The barriers are At Individual level: they often lack research skills when they are isolated from people with or without expertise in research as well as they do lack confidence to take to change.
What is the barrier at the Organizational level?In this level, one do lack time to be able to read as well as carry out research of healthcare institutions that has inadequate library research holding as well as organization support is lowered if people implement change in patient care.
Therefore, The barriers are At Individual level: they often lack research skills when they are isolated from people with or without expertise in research as well as they do lack confidence to take to change.
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24 year old g2p1 woman who underwent an elective termination two days ago presents to the emrgency room with abdominal and pelvic pain
This patient has postoperative endometritis, which may be caused by bacteria that were introduced into the uterine cavity during the dilation and curettage procedure. It's crucial to start taking antibiotics right away. To check for foetal products after starting antibiotics, an ultrasound should be ordered. If the patient were to be located, further dilation and curettage would be necessary. A Beta-hCG level two days after the termination would be useless. The use of a hysterosonogram is not advised in cases of infection. Laparoscopy is not warranted for this patient.
What is termination of pregnancy ?A procedure to end a pregnancy called an abortion.
It's also referred to as a pregnancy termination on occasion. Either a surgical procedure or the administration of medication will end the pregnancy.
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a 52-year-old man presents with a 3-day history of persistent diarrhea. he reports seven watery, non-bloody bowel movements daily. he has associated lower-abdominal cramping and mild nausea. he denies recent travel out of the country. he does not recall eating anything unusual, and none of his family members are sick. past medical history is significant for gerd, for which he takes pantoprazole daily. he recently completed a course of oral levofloxacin for pneumonia. a stool sample is negative for
The surgical treatment that can improve the patient's symptoms most efficiently is option 1: Laparoscopic fundoplication.
What does persistent diarrhea mean?If a diarrhea lasts more than a few days and goes into weeks, it usually shows that there's another underlying issue for example: irritable bowel syndrome (IBS) or a another serious disorder.
Note therefore that the surgical treatment that can improve the patient's symptoms most efficiently is option 1: Laparoscopic fundoplication.
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See full question below
A 52-year-old man presents with heartburn associated with reflux of sour-tasting material in the mouth. Some episodes are accompanied by increased salivation, coughing, and regurgitation of food. Episodes have become more frequent during the past 6 months despite treatment over several years with various treatment combinations, including antacids, histamine 2 receptor antagonists (H2RAs), and proton pump inhibitors (PPIs). He denies bleeding or abnormalities in his stool. He is slightly overweight and has mild hypertension, which is well-controlled with antihypertensive medication. Vital signs are within reference ranges, and the physical examination is unremarkable. Upper endoscopy reveals a large hiatal hernia and coalescing linear erosions throughout the esophageal circumference and a 5.5 cm circumferential cherry red patch above the gastroesophageal junction. Biopsy of the patch reveals columnar metaplasia, but no dysplasia.
What surgical treatment can improve the patient's symptoms most efficiently?
1 Laparoscopic fundoplication
2 Whipple procedure
3 Esophagectomy
4 Radiofrequency thermal coagulation of the lower esophageal wall
5 Laser ablation of the Barrett's mucosa
a nurse has been hired to ooversee the operations of a sereis of ambulatory clincis the nurse can best promote
Integrating leadership skills and management skills
While encouraging certain management abilities among staff members may be beneficial, it cannot replace the value of the loaden manager's own skill set. The best way to encourage success and high achievement is for people to combine their management and leadership responsibilities. Following cannot be compelled; it must be earned. Due to the diversity of stakeholders, change may be more challenging to accomplish when numerous leaders are present.
What exactly are management and leadership skills?Management is exercising control over a group or a collection of entities in order to accomplish a goal. Leadership is the capacity to convince, inspire, and enable others to contribute to the success of an organisation. Influence and inspiration, as opposed to power and control, separate leaders from managers.
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If two drugs are taken together and one of them intensifies the action of the other, what type of drug interaction has occurred?
If two drugs are taken together and one of them intensifies the action of the other, potentiation is the type of type of drug interaction has occurred.
What are the types of drug interaction ?Drug-drug interactions is the process which involve the prescription or nonprescribed drugs, different types of drug-drug interactions are duplication, opposition or antagonism and alteration.
Duplication can be defined as when two drugs have same effect and their side effects may be intensified, it may occur when people inadvertently take two drugs having same active ingredient.
Opposition or antagonism can be defined as when Two drugs with opposite actions can interact, reduce the effectiveness of one or both, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are common type of drug.
If a person takes both types of drug, the NSAID reduce the diuretic's effectiveness and beta-blockers like propranolol are taken to control high blood pressure and heart disease and it counteract beta-adrenergic stimulants.
Alteration is the mechanism where one drug can change how the body absorbs, distributes, metabolizes another drug, Acid-blocking drugs, like histamine-2 (H2) blockers and proton pump inhibitors.
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27 of 50 question 27. which of the following would indicate that an applicant for licensure is likely to possess the good professional character necessary to hold a nursing license in texas? a. the occupations of the applicant's parents and their standing in the community. b. the applicant's personal acquaintance with community and government leaders. c. the applicant provides satisfactory evidence that he/she has not committed a violation of the nursing practice act or a board rule. d. the applicant's knowledge about state regulations for the health care industry.
(c) the applicant provides satisfactory evidence that he/she has not committed a violation of the nursing practice act or a board rule would indicate the said scenario.
In order to practice nursing in Texas, a person must have strong moral character connected to nursing practice. All people looking to get or keep their license or right to practice nursing in Texas must meet this prerequisite.
The Nursing Practice Act, the Board's rules, and generally accepted standards of nursing practice are all requirements for conduct, and the Board defines good professional character as the integrated pattern of personal, academic, and professional behaviors that show an individual is able to consistently conform his or her conduct to those standards.
A person is regarded as having excellent professional character with regard to the practice of nursing if they can demonstrate with sufficient proof that they have not broken the Nursing Practice Act or a regulation established by the Board.
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a client with a diagnosis of preeclampsia suddenly begins to exhibit seizure activity. which is the first action on the part of the nurse?
The first action on the part of the nurse is that nurse should offer rest time with proper bed rest.
What is nursing intervention?Nursing intervention is the act that is performed by the nurse in order to take care of the patient that help the patient to get healthy. Nursing intervention is like taking care, giving proper medicine, or aid that is helpful for the patient.
Healthcare is the most important phenomena is order to treat the patient and healthcare is the most growing industry in modern era. Healthcare is very important for patient because good care will make the patient healthy easily.
Therefore, The first action on the part of the nurse is that nurse should offer rest time with proper bed rest.
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In blood pressure measurement, _____ reflects the lowest pressure during the relaxation phase following a contraction.
In blood pressure measurement, Diastolic pressure reflects the lowest pressure during the relaxation phase following a contraction.
What is relaxation?In psychology, relaxation is the low-tension emotional state of a living creature in which there is no arousal, especially from negative sources like anger, anxiety, or terror. The Oxford Dictionary defines relaxation as a state of physical and mental calmness.
What relaxation method works the best?One of the simplest relaxation techniques is breathing exercises, which can be used at any time or place to calm your stressed-out body and mind. Put one hand on your belly and sit or lay down in a peaceful, secure location, like your bed or the floor at home.
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Examples of HIPAA compliance/standards of use:
Answer:
HIPAA compliance requirements include the following:
Privacy: patients' rights to PHI.Security: physical, technical and administrative security measures.Enforcement: investigations into a breach.Breach Notification: required steps if a breach occurs.Omnibus: compliant business associates.Explanation:
Hope this helps u let me know if u need anything else. ; )
a client in the acute stage of inflammation will experience vasodilation of the arterioles and congestion in the capillary beds. the nurse would assess the client’s skin for
The nurse would assess the client’s skin for redness.
After specific injury, soluble mediators such as cytokines, acute-phase proteins and chemokines are released and promote the migration of neutrophils and macrophages to sites of inflammation. This is the beginning of acute inflammation. These cells are innate immune cells that can actively participate in acute inflammation. If inflammation persists after 6 weeks, it progresses from acute to subacute to chronic inflammation, in which T lymphocytes and plasma cells migrate to the site of inflammation. If this continues uncorrected, the result is tissue damage and fibrosis. Both acute and chronic inflammation are influenced by different cell types such as monocytes and macrophages. Acute inflammation is a rapid, low-specificity adaptive response triggered by a variety of noxious stimuli, including infection and tissue damage (tissue necrosis).Therefore, redness is the correct answer.
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finfer s, bellomo r, boyce n, et al. a comparison of albumin and saline for fluid resuscitation in the intensive care unit. n engl j med. 2004;350(22):2247-2256.
On comparison of saline and albumin for fluid resuscitation in the ICU, the outcome was similar for both and hence it is uncertain if it affects survival.
By administering fluid and electrolytes, fluid resuscitation primarily serves to maintain organ perfusion (hemodynamics) and substrate supply (electrolytes, oxygen, and other substances).
Lack of fluid intake, excessive fluid loss, or a combination of the two can all lead to fluid volume deficits. Such deficiencies are frequently caused by blood loss, vomiting, diarrhea, and dehydration. The most popular forms of fluids utilized in fluid resuscitation are colloids and crystalloids.
Plasma volume expanders are the major function of colloids in the management of circulatory shock. They are maintained in the blood arteries due to their big molecules, which do not easily pass capillary walls. Thus, when significant hemorrhage occurs, they sustain tissue perfusion and restore vascular volume, stabilizing circulatory hemodynamics. The plasma replacements Gelofusine and Haemaccel are frequent examples.
Balanced salt solutions known as crystalloids may easily pass capillary barriers. They persist in the circulatory compartment for a shorter period of time than colloids and are composed of water and electrolytes. Examples that are frequently used are regular saline and sodium lactate solutions like Hartmann's and Ringer-Lactate solutions. Crystalloids are helpful for keeping the equilibrium of fluids.
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findings and patterns on mri and mr spectroscopy in neonates after therapeutic hypothermia for hypoxic ischemic encephalopathy treatment
In neonates, after therapeutic hypothermia abnormal results were observed on MRI and MRS for hypoxic-ischemic encephalopathy treatment.
29.5% of newborns who had magnetic resonance imaging (MRIs) following therapeutic hypothermia (TH) on day of life (DOL) 4 to 8 had abnormal results. In 93% of newborns, deep nuclear damage was found. Lactate was detected on magnetic resonance spectroscopy (MRS) in 18% of newborns, and between DOL 4 and 8, relative apparent diffusion coefficient (rADC) values on MRI showed the greatest reduction.
Therapeutic hypothermia is a treatment used for people who have a cardiac arrest. Once the heart starts beating again, cooling devices are used to lower the temperature of the patient for a short time.
When used on individuals who have undergone cardiac arrest or newborns who have moderate to severe hypoxic-ischemic encephalopathy, therapeutic hypothermia enhances neurological recovery and lowers mortality after global ischemia.
A shortage of oxygen and blood flow to the brain can result in brain dysfunction in infants known as hypoxic-ischemic encephalopathy (or HIE).
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which choice is best for lowering the amount of saturated fat in your diet? a. replace processed grains with whole grains b. replace beef or pork with
Option A) The best choice for lowering the amount of saturated fat in the diet is to replace beef or pork with leaner meat.
Can saturated fat be reduced or swapped out for a healthier option?Research has shown that replacing saturated fats (animal fats like butter, cream, and fat on meats) with unsaturated fats, especially polyunsaturated fats, improves heart health.
The amount of LDL cholesterol present in your blood can increase if you consume too much of saturated fat.
How do you lower saturated fat?The presence high amount of LDL cholesterol in your blood increases the risk of heart disease and stroke.
In place of frying or roasting, you can grill, bake, poach, or steam food. In order to regulate the amount of oil you use, use a teaspoon or an oil spray. Remove the skin and visible fat off meat and poultry.
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Following ingestion, a drug crosses a membrane from an area of higher concentration to an area of lower concentration. this is an example of?
A medication crosses a membrane after intake to move from one location of higher concentration to one of lower concentration. This is an illustration of: Diffusion
In other words, the medication has the ability to cross membranes and passively disperse along the body's fluid-filled cavities (whether through gaps or by diffusion).
Just a few routes exist for a drug to enter a living thing:
diffusion of drug inside cells (aqueous)cellular diffusion of drug inside (lipid)cellular diffusion of drug (usually, aqueous)Active diffusion of drug and assisted transportIt can enter cells directly by diffusing across the lipid bilayer, or it can actively enter cells through pinocytosis, assisted diffusion, active uptake, or another method.
In essence, all of these methods—aside from active pump-mediated transport—rely on diffusion in some way, and as a result, they are influenced by the same factors that affect diffusion of anything through anything.
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a client presents to the health care clinic for her first prenatal visit. the client's current nonpregnant weight is normal for her height. what recommendation for proper weight gain should the nurse discuss with the client?
25 to 35 pounds weight gain should the nurse discuss with the client
What is weight gain ?Increased body weight is referred to as weight gain. This could be brought on by a rise in muscle mass, fat deposition, an abundance of fluids like water, or other elements. One sign of a significant medical condition is weight gain.
It is normal to acquire more weight as you approach the conclusion of your first trimester and the start of the second. Some medical professionals prefer it when pregnant women with "good" BMI gain 10 pounds by 20 weeks. In most cases, recommendations call for gaining 1/2 to 1 pound each week during the second and third trimesters.Learn more about Weight gain here:
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which of these statements represents subjective data the nurse obtained from the patient regarding the patient’s skin?
The comments express subjective data the nurse obtained from the patient about the patient’s skin Patient refuses any color difference.
What does nursing subjective data entail?Observations by the nurse are not the only source of subjective nursing data. This kind of information reflects the patient's opinions, sentiments, or worries as discovered during the nursing interview. The patient is seen as the principal source of irrational information. Anecdotal information based on views, impressions, or experiences is referred to as subjective data. The degree of a patient's suffering and their descriptions of their symptoms are two examples of subjective information in healthcare. Subjective data, often known as "symptoms," are details about the client's thoughts and feelings that are learned through interviews. Observable and quantifiable data (also known as "signs") are gathered by observation, physical examination, laboratory testing, and diagnostic procedures.Therefore the correct answer is c. Patient denies any color change.
The complete question is:
Which of these statements represents subjective data the nurse obtained from the patient regarding the patient's skin?
a. Skin appears dry.
b. No lesions are obvious.
c. Patient denies any color change.
d. Lesion is noted on the lateral aspect of the right arm.
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a patient presents to the emergency room with a severely damaged eye. the injury was sustained when the patient was a passenger in a multi-car accident on the public highway. the patient sustained a large open lacerated wound to the left eye. the posterior chamber was ruptured and significant vitreous and some intraocular tissue was lost. the eyeball was not repairable and was removed, en masse. a permanent implant was inserted but not attached to the extraocular muscles. the patient was released with an occlusive eye patch. what cpt® and icd-10-cm codes are reported?
CPT® and ICD-10-CM codes 65103-LT, S05.22XA, V49.59XA, Y92.411 are reported.
The term "ICD-10" refers to the tenth edition of the International Classification of Diseases, a system of medical coding developed primarily by the World Health Organization (WHO) to classify medical conditions by groups of related illnesses under which more specific illnesses are listed, tying subtle diseases to more extensive morbidities. ICD-10-CM codes must be reported to the payer in order for a medical practitioner to be paid for medical services.
ICD-10-CM codes show the patient's diagnosis, which support the CPT® codes' depiction of the patient's services as being medically essential.
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association between weight bias internalization and metabolic syndrome among treatment-seeking individuals with obesity
Association between weight bias internalization and metabolic syndrome among treatment-seeking individuals with obesity is scholarly article.
What is internalised weight bias?Internalized weight bias (IWB), the conviction that unfavorable weight stereotypes apply to oneself, is a serious issue for women because it has been connected to a number of physical and mental conditions, including disordered eating.
Objective Chronic stressors :Objective Chronic stressors like weight stigmatization may raise cardiometabolic risk. Some people who are obese self-stigmatize (ie, weight bias internalization, WBI). No research has yet looked into the connection between WBI and the metabolic syndrome. Methods 178 obese adults participating in a weight-loss experiment had their blood pressure, waist circumference, fasting glucose, triglycerides, and high-density lipoprotein cholesterol evaluated at baseline.
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eichenfield lf, krakowski ac, piggott c, et al. evidence-based recommendations for the diagnosis and treatment of pediatric acne. pediatrics 2013; 131 suppl 3:s163.
A GP would diagnose acne by inspecting your skin. Examine your face, chest, and back for different types of spots, such as blackheads and sore, red nodules. The severity of your acne will dictate where you should seek therapy and what treatment they should receive.
What is acne?Young adults and adolescents are the most susceptible to acne. Uninflamed blackheads and pus-filled pimples or huge, red, and sensitive bumps are common symptoms. Placed above white lotions and cleansers, along with prescription antibiotics, are used as treatments.
What do pimples do to your face?Acne is a common skin ailment in which the pore of your skin becomes clogged by hair, sebum (an oily fluid), germs, and dead skin cells. These obstructions cause blackheads, whiteheads, nodules, and other types of blemishes. If you experience acne, realize that you are not alone.
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true or false. the f.i.n.d. decision-making model only applies to making decisions about babysitting?
yamoah k, johnson mh, choeurng v, et al. novel biomarker signature that may predict aggressive disease in african american men with prostate cancer. journal of clinical oncology : official journal of the american society of clinical oncology 2015;33:2789-96.
Prostate cancer (PC) is more common among and kills more African American (AA) males than men of other races and ethnicities, including European Americans (EA). 1,2 This disparity has been linked in part to socioeconomic factors, limited access to healthcare, and individual genetic susceptibilities.
To determine whether genetic/biologic factors have an impact on ethnic inequalities in PC pathogenesis and disease progression, an investigation was performed on the ethnicity-specific expression of prostate cancer (PC)-associated biomarkers.
The risk of one or more unfavorable clinicopathologic outcomes in AA men can be predicted using a set of biomarkers that demonstrate ethnic reliance. These findings demonstrate that there are variations in PC biology and pathogenesis between AAmen and EAmen that have an impact on applicability for both diagnostics and therapies. For use in PC diagnosis and treatment, further testing is necessary. Clinicians will be able to more precisely risk stratify these patients for recommended treatments that will enhance disease control and ultimately lessen the disparities in outcomes in this patient population by being able to identify a subset of AA males who have severe illnesses.
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drug-related visits to the emergency department: how big is the problem? pharmacotherapy, 22(7): 915-923. doi: 10.1592/phco.22.11.915.33630
In order to avoid drug-related visits to the emergency department and associated morbidity and mortality, primary caregivers, such as family physicians and pharmacists, should collaborate more together to establish and reinforce care regimens and monitor patients.
Drug-related emergency department visits and hospital admissionsDrug-related hospital admissions and ER visits were examined in terms of frequency and underlying reasons. In order to identify drug-related contacts and admissions for all patients who came to the emergency room of a 517-bed major care facility during a four-month period, a retrospective chart review was done. Adverse drug reactions (ADR), excess or abuse, noncompliance, drug interaction, or toxicity were used to categorize drug-related illnesses.
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which element of malpractice occurs when the nurse does not act as a reasonable, prudent person would have acted in a similar circumstance?
Answer:
breach of a duty
Explanation:
a nurse is providing discharge teaching to a client who has pulmonary tuberculosis and a new prescription for rifampin. which of the following information should the nurse provide?
While taking this drug, anticipate your urine and other discharges to be orange.
What is the causes of pulmonary tuberculosis?Pulmonary tuberculosis (TB) is a bacterial infection of the lungs that can produce a variety of symptoms such as chest pain, shortness of breath, and severe coughing. If a person does not receive treatment for pulmonary tuberculosis, it can be fatal. People who have active tuberculosis can spread the bacterium through the air.
What is pulmonary tuberculosis?Tuberculosis (TB) is a dangerous infection caused by the bacteria Mycobacterium tuberculosis (MTB) that primarily affects the lungs but can spread to other organs. TB is an infectious disease that can infect everyone who comes into contact with MTB.
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a nurse on long-term care unit is creating a plan for a client who has alzheimers disease. which intervention should the nurse include in the plan of care
For a nurse on long-term care unit creating a plan for a client who has Alzheimer's disease. Intervention the nurse should include in the plan of care would be to: Provide a consistent daily routine
-For a client with Alzheimer's disease, picture symbols rather than written schedules are appropriate.
-A client with Alzheimer's disease should be cared for according to a consistent daily schedule.
-Giving a client with Alzheimer's disease alternatives can make them more anxious, therefore doing so is inappropriate for their care.
-Alzheimer's patients experience memory loss, wandering, and confusion. This client's care plan calls for nursing assistance to remove environmental dangers.
What is Alzheimer's disease?
A degenerative neurologic condition called Alzheimer's disease results in the death of brain cells and brain shrinkage. The most frequent cause of dementia, which is characterized by a steady deterioration in mental, behavioral, and social abilities and impairs a person's capacity for independent functioning, is Alzheimer's disease.
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a client has been prescribed hydrochlorothiazide, and the nurse is preparing to give the client discharge instructions. which adverse effects should the nurse caution the client about? select all that apply.
These are the adverse effects that the nurse should caution the client about:
B) Dizziness
D) Nocturia
E) Muscle cramps
High blood pressure is treated with hydrochlorothiazide. Bringing down high blood pressure reduces the risk of heart attacks, renal issues, and strokes. Diuretics, or "water pills," are a family of medications that includes hydrochlorothiazide. It works by increasing your pee production.
This aids in your body's elimination of surplus salt and water. This drug also lessens edema, or excess fluid in the body, which is brought on by ailments including heart failure, liver illness, or renal disease. This can alleviate symptoms like shortness of breath or ankle or foot swelling.
You can get nocturia, dizziness, or muscular cramping while your body becomes used to the medicine. Inform your doctor or pharmacist as soon as possible if any of these side effects persist or grow worse.
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Question correction:
A patient has been prescribed hydrochlorothiazide (HydroDIURIL) and the nurse is preparing to give the patient discharge instructions. Which adverse effects may this patient experience while taking this medication? (Select all that apply.)
A) Constipation
B) Dizziness
C) Polyphagia
D) Nocturia
E) Muscle cramps
When you give patients nitroglycerin, they sometimes develop a headache. this would be called a(n):_____.
a nurse is caring for a client who received an injection of penicillin g procaine. the client begins to experience dyspnea and tongue swelling. which of the following actions should the nurse perform first?
After the client received an injection of penicillin g, the nurse first action should be subcutaneous epinephrine administration.
Why epinephrine is administered?
The nurse's primary goal should be to administer epinephrine when the client receives an injection of penicillin while using the airway, breathing, and circulation approach to client care. By acting on adrenergic receptors, epinephrine produces bronchodilation of the lungs and an increase in blood pressure. Because it stimulates both alpha and beta adrenergic receptors to achieve these effects, it treats anaphylaxis more successfully than any other medication.
In addition to emergency medical care, epinephrine injections are used to treat allergic responses that are life-threatening and brought on by foods, drugs, latex, insect bites or stings, and other causes.
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short tribute speech about the health workers who lost their lives during the pandemic
Answer:
Rest in peace to the heroes that lost their lives on the front lines of the covid-19 pandemic helping every moment that their bodies could handle.
A local infection confined to a particular part of the body is indicated by?
Lesion containing pus indicates a local infection is one that is confined to a particular part of the body.
A skin lesion is a region of the skin that differs from the surrounding skin in terms of growth pattern or appearance. Skin lesions can be divided into two categories: primary and secondary. Primary skin lesions are abnormal skin disorders that can develop during a person's lifetime or be present at birth.
Primary skin lesions that have been handled or inflamed will lead to secondary skin lesions. For instance, if a mole is scratched until it bleeds, the crust that forms as a result is now considered a secondary skin lesion. Pustules are tiny sores that contain pus. They frequently occur from impetigo, boils, or acne.
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After applying oxygen using bi-nasal prongs to a client who is having chest pain, the nurse should implement which intervention?
After applying bi-nasal prongs the nurse should put indicators stating that oxygen is being used on the client's door and in the room.
What are bi-nasal prongs?
Nasal polyps are benign, painless growths that line the sinuses or nose. People who have asthma, allergies, recurrent infections, or nasal irritation are more likely to experience them. Nasal polyps can diminish and their symptoms can be relieved with medication and outpatient surgery.
Nasal catheter one for oxygen treatment administration that slips into the nostrils. also known as nasal prongs. When applying continuous positive airway pressure (CPAP), binasal prongs are superior to single nasal and nasopharyngeal prongs in reducing the need for re-intubation.
The complete question:
After applying oxygen using bi-nasal prongs to a client who is having chest pain, the nurse should implement which intervention?
1. Have the client take slow deep breaths in through the mouth and out through the nose
2. post signs on the client's door and in the client's room indicating that the oxygen is being used.
3. Apply Vaseline petroleum to both nares and 2x2 gauze around the oxygen tubing at the client's ears.
4. Encourage the client to hyperextend the neck, take a few deep breaths and cough.
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