Answer:
It could be construed as assault.
Explanation:
So according to nursing practice, an assault is basically threatening to do bodily harm to a patient and it is usually not supported by any lawful justification, which can result in the offence being punishable by the state law. Another example to further define assault would be, when walking past someone and intentionally bumping into them. This can be interpreted as assault. I hope this helps.
The mother of a 10-year-old boy with diabetes type 1 calls, very concerned about her son. He has been sick for 2 days with a fever and loss of appetite, and he now is very lethargic and is vomiting, and his breath smells fruity. What health emergency may be developing?
Answer:
Diabetic coma.
Explanation:
Diabetic coma is a very dangerous medical emergency that occurs to people diagnosed with diabetes as a consequence of either high blood sugar (hyperglycemia) or low blood sugar (hypoglycemia). It leads to unconsciousness and without adequate treatment can end in one's death.
In this scenario, the little boy is experiencing all the symptoms of hypoglycemia.
After a motor vehicle crash, a client who sustained multiple injuries is oriented to person and place but is confused as to time. The client complains of a headache and drowsiness, but assessment reveals that the pupils are equal and reactive. Which nursing action takes priority?
Answer:
The given question is not complete as it lack the proper option Which are as follow-
a. Moving the client as little as possible
b. Preparing the client for mannitol administration
c. Stimulating the client to maintain responsiveness
d. Monitoring the client for increasing intracranial pressure - is correct answer.
Explanation:
According the symptoms that is shown by the client mentioned in the question which are, - losing sense of time, nausea, drowsiness and headache. These symptoms are suggested that an individual client is having increased intracranial pressure.
The intracranial pressure is the pressure that is present inside the brain. As it is the pressure that is present in cerebrospinal fluid and brain tissue.
Thus, the correct answer is - option d.
Vanessa is a new mom who is experiencing many of the pressures of having a new baby. She has always been thin and was alarmed by the weight she gained during pregnancy. In order to take the weight off, she went on a crash diet and now weighs less than she did before pregnancy. She was inspired by this weight loss and has continued to restrict her calories. She is now at 80% of her expected body weight and has expressed to her husband that she is still too fat. She avoids eating with other people and tries to eat less than 500 kilocalories per day. What eating disorder does Vanessa have?
Answer:
Anorexia nervosa
Explanation:
Anorexia nervosa is an eating disorder that affects people from all social situations, age or gender.
In this case we can easily identify Vanessa is facing it because she does not have the ideal weight according to her height, the self image of her body is distorted and she considers she is still fat and she is restricting the amount of kilocalories she needs to one that is not healthy.
The ability to perform moderate to vigorous physical activities on a regular basis and to complete daily tasks without undue fatigue demonstratesa) weight-loss success.b) physical activity.c) endurance exercise.d) physical fitness.
Answer:
d) Physical fitness.
Explanation:
The ability to perform moderate activity demonstrates physical activity. The ability to perform moderate to vigorous physical activities demonstrates endurance exercise. The ability to perform moderate to vigorous physical activities regularly and to complete daily tasks without undue fatigue demonstrates physical fitness.
Shelly, a breastfeeding mom, is obtaining the equivalent of 8 cups of water per day from foods and beverages and feels that she is drinking enough water. How many more cups of fluid should Shelly really be consuming per day?
a. 2
b. 3
c. 4
d. 5
Answer:
d. 5
Explanation:
Being hydrated can help produce breast milk and also improve Shelly's health.
Final answer:
Breastfeeding mom Shelly should consume 3 more cups of fluid per day in addition to the 8 cups she is already obtaining from food and beverages, to meet the Institute of Medicine's Adequate Intake recommendation.
Explanation:
According to the Food and Nutrition Board of the Institute of Medicine (IOM), the Adequate Intake (AI) for water for adult females is 2.7 liters (11 cups), inclusive of all dietary sources of water. Breastfeeding mothers typically need to consume more water than the recommended amount for adult females due to the additional demand of milk production. Considering Shelly is already obtaining the equivalent of 8 cups of water from foods and beverages, she should increase her fluid intake to meet the AI. If we subtract the 8 cups she is already consuming from the 11 cups recommended, we find that Shelly should be consuming 3 more cups of fluid per day to reach the AI recommendation for water intake. Option b is correct .
Reductions in stress, increases in focus and concentration, enhanced academic performance, and increases in vitality have all been positively related to the presence of nature. A. True.B. False
Answer:
True
Explanation:
Nature has always had a very positive effect in human being, it is something deeply wired in our brain that makes us have that feeling of peace and relaxation when in contact with nature, activities such as walking in the woods or by the beach, sitting on the grass, or simply hug a tree have been proven to have beneficial effects in our mental health and a reduce in anxiety and stress.
The Davises were excited about their newborn twin boys and couldn’t wait to take them to see Mr. Davis’s father. Grandfather Davis was excited to see his first grandsons as well and thought their visit might help take his mind off the pain of his shingles, which had suddenly appeared only days before. Which virus is responsible for Grandfather Davis’s shingles?
Answer:
Varicella-zoster virus
Explanation:
This type of virus is the one that is responsible for getting chickenpox, which are also called varicella and shingles. There is a big possibility that grandpa Davis had chicken pox when he was a little boy, maybe a teen, but the virus never left the body. On the contrary, it's hidden in the nerve tissue. The virus remains passive through one's life, but sometimes, it wakes up and reaches the nerve fibers and as a result an individual gets shingles.
Low alveolar po2 can be caused by one of two mechanisms. One of them is that the inspired air has low oxygen content. What is the other reason?
Answer:
Hypoventilation
Explanation:
The prefix hypo means below, or less than normal. Hypoventilation is the other reason that can cause low alveolar po2. When this situation happens it means that the amount of ventilation is not the adequate to perform the correct gas exchange.This condition is considered a medical emergency and it is necessary to act immediately.As discussed in lecture, the blink response of individuals diagnosed as psychopaths has been measured on IAPS images rated as pleasant, neutral or unpleasant. The researchers found that, compared to normal subjects, psychopaths….
Answer:
Psychopaths have a blink response to unpleasant IAPS images that resemble their blink response to pleasant images.
Explanation:
Psychopaths, particularly those with antisocial personality disorder, show unique neurophysiological responses to emotional stimuli, rewards, and punishments, including impaired perception towards high-magnitude rewards, lower fear responses to environmental cues, and reduced activity of the autonomic nervous system as measured by skin conductance during fear or anxiety-provoking situations.
Explanation:Based on the provided research information, individuals diagnosed as psychopaths exhibited a differential response pattern compared to normal individuals when exposed to IAPS images rated as pleasant, neutral, or unpleasant. This corresponds to findings where psychopaths, particularly those with antisocial personality disorder, showed impaired perception towards high-magnitude rewards and a lack of typical fear response to environmental cues signaling punishment or pain.
Moreover, they demonstrated lower skin conductance, a measure of autonomic nervous system activity, during situations intended to elicit fear or anxiety. Interestingly, these individuals also seem to lack a moral compass, acting as though they neither comprehend nor care about right versus wrong.
Therefore, it can be concluded that psychopaths respond differently at a neurophysiological level to emotional stimuli, rewards, and punishments, and their disorder is evident not just in their actions, but also in their physiological responses and cognition.
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To begin the administration of total parenteral nutrition (TPN), a client has a right subclavian central venous access device inserted. Immediately after insertion of the catheter, what is the priority nursing action?
1. Obtain a chest x-ray to determine placement.
2. Auscultate the lungs to evaluate breath sounds.
3. Draw a blood sample to assess blood glucose level.
4. Assess the right upper extremity for neurologic deficits."
The priority nursing action after inserting a right subclavian central venous access device is to obtain a chest x-ray to determine placement.
Explanation:The priority nursing action immediately after insertion of a right subclavian central venous access device is to obtain a chest x-ray to determine placement. This is important because it ensures that the catheter is properly positioned in the subclavian vein and not causing any complications. Auscultating the lungs, drawing a blood sample to assess blood glucose level, and assessing the right upper extremity for neurologic deficits are important nursing actions but not the immediate priority after the insertion of the catheter.
The nurse has completed medication education with the patient who is receiving risperidone (Risperdal). The nurse evaluates that the education has been effective when the patient makes which statement?
Answer and Explanation:
Risperidone is a potent atypical antipsychotic drug. It is a selective monoaminergic antagonist with unique properties. It has high affinity for 5-HT2 serotoninergic and D2 dopaminergic receptors. Risperidone also binds to alpha-1 receptors adrenergic and, with lower affinity, histamine H1 and alpha2 adrenergic receptors. Risperidone does not have affinity for cholinergic receptors. Although risperidone is a potent D2 antagonist, this is considered responsible for improving the positive symptoms of schizophrenia, its depressant effect on motor and catalepsy inducer is less potent than classical neuroleptics.
It is most often used in the treatment of delusional psychoses, including schizophrenia. However, risperidone, like other atypical antipsychotics, is also used to treat some forms of bipolar disorder, depressive psychosis, obsessive compulsive disorder, and Tourette's syndrome. In the United States, it has also been approved for the treatment of irritability in children and adolescents (although is not recommended for the treatment of autism spectrum disorders and milder forms of autism due to its effects).
How is the family of a person with down syndrome affected
Answer:
the family grows stronger and closer together as a result of the experience of dealing with someone with a disability and they become more focused on the things that really matter in life
Bacterial encephalitis and meningitis are difficult to treat because Group of answer choices the infections move along peripheral nerves. antibiotics damage nervous tissue. many antibiotics cannot penetrate the blood-brain barrier. it is very difficult to determine the causative microbe. no medications exist for treatment of these infections.
Answer:
The correct answer will be option-many antibiotics cannot penetrate the blood-brain barrier
Explanation:
Meninges is the membrane which surrounds the spinal cord and the brain and the infection of the meninges is thus called meningitis and Encephalitis is the inflammation of the brain. These two diseases are caused by the micro-organism which could be viruses, bacteria or fungus.
The treatment of the disease is difficult sometimes as the entry of the drug into the brain through the cellular membrane of the capillaries is inhibited like in the case of penicillin which is polar and finds difficult to cross the membrane.
Thus, the selected option is the correct answer.
Encephalitis and meningitis are hard to treat due to the blood-brain barrier hindering antibiotics, and difficulty in identifying the causative bacteria. Movement along peripheral nerves and damage caused by antibiotics are generally not significant factors.
Explanation:Bacterial encephalitis and meningitis are indeed difficult to treat, primarily because many antibiotics cannot penetrate the blood-brain barrier. This barrier serves as a protective layer to prevent harmful substances from reaching the brain, but it also blocks many of the antibiotics that could be used to treat infections. While some antibiotics can pass this barrier, those that do are typically less effective against the specific bacteria causing the illness.
Identifying the causative microbe can also pose a challenge, as different bacteria require different treatment approaches, and incorrect treatment can lead to complications. Lastly, the infections moving along peripheral nerves is not a significant factor in the difficulty of treatment, and while antibiotics could theoretically harm nervous tissue, they are generally considered safe for use.
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Maaz is experiencing anxiety about his upcoming football tryout. In an effort to retain his sense of worthiness, in case he is cut from the team roster, he tells everyone on the way to the tryout that he is feeling ill. This is an example of:
Answer:
Self-handicapping.
Explanation:
Self-handicapping may be defined as a type of cognitive strategy by which the individual prevents the self esteem. This strategy was first explained by Edward E. Jones.
The individual in this strategy avoid the efforts and keep hopes for the potential failure and hurting from the self esteem. The individual thinks that self handicaps are the obstacles claimed by himself and anticipation of failing performance. Here, Mazz can be used as an example of self-handicapping.
Thus, the answer is self-handicapping.
Answer: B. self-handicapping
Explanation:
Self-handicapping can be defined as a strategy in which a person tries to avoid effort while assuming that all the efforts will be worthless. Such a strategy can lead to potential failure in self-esteem. Self-handicapping can engage a person in behaviors that restricts once success. A person makes excuses for not trying to achieve success.
The given situation is an example of self-handicapping. This is because here Maaz is making excuse for being ill if he will not be selected for the team sport.
Having a collision with a larger animal could result in serious injuries to the vehicle’s occupants and damage to your vehicle, but could be the safest option as the alternative could involve hitting another vehicle with the result significantly worse.a. True.b. False
Answer:
a. True
Explanation:
If you ever happen to get into this situation on the road, it is by all means safer to collide with an animal than to hit another vehicle. Drivers are advised to keep their hands tight on the wheel in order not to lose control.
On the other hand if you try to avoid this and hit a vehicle, the result would be much worse. A motor vehicle can cause greater damage since there could be fire and other possible consequences causing worse injuries (by glass and other heavy and dangerous materials) than hitting an animal.
A client is concerned about a dark skin lesion on her anterolateral abdomen. The lesion has not changed, nor is there any discharge or bleeding. On examination, there is a medium brown circular lesion on the anterolateral wall of the abdomen. It is soft, has regular borders, is evenly pigmented, and is about 7 mm in diameter. What is this lesion?
Answer:
It is a supernumerary nipple.
Explanation: A supernumerary nipple is one or more extra nipples in addition to the two that everyone has. It is a birth defect that does not have any risk. A supernumerary nipple is smaller than the normal ones and it can be located in the abdomen, near the armpit, down the chest or near the groin.
The nurse is caring for an elderly patient who has diarrhea, and the nurse suspects that the patient has a biomedical perspective of illness. Which statement by the patient helped the nurse to reach this conclusion?1. "I will recover if I drink hot beverages."2. "I will feel better after meeting with a mambo."3. "I am sick because of unhygienic surroundings."4. "I am sick because of supernatural forces surrounding me."
Answer: 3. "I am sick because of unhygienic surroundings."
Explanation:
"Biomedical theory postulates that microorganisms are responsible for specific disease conditions. Therefore, the patient's statement that unhygienic surroundings are responsible for the illness supports the nurse's conclusion. "
Kaylee is so afraid of spiders and insects that she avoids most outdoor activities and even refuses to go to the basement of her own house alone. Kaylee appears to suffer from a(n):
Answer:
Entomophobia
Explanation:
I'm not sure if this question is asking for what phobia this is but Kaylee's extreme fear of spiders and insects is called entomophobia. Which is the fear of spiders and insects. Phobia's like these can really impact the person's ability to do certain things. Which in Kaylee's case it is to go outside or in the basement.
Match The Following
1. used by the body to synthesize Vitamin D
2. fats that can increase the amount of "bad" cholesterol in the blood
3. nutrient that Vitamins A, D, E, and K are dependent upon for their absorption by cells
4. one factor that can be changed in order to lower your body fat
5. body type that is tall and thin
6. body type that is normal height and well-built
7. good source of carbohydrates and Vitamin B complex
8. the body type that is short and overweight
9. the conversion of nutrients into energy
cholesterol
endomorph
mesomorph
exercise
saturated
grain
ectomorph
fat
catabolism
Answer:
(1)used by the body to synthesize Vitamin D= Cholesterol
(2)fats that can increase the amount of "bad" cholesterol in the blood= Saturated
(3)nutrient that Vitamins A, D, E, and K are dependent upon for their absorption by cells= fat
(4) one factor that can be changed in order to lower your body fat= exercise
(5) body type that is tall and thin= ectomorph
(6) body type that is normal height and well-built= mesomorph
(7) good source of carbohydrates and Vitamin B complex= grain
(8) the body type that is short and overweight= endomorph
(9)the conversion of nutrients into energy=catabolism.
This response matches various health terms to their definitions, covering topics like nutrition, body types, and biochemical processes.
Explanation:1. The nutrient used by the body to synthesize Vitamin D is cholesterol.
2. The type of fats that can increase the amount of 'bad' cholesterol in the blood are saturated fats.
3. Vitamins A, D, E, and K are dependent upon fat for their absorption by cells.
4. One factor that can be changed in order to lower your body fat is exercise.
5. The body type that is tall and thin is known as the ectomorph body type.
6. The body type that is of normal height and well-built is known as the mesomorph body type.
7. A good source of carbohydrates and Vitamin B complex is grain.
8. The body type that is short and overweight is known as the endomorph body type.
9. The conversion of nutrients into energy is termed as catabolism.
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Which statement about typical nursing home residents is false?
a.The majority have Alzheimer's disease.
b.They usually have basic ADL problems.
c.They are often wealthy.
d.They are old-old women.
Answer:
C. they are often wealthy
Explanation:
nursing homes, also called care homes, rest homes, convalescent home, convalescent care, is a facility provided for the sole purpose of caring for the people who do need to be the in the hospital and cannot be taken care of at home. it is usually equipped with the required personnel such as a nursing home administrator or an executive director. basically a number of care are provided and this includes but not limited to speech therapy, physical therapy and occupational therapy.
"A 13-year-old adolescent is seen in the office and appears very anxious. For the past 2 weeks, the adolsecent has had some muscle twitching; upon examination, the client is found to have a positive Chvostek's sign. Which would be an appropriate explanation of Chvostek's sign?"
•Pain can be caused by touching the muscles.Correct response:
•Chvostek's sign is a facial muscle spasm demonstrated by tapping the facial nerve.
Answer:
the second option
Explanation:
Chvostek's sign is a clinical sign of neuromuscular irritability often associated with low blood calcium levels. It can induce a facial muscle spasm when the facial nerve is tapped, and can suggest latent muscle twitching.
Explanation:Chvostek's sign is a clinical sign that is indicative of neuromuscular irritability, and is specifically associated with conditions causing hypocalcemia, or low calcium levels in the blood. This sign is provoked by tapping on the facial nerve, usually where it crosses the zygomatic arch, just in front of the ear. If it's positive, it will elicit a contraction or spasm of the facial muscles. The presence of Chvostek's sign often suggests a latent tetany (muscle twitching), which could explain the muscle twitching that the 13-year-old adolescent has been experiencing for the last 2 weeks.
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Sean, a junior in college, has difficulty making decisions and when he finally makes a decision he worries about whether it was the right decision. He constantly worries about his courses, future, girlfriend, and getting a summer job. Recently Sean has had heart palpitations and muscular tension. Sean's symptoms are MOST consistent with___________.a. generalized anxiety disorderb. posttraumatic stress disorderc. obsessive-compulsive disorded. bipolar disorder
Answer:
Bipolar Disorder
Explanation:
Anxiety includes related illnesses and can suffer from 'mood swings'.
Sean's symptoms are most consistent with generalized anxiety disorder. The correct option is a.
What is anxiety disorder?Anxiety disorder is a mental disorder in which a person worries or gets tensed about small things. This causes his behavior restless, he doesn't feel any happiness.
Sean is always in worry about his future and relation, this causes difficulty with concentration.
Thus, the correct option is a. generalized anxiety disorder.
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You have voluntary control over the function of _____.
a. cardiac muscle.
b. simple squamous.
c. epithelium
d. smooth muscle.
e. skeletal muscle.
Answer:
skeletal muscle.
Explanation:
All of the following are in the top ten principles of safety except________.
A. fully investigate product safety incidents
B. encourage customers to try out the product before purchasing it.
C. report product safety defects promptly.
D. track your product's safety performance.
Answer:
The correct answer is option B
B. encourage customers to try out the product before purchasing it.
Explanation:
I believe the safety and satisfaction of the customers is the priority in business so it will put the customer's life at risk to ask them to try out the product before purchasing it. What if there is a defect in the product which could be harmful to the customers?. To I believe that option is not part if the safety principle.
Final answer:
The option that is not one of the top ten principles of safety is 'encourage customers to try out the product before purchasing it', as it relates more to customer satisfaction than safety. So the correct option is B.
Explanation:
The option that is not in the top ten principles of safety is B. encourage customers to try out the product before purchasing it. The principles of product safety generally focus on ensuring that the product is safe to use and that it complies with all relevant safety standards. This includes establishing safety as a formal design parameter, reviewing designs for safety, verifying compliance with government and industry standards, monitoring material substitutions, and implementing tracking methods for product traceability. Additionally, other important safety principles involve investigating incidents, reporting defects promptly, and monitoring the product's safety performance. However, encouraging customers to try out products before purchasing is generally more related to customer satisfaction and marketing rather than being a principle of safety.
A client diagnosed with Polycythemia vera has come into the clinic because they have developed a night-time cough, fatigue, and shortness of breath. What complication would you suspect in this client?
A. Stroke
B. Tissue infarction
C. Congestive heart failure
D. Pulmonary embolus
Answer:
C) Congestive heart failure
Explanation:
Polycythema is a stem cell disorder in bone marrow or slow growing blood cancer in which marrow produces too much Red blood Cell. This blood thickening leads to Heart Failure or congestive heart failure, it's sign and symptoms are cough, fatigue and shortness of breath.
Which of the following roles would require the knowledge of psychological, social, economic, and cultural determinants of behavior and methods to promote healthy lifestyles?
a. public information specialists
b. health educators
c. public health administrators
d. epidemiologists
One explanation for why the healthcare system in the United States resists most attempts at change is __________. This explains how institutions that develop a particular way of working find it very difficult to reverse course.
Answer:
One explanation for why the healthcare system in the United States resists most attempts at change is path dependance. This explains how institutions that develop a particular way of working find it very difficult to reverse course.
Explanation:
Path dependence states that every decision made in the past or any event experienced affects the present and the decisions that an institution has to take. That is the reason why institutions with a particular way of working find it difficult to reverse the course they have developed because they are restricted by the choices that were made in the past.
47. Although Francesca has been obese for as long as she can remember, she is determined to lose excess body weight with a low-calorie diet. When dieting, Francesca is most likely to have difficulty becoming and staying thin because :
Final answer:
Francesca is likely to have difficulty becoming and staying thin due to factors such as inactivity, genetics, metabolism, and the body's set point. Obese people can struggle to lose weight due to their bodies becoming more efficient when caloric intake is reduced.
Explanation:
When dieting, Francesca is most likely to have difficulty becoming and staying thin because of a combination of factors including inactivity, genetics, metabolism, and the body's set point (ideal weight). When a person cuts caloric intake, the body reacts as if it is starving and becomes more efficient, making it harder to lose weight. Obese people may also have difficulty in losing weight because of the adaptation of their bodies to certain weights and the fact that they often consume more calories than they burn.
Francesca is most likely to have difficulty becoming and staying thin because of adaptive thermogenesis.
Adaptive thermogenesis refers to the process by which the body's metabolism slows down in response to a reduction in calorie intake. When Francesca starts a low-calorie diet, her body may respond by decreasing its resting metabolic rate to conserve energy, making it harder to lose weight. This is a natural physiological response that can persist even after weight loss, contributing to the difficulty in maintaining a lower body weight.
Other factors that can make it challenging for individuals like Francesca to lose weight and keep it off include:
1. Hormonal changes: Dieting can lead to changes in hormones that regulate hunger and satiety, such as ghrelin and leptin, which can increase appetite and decrease feelings of fullness.
2. Reduced energy expenditure: As Francesca loses weight, her body requires fewer calories to maintain its new, lower weight, which can make it easy to regain weight if she returns to her previous eating habits.
3. Psychological factors: The psychological stress of dieting, along with the social and emotional challenges associated with changing eating habits, can lead to overeating or abandoning the diet altogether.
4. Genetic predisposition: Genetics play a role in obesity, influencing metabolism, fat storage, and the body's response to food.
5. Lifestyle and environmental factors: Physical inactivity, lack of sleep, and other environmental factors can contribute to obesity and hinder weight loss efforts.
The second neuron's axons extend to the
from the ganglion.
Answer:
The second neuron's axons extend to the autonomic effector from the ganglion.
Explanation:
The second neuron’s axons are also called as the postganglionic neuron. In the autonomic nervous system the neurons have only one axon. Instead of having the multiple axons, the neuron itself branches so there are many neurons with one axon each. The second neuron has the "cell body in the autonomic ganglion" and its axon has the position that starts from the ganglion and extends straight up to the autonomic effector.The second neuron's axons, which extend from the ganglion, serve to transmit nerve signals or impulses to various goal areas. These areas could be muscles, organs, or other neurons, depending on the function of the neuron.
Explanation:The axons of the second neurons often extend from the ganglion to different areas based on the function of the particular neuron. Neurologically speaking, this could be to muscles or organs in the body for motor neurons or to other neurons within the central nervous system in the case of interneurons. The axons serve the purpose of transmitting nerve signals or impulses from the ganglion to the target locations, thus enabling the neural network's functioning.
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A 12-year-old male is brought to his primary care physician. His parents are concerned with his recent decline in school work due to persistent blurred vision. On physical exam, planar xanthomas are noted and laboratory testing reveals extremely low plasma HDL. This presentation would be consistent with a loss of which of the following apoproteins?
A. ApoB 100
B. ApoA
C. ApoB 48
D. ApoE
Answer:
B. ApoA
Explanation:
Apolipoprotein A is a protein carried in HDL ("good") cholesterol. It helps start the process for HDL to remove bad types of cholesterol from your body. In this way, apolipoprotein A can help to lower your risk for cardiovascular disease.
Therefore, loss in ApoA will result in increased "bad" cholesterol since HDL process is not started, this will result in symptoms such as blurred vision