of the authorized person should be obtained to ensure that the authorization is valid.
Long-term hemodialysis services can be life-saving for some medical patients, and it is important to obtain verbal authorization in order to provide the necessary services. By obtaining the four important items mentioned above, medical professionals can ensure that the authorization is valid and that the patient will receive the necessary care.
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a nurse is palpating the pulse of a child with suspected aortic regurgitation. which assessment finding should the nurse expect to note?
The nurse should expect to note a forceful and/or bounding pulse with aortic regurgitation in a child.
Aortic regurgitation (AR) is a condition in which blood flows backward through the aortic valve in the heart during the cardiac cycle, leading to the leakage of blood from the aorta into the left ventricle. This can be caused by damage or disease of the aortic valve or the aortic root.
Symptoms of AR can include chest pain, shortness of breath, and a rapid pulse. If left untreated, it can lead to severe complications, such as heart failure or stroke. Treatment options for AR include medications, lifestyle changes, and, in some cases, surgery.
Lifestyle changes may include eating a healthy diet and exercising regularly. Medications that can be used to reduce the workload of the heart include ACE inhibitors and diuretics. In cases of severe aortic regurgitation, surgery is usually necessary to replace the aortic valve with an artificial valve. This will restore the normal flow of oxygen-rich blood throughout the body and prevent further damage.
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the nurse is preparing to apply a mitten restraint to the client's hand. the nurse should take which action to ensure that the restraint is applied correctly? click on the question video button to view a video showing preparation procedures.
To ensure that the mitten restraint is applied correctly, the nurse should follow these preparation procedures, as demonstrated in the video link provided below:
Clean the client's hand thoroughly.Put the hand through the center of the mitten, with the fingers facing the open end of the mitten.Bring the cuff of the mitten up to the wrist, making sure that the client's hand is fully enclosed.Wrap the straps around the client's wrist and secure the restraint with a double knot.Check to make sure that the mitten is not too tight or too loose, and that the client's circulation is not compromised.Document the procedure and any related observations in the client's medical record.Link to video: https://youtu.be/oDknQamgljg
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Help pls for some reason here’s my problem when I look at my iPad to much and I look at something far away it’s kinda blurry but when I rest my eyes by not looking at the screen it’s kinda gets better this has been happening for a month