The most important predictor of survival in patients with aortic coarctation is the age at which the coarctation is corrected.
Aortic coarctation is a congenital condition in which there is a narrowing of the aorta, which can lead to increased blood pressure and strain on the heart. If left untreated, it can lead to complications such as heart failure, stroke, and aneurysm.
Studies have shown that early diagnosis and correction of aortic coarctation are associated with better outcomes and longer survival. The American Heart Association recommends that patients with aortic coarctation undergo corrective surgery or catheter-based interventions as soon as possible after diagnosis, ideally before the age of 1 year.
Other factors that may influence survival in patients with aortic coarctation include the presence of associated heart defects, the severity of the coarctation, and the development of complications such as hypertension or aneurysm. Regular follow-up and management of these factors are important for optimizing outcomes in patients with aortic coarctation.
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What are the five EBP levels of collaboration
The five Evidence-Based Practice (EBP) levels of collaboration are:
1. Individual: This level involves personal reflection and learning, which includes reviewing literature, attending conferences, and seeking mentorship to improve one's practice.
2. Interprofessional: At this level, collaboration occurs between professionals from different disciplines (e.g., nurses, physicians, social workers) to enhance patient care by sharing knowledge, skills, and experiences.
3. Organizational: This level focuses on collaboration within healthcare organizations to support and implement EBP, including providing resources, creating policies, and fostering a culture of learning and improvement.
4. Community: This level involves partnering with community stakeholders such as schools, government agencies, and non-profit organizations to improve public health outcomes and address social determinants of health.
5. Policy: The highest level of collaboration focuses on advocating for and influencing healthcare policies at local, national, and global levels to support the use of evidence-based practices and improve health outcomes for all.
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Name 3 different Nursing Diagnoses r/t Immobility affecting the Respiratory System
Ineffective airway clearance associated with weakened respiratory muscles and restricted movement, as well as increased risk of pneumonia.
What is an immobility nursing diagnosis?Immobility-related nursing diagnoses include the following: pressure ulcer risk because of immobility. Immobility-related muscle atrophy and weakening. due to immobility, at risk for venous stasis and emboli. at risk for pulmonary function changes and impairment brought on by immobilisation.
What are three nursing diagnoses examples?Examples of nursing diagnoses include: decreased cardiac output, risk for impaired liver function, urine retention, and disrupted sleep patterns. A medical diagnosis, on the other hand, is made by a doctor or other skilled healthcare professional.
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TRUE/FALSE. qualitative research is allied with the constructivist tradition
True, qualitative research is allied with the constructivist tradition.
Qualitative research is an approach to understanding and interpreting human experiences, behaviors, and social phenomena through the collection of non-numerical data, such as interviews, observations, and textual analysis. This type of research seeks to understand the meaning and context of experiences from the participants' perspective, focusing on the quality and depth of the data.
The constructivist tradition is a theoretical perspective that asserts that knowledge and reality are constructed by individuals as they interact with their environment and interpret their experiences. Constructivists believe that people actively create their own understanding of the world based on their unique experiences, cultural backgrounds, and personal histories.
Qualitative research is allied with the constructivist tradition because it aligns with the key principles of constructivism. In qualitative research, the researcher and participants co-construct meaning through their interactions and the researcher interprets the data to uncover the participants' perspectives and understandings. This approach acknowledges the subjective nature of reality and the importance of the individual's experience in constructing knowledge.
In summary, qualitative research is closely connected to the constructivist tradition, as both emphasize the role of individual experiences, interpretation, and the co-construction of meaning in the process of understanding human behaviors and social phenomena.
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the nurse is collecting data from a client who is taking pantoprazole. the nurse determines that the medication is most effective if the client states relief of which symptom?
The nurse determines that pantoprazole is most effective if the client states relief of heartburn or acid reflux symptoms.
Pantoprazole is a proton pump inhibitor (PPI) that reduces the amount of acid produced in the stomach. It is used to treat conditions caused by excessive stomach acid, including heartburn, acid reflux, and gastroesophageal reflux disease (GERD).
Therefore, if the client is taking pantoprazole and reports relief of these symptoms, it suggests that the medication is working effectively to reduce the amount of acid in the stomach. It is important for the nurse to assess the client's response to the medication to determine its effectiveness and to monitor for any adverse effects.
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When the nurse completes the patient's admission nursing database, the patient reports that he does not have any allergies. Which acceptable medical abbreviation can the nurse use to document this finding?
1) NA
2) NDA
3) NKA
4) NPO
When the nurse completes the patient's admission nursing database and the patient reports that he does not have any allergies, the acceptable medical abbreviation the nurse can use to document this finding is NKA. NKA stands for "No Known Allergies." So the correct answer is option number 3.
It is important for healthcare providers to document accurate allergy information for their patients, as allergies can have serious implications for treatment and medication administration. The use of standardized medical abbreviations, such as "NKA," helps to ensure clear and concise communication between healthcare providers and can help prevent errors or misunderstandings. However, it is important to note that the use of medical abbreviations can also lead to confusion or misinterpretation if they are not universally understood or used consistently.
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What are some current priorities for clinical nursing research?
Current priorities for clinical nursing research include improving patient safety, and healthcare outcomes through evidence-based practices, exploring the impact of technology on healthcare delivery, addressing health disparities among underserved populations.
Nursing research is essential to improve the delivery of healthcare and achieve better patient outcomes. Some of the current priorities in clinical nursing research focus on enhancing patient safety and quality of care through evidence-based practices. This includes investigating the impact of technology on healthcare delivery and identifying interventions to reduce health disparities among underserved populations.
Another priority is promoting nursing workforce development and education to ensure a highly skilled and competent workforce that can meet the evolving needs of patients and the healthcare system. These priorities aim to advance the science of nursing and improve the quality of care provided to patients.
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What is the initial treatment for an acute grade I-III AC joint sprain?
The initial treatment for an acute grade I-III acromioclavicular (AC) joint sprain involves the RICE protocol, which stands for Rest, Ice, Compression, and Elevation.
Rest is essential to prevent further damage and allow the ligaments to heal, immobilization using a sling can be helpful for supporting the affected arm and reducing pain. Applying ice to the injured area for 15-20 minutes every 2-3 hours during the first 48-72 hours can help minimize swelling and inflammation, it is essential to use a barrier between the ice and skin to avoid frostbite. Compression, such as using an elastic bandage, can aid in controlling swelling by applying pressure around the injured area. However, care should be taken not to wrap the bandage too tight, as it may impede blood flow.
Elevation of the injured arm above heart level, when possible, can assist in reducing swelling and inflammation. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can be used to manage pain and inflammation. Additionally, physical therapy may be recommended to help regain range of motion and strength once the initial healing process begins, it is crucial to follow a healthcare professional's advice regarding the duration and intensity of the treatment to ensure a proper recovery. The initial treatment for an acute grade I-III acromioclavicular (AC) joint sprain involves the RICE protocol, which stands for Rest, Ice, Compression, and Elevation.
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Vaginal bleeding in pregnant lady with NO PAIN, think what?
Vaginal bleeding in a pregnant woman with no pain can be a sign of several things, but most importantly Miscarriage.
What are other complications?Implantation bleeding: In the early stages of pregnancy, a small amount of bleeding can occur when the fertilized egg implants in the uterus.
Cervical changes: During pregnancy, the cervix can become more sensitive and may bleed more easily.
Ectopic pregnancy: Vaginal bleeding can also occur in women with an ectopic pregnancy, where the fertilized egg implants outside the uterus, usually in the fallopian tube. This is a medical emergency and requires immediate attention.
Placenta previa: In this condition, the placenta partially or completely covers the cervix, leading to vaginal bleeding. This requires close monitoring and may require early delivery by C-section.
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triangles of the neck
(what separates them?)
The triangles of the neck are separated by key anatomical structures, specifically muscles and bones.
The neck is divided into two main regions: the anterior triangle and the posterior triangle. The anterior triangle is further divided into four smaller triangles: the submental, submandibular, muscular, and carotid triangles.
The key structures that separate these triangles are:
1. The sternocleidomastoid muscle: This muscle separates the anterior and posterior triangles of the neck.
2. The digastric muscle: It divides the anterior triangle into submandibular and submental triangles.
3. The hyoid bone: This bone serves as a landmark to differentiate the submental and muscular triangles.
4. The omohyoid muscle: It separates the muscular and carotid triangles.
These structures help to organize and define the different regions of the neck, making it easier to study and understand the neck's complex anatomy.
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How much longer before this llama will give birth? At what age are crias normally weaned? Do you want to wait that long if it's a tooth root infection?
a. The gestation period for a llama is approximately 11 months
b. As for weaning, crias are typically weaned at around 6 months of age
c. Regarding a tooth root infection, it is important to seek veterinary attention as soon as possible
The gestation period for a llama is approximately 11 months, so if you know the date of conception or the breeding date, you can estimate when the llama will give birth. However, it is important to note that there is some variation in gestation length, so it is best to monitor the llama closely and consult with a veterinarian if you have any concerns.
As for weaning, crias are typically weaned at around 6 months of age. This can vary depending on the health and growth of the cria, as well as the preferences of the owner or breeder.
Regarding a tooth root infection, it is important to seek veterinary attention as soon as possible. Tooth root infections can cause a great deal of pain and discomfort for the animal, and can also lead to more serious health issues if left untreated. Waiting for an extended period could exacerbate the infection and make treatment more difficult or costly.
In conclusion, monitoring the gestation period and weaning age of llamas can help ensure their health and well-being. Additionally, seeking prompt veterinary care for tooth root infections is crucial for the animal's health and comfort.
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the nurse is teaching his client about laxative use. what should be included in the instructions? select all that apply.
When teaching a client about laxative use, the nurse should instruct the client to use laxative only as directed, drink plenty of fluids, increase fiber intake, take laxatives while empty stomach.
When teaching a client about laxative use, the nurse should include the following instructions
Use laxatives only as directed. Overusing laxatives can lead to dependence and may cause damage to the bowel. Drink plenty of fluids while taking laxatives to prevent dehydration.
Increase fiber intake through foods such as fruits, vegetables, and whole grains to help regulate bowel movements. Take laxatives on an empty stomach for faster results.
Avoid taking laxatives before bed as they may cause abdominal cramping and disrupt sleep. Do not take laxatives for more than one week without consulting a healthcare provider.
Avoid using stimulant laxatives, such as senna or bisacodyl, for extended periods of time as they can damage the bowel. If experiencing persistent constipation, consult a healthcare provider for further evaluation and treatment.
It is important to note that laxatives should not be used as a long-term solution for constipation and that clients should consult with their healthcare provider if they experience any adverse effects or if their symptoms persist.
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-- The given question is incomplete, the complete question is given below
"What instructions must be given to the client when a nurse is teaching his client about the use of laxative?" --
what is found in the posterior wall of the prostatic urethra?
The posterior wall of the prostatic urethra is composed of an elevation called urethral crest.
Prostatic urethra is that portion of the urethra which traverses the prostate gland. It is the widest part of the urethra which is also most dilatable. Urethra is the organ in the males through which the urine leaves their body. Whereas the prostate gland is responsible for the production of seminal fluids.
Urethral crest is also known by some other names like crista urethralis masculinae or crista phallica. It is a longitudinal fold of the wall of the urethra. The ejaculatory ducts of the male open at the center of this urethral crest.
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What cortex receives input from the olfactory bulb?
The olfactory cortex plays a crucial role in our sense of smell and is involved in a wide range of cognitive and behavioral functions.
The olfactory bulb is a specialized structure in the brain responsible for processing information related to the sense of smell. It receives input from olfactory sensory neurons in the nasal cavity and sends this information to several brain regions, including the olfactory cortex.
The olfactory cortex is a collection of brain regions located in the temporal lobe, including the piriform cortex, the entorhinal cortex, and the amygdala. These regions are involved in processing and integrating olfactory information with other sensory modalities and higher cognitive functions.
The piriform cortex is the primary cortical region that receives direct input from the olfactory bulb. It is involved in processing the identity and quality of odors, as well as their emotional significance. The entorhinal cortex, which is also involved in memory processing, receives indirect input from the olfactory bulb via the piriform cortex. The amygdala, on the other hand, is responsible for processing the emotional and behavioral aspects of olfactory information.
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which statment must the nurse emphasize to the family when preparing a school-aged child with persistent asthma for discharge
The nurse should emphasize the importance of taking the prescribed asthma medication consistently, even when the child is feeling well, to prevent asthma attacks and maintain control of the condition.
Asthma is a chronic condition that requires ongoing management, and medication plays a key role in controlling symptoms and preventing exacerbations. It is important for the family to understand that even when the child is feeling well, they should continue to take their medication as prescribed to maintain control of the condition and prevent future asthma attacks.
The nurse should also provide education on identifying and responding to asthma triggers and developing an asthma action plan for use at school or during physical activity.
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where is the suprapatellar bursa located?
The suprapatellar bursa is a synovial fluid-filled sac located above the patella (kneecap) and is situated between the quadriceps tendon and the femur (thigh bone).
The quadriceps tendon is a thick tendon that connects the quadriceps muscles in the thigh to the patella, and it continues as the patellar ligament below the patella to attach to the tibia. The suprapatellar bursa acts as a cushion or lubricating sac that reduces friction between the quadriceps tendon and the femur during knee movement.
It also helps to protect the underlying structures from excessive pressure and trauma. Inflammation of the suprapatellar bursa, known as prepatellar bursitis, can cause pain and swelling in the front of the knee, limiting range of motion and mobility.
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■ Toddlers range in age from 1 to 3 years, and become increasingly mobile and communicative. They master control over excretion and are known for exerting their own opinions and wishes to parents. Injury prevention and toilet training are specific parental teaching needs.
Injury prevention and toilet training are specific parental teaching needs. This statement is true. When it comes to injury prevention and promoting health in children aged 1-3 years, it is important for parents to prioritize teaching strategies for staying safe while being active and mobile. This may include supervising toddlers during playtime, ensuring that toys and equipment are age-appropriate and in good condition, and teaching children how to safely navigate stairs and other potential hazards in the home environment.
Steps to keep toddlers safe:
Injury prevention for toddlers is crucial as they become more mobile and communicative. Parents can teach their children how to stay safe by:
1. Supervising their children closely, especially during playtime and while exploring new environments.
2. Childproofing the home by installing safety gates, and outlet covers, and securing heavy furniture.
3. Teaching children basic safety rules, such as not touching hot surfaces or sharp objects.
4. Encouraging children to express themselves and communicate their needs to reduce frustration and tantrums, which can lead to accidents.
5. Demonstrating safe behavior, such as holding hands while crossing the street.
Toilet training steps to be followed:
Toilet training is another essential aspect of teaching toddlers, and parents can support their children by:
1. Observing signs that the child is ready for toilet training, such as expressing an interest in using the toilet or staying dry for longer periods.
2. Encouraging and praising the child for their progress in using the toilet.
3. Providing a comfortable and accessible toilet or potty chair for the child.
4. Establishing a regular routine for toilet use and gradually increasing the child's independence.
5. Being patient and understanding during setbacks, as toilet training is a learning process.
Overall, focusing on injury prevention and toilet training is essential for promoting the health and well-being of children aged 1 to 3 years.
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after 1 month of therapy, the client in spinal shock begins to experience muscle spasms in the legs, and calls the nurse in excitement to report the leg movement. which response by the nurse would be the most accurate?
The most accurate response by the nurse would be:" Nervous system recovery after spinal shock can result in muscle spasms and movement.
This is a positive sign of progress and improvement. However, it's important to note that muscle spasms and leg movement alone do not necessarily indicate full recovery. We will continue to monitor your progress and work closely with the healthcare team to provide the best care for your condition."
If someone becomes hypertensive during therapy as well as autonomic dysreflexia has been identified, the therapist should immediately place the patient in an upright position. This makes use of an orthostatic response and aids in blood pooling in the lower extremities.
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What must be true to equate odds ratio with relative risk
The following conditions must be met in order to equal odds ratio (OR) with relative risk (RR):
The likelihood of the outcome has to be low: OR and RR are association measures that are used to explain the connection between an exposure and a result. When the likelihood of the result is low, OR approaches RR.
The study has to be a case-control study: in case-control studies, the measure of association is OR, whereas in cohort studies, the measure of association is RR. When the occurrence of the outcome is low in a case-control research, the OR can be utilized for estimating the RR.
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A 68-year-old client with end-stage chronic obstructive pulmonary disease (COPD) has discharge orders that include home oxygen therapy. The client exhibits anxiety about becoming dependent on supplemental oxygen. How can a nurse help allay the client's anxiety?
Nursing help to allay the client's anxiety -
Education about therapyProper usageReassuranceAs a nurse, there are several ways to help allay the anxiety of a 68-year-old client with end-stage COPD who is worried about becoming dependent on supplemental oxygen.
Firstly, the nurse can explain to the client that supplemental oxygen therapy is not a cure for their condition but a way to improve their quality of life by reducing symptoms such as shortness of breath and fatigue. The nurse can also reassure the client that many people with COPD rely on home oxygen therapy to manage their condition and lead fulfilling lives. Additionally, the nurse can provide education on the proper use and maintenance of the oxygen equipment, as well as encourage the client to engage in pulmonary rehabilitation programs to improve their lung function and overall well-being. Finally, the nurse can collaborate with the client's healthcare team to develop a personalized care plan that addresses their concerns and ensures their comfort and safety at home.Know more about chronic obstructive pulmonary disease (COPD) - brainly.com/question/9994169
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A significant cause of morbidity in thalassemia patients. Treatment?
A significant cause of morbidity in thalassemia patients is anemia and iron overload. Thalassemia can be treated by a bone marrow or blood transplant.
Thalassemia is a blood disorder where the number of hemoglobin is very low because the body is unable to make it. This is an inherited diseases. Mild form of thalassemia is easily treatable but severe forms require transfusions.
Bone marrow is the soft spongy part of the bone located in its center. It is comprised of several blood vessels and is responsible for producing new blood cells. There are two categories of bone marrow: the red bone marrow and the yellow bone marrow.
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Most common cause of death in patient struck by lightening?
The most common cause of death in a patient struck by lightning is the electrical current can disrupt the heart's normal rhythm leading to a sudden cardiac arrest.
Lightning strikes can cause various injuries to the human body, and the severity of the damage depends on factors such as the strength of the lightning bolt, the pathway it takes through the body, and the duration of the contact. In addition to cardiac arrest, lightning strikes can cause respiratory arrest, which occurs when the electrical current disrupts the respiratory muscles.
Neurological damage is also possible, leading to symptoms such as confusion, memory loss, and muscle weakness. Thermal injuries may also occur, such as burns and tissue damage from the heat generated by the lightning bolt.
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The patient's IV has 500 ml of DSW left to infuse. The pump is infusing at 125 ml/hr. How many hours longer will this IV run?
The IV will continue to run for a further four hours before the infusion is finished.
What is IV?Generally in medicine when we talk about an IV we are referring to an intravenous infusion that is given to a patient. This is believed to be generally more effective than other kinds of medication.
500 ml of DSW remain in the patient's IV, and the pump is infusing at 125 ml per hour.
Divide the remaining volume by the infusion rate to calculate the number of hours this IV will continue to run:
500 ml x 125 ml/hr = 4 hours.
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where does the lymphatics from the dorsum of the foot drain?
Lymphatics drain from the top of the foot to the popliteal lymph nodes, which are located in the popliteal fossa (the hollow at the back of the knee).
What is lymphatics?The lymphatic system is a network of tissues, organs, and vessels that aid in the maintenance of fluid balance and the defense of the body against infections. It is a component of the immune system that collaborates with the circulatory system to eliminate waste, toxins, and other potentially harmful substances from the body.
Lymph nodes, lymphatic vessels, lymphatic fluid (lymph), thymus, spleen, and tonsils are all part of the lymphatic system. Lymphatic vessels are in charge of collecting lymph and transporting it to lymph nodes, where it is filtered and purified. The lymphatic system is essential for maintaining the body's health and protecting it from disease.
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The purpose statement of a qualitative study is expected to identify
The purpose statement of a qualitative study is expected to identify the main goal or objective of the research, as well as the research question or questions that the study aims to answer. It may also outline the scope and boundaries of the study, the target population or sample, and the theoretical framework or perspective that will guide the analysis and interpretation of the data.
The purpose statement of a qualitative study is expected to identify the overall goal or aim of the study, as well as the specific research questions that the study seeks to address. In a qualitative study, the purpose statement may also describe the theoretical framework or perspective that informs the study and the methods or approach that will be used to collect and analyze data.
The purpose statement should be clear, concise, and focused, and should provide a rationale for why the study is important and what it aims to achieve. It should also be tailored to the specific research context and audience and should be consistent with the overall research design and methodology.
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Define Referrals:
A) A physicians order for lab work
B) An arrangement for services by another care provider
C) Any physicians order that requires a authorization from the insurance company.
D) Treatment options the physician discusses with the patient.
Referrals refer to 'an arrangement for services by another care provider' (option b).
Referrals are usually made by a primary care physician to a specialist or other healthcare provider for further evaluation and treatment of a patient's medical condition.
A physician may refer a patient to another healthcare provider if they require additional specialized medical attention that is beyond the scope of the primary care physician's practice. The healthcare provider that the patient is referred to could be a specialist, a physical therapist, a psychologist, or any other healthcare professional that can provide the necessary medical care.
Referrals are important to ensure that patients receive the best possible medical care and that their health needs are met. Referrals also help to streamline the healthcare system and improve patient outcomes.
Option b is answer.
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What are the contraindications of Trendelenburg position?
Adenocarcinoma of stomach is found on biopsy, next step?
If adenocarcinoma of the stomach is found on biopsy, the next step would typically be to stage cancer to determine the extent of its spread.
This step may involve additional imaging tests such as CT scans or MRIs, as well as further biopsies of any suspected metastases. The stage of cancer will determine the appropriate plan for further process. Treatment options will depend on the stage of cancer and may include surgery, chemotherapy, radiation therapy, or a combination of these approaches. It is important to consult with a healthcare professional who specializes in treating stomach cancer to develop an individualized treatment plan.
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the nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis who is scheduled for surgery in 2 hours. the client begins to complain of increased abdominal pain and begins to vomit. on assessment, the nurse notes that the abdomen is distended and bowel sounds are diminished. which is the most appropriate nursing intervention?
The most appropriate nursing intervention for this client is to notify the healthcare provider immediately and prepare the client for surgery.
The client's increased abdominal pain, vomiting, distended abdomen, and diminished bowel sounds are signs of a possible complication of appendicitis, such as perforation or abscess formation. These complications require prompt surgical intervention to prevent further deterioration of the client's condition.
Therefore, the nurse should notify the healthcare provider immediately and prepare the client for surgery by ensuring that the client is NPO (nothing by mouth), administering prescribed preoperative medications, and ensuring that the client's surgical consent is signed and on file.
In summary, when caring for a client with appendicitis who is scheduled for surgery and complains of increased abdominal pain, vomiting, distended abdomen, and diminished bowel sounds, the most appropriate nursing intervention is to notify the healthcare provider immediately and prepare the client for surgery.
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If a topic is a priority for the organization, what is the next step in the Iowa Model?
If a topic is identified as a priority for the organization in the Iowa Model, the next step is to gather information and evidence for the topic.
To find the most recent and literary research on the subject a thorough review of the pertinent literature must be conducted.
After the information is gathered, it is critically analyzed to ascertain its reliability, applicability and relevance to the particular clinical setting. This entails assessing the reliability of the data the potency of the research strategy and the applicability of the findings to the clinical issue at hand.
The implementation of evidence based practice changes in the clinical setting is then advised based on the findings of the critical appraisal.
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If you can't create an airtight seal over an infant's mouth and nose, what technique should you use?
It is important to note that creating an airtight seal over an infant's mouth and nose is not recommended, as it can increase the risk of suffocation. Instead, a technique known as the "chin lift and head tilt" should be used. This involves gently tilting the infant's head back while lifting their chin upwards, which opens up their airway and allows for proper breathing.
The following techniques can also be followed-
1. Lay the infant on a firm, flat surface.
2. Ensure that their airway is open by gently tilting their head back and lifting their chin.
3. Instead of attempting to create an airtight seal over both the infant's mouth and nose, you should use the "mouth-to-mouth-and-nose" technique. This involves covering both the infant's mouth and nose with your mouth, creating a seal around them as best as you can.
4. Deliver gentle breaths, ensuring that you see the infant's chest rise with each breath. The breaths should be smaller than what you would give an adult or older child, as infants have smaller lungs.
5. After giving each breath, remove your mouth and allow the infant's chest to fall naturally. This will help to expel the air.
6. Continue giving breaths at a rate of one breath every 3-5 seconds, or approximately 12-20 breaths per minute.
7. Monitor the infant's condition and adjust your technique as needed. If the chest is not rising, reposition the infant's head and try again. By using this technique, you can still provide effective rescue breaths to an infant even if you cannot create a completely airtight seal over their mouth and nose.
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