a 58-year-old woman with hypertension and elevated ldl blood levels is complaining that she suddenly is feeling very tired, dizzy, and weak. what would you advise her to do?

Answers

Answer 1

The advice a 58-year-old woman with hypertension and elevated ldl blood levels is complaining that she suddenly is feeling very tired, dizzy, and weak is she might be experiencing a heart attack, so get her to the hospital right away.

When the blood supply to the heart is significantly impeded or blocked, a heart attack happens. The accumulation of fat, cholesterol, and other chemicals in the heart's (coronary) arteries is typically what causes the obstruction. Plaques are the name given to the fatty, cholesterol-containing deposits. Atherosclerosis is the name for the process of plaque accumulation.

A plaque may occasionally rupture and form a clot that restricts blood flow. Part of the heart muscle can be harmed or destroyed by a lack of blood flow.

To know more about heart attack, click here,

brainly.com/question/1373449

#SPJ4


Related Questions

The patient offers the health care worker a little extra money for the care received. The health care worker should: A Accept and say nothingAccept and say nothing B Accept & share with other team membersAccept & share with other team members C Pretend the offer wasn't heardPretend the offer wasn't heard D Refuse courteouslyRefuse courteously

Answers

determine what your hospitals policy on that is. if your hospital has rules aginst it,  dont accept it because its not worth getting fired over. if they dont,  determine how much money it is and dont speak a word of it to ANYONE else.  

You are setting up a sterile tray and have already applied your sterile gloves before you realize you forgot to place the suture package on the tray. You have several options. What are they, and what are the advantages and disadvantages of each?

Answers

You’re a doctor and do not stress out abt this

4. Reforms in the Bismarck system include and are meant to use more health technology assessment strategies lower expenditures all of the choices curtail patient choices curtail hospital choices

Answers

Reforms in the Bismarck system aim to use more health technology assessment strategies. These reforms are intended to lower expenditures and curtail patient and hospital choices.

The Bismarck system refers to a type of healthcare financing and delivery system found in countries like Germany and Japan. Reforms within this system often focus on incorporating health technology assessment (HTA) strategies. HTA involves evaluating the effectiveness, safety, and cost-effectiveness of healthcare technologies, such as medical devices and pharmaceuticals, before they are approved for use. By implementing HTA strategies, policymakers aim to ensure that healthcare resources are allocated efficiently and that unnecessary or ineffective technologies are not adopted, thus reducing overall expenditures. Additionally, curbing patient and hospital choices may be part of the reforms to maintain cost control and standardize care across the system.

Learn more about patient and hospital  here:

https://brainly.com/question/32130726

#SPJ11

You have just been hired in a dental practice where the restorative material of choice is amalgam. The
hiring dentist has commented on how he and the other dentists struggle when placing amalgams because each of the dentists in the practice has his or her own sequence and instrument choice and the dental
assistants can't keep each of their preferences straight. You have been assigned the task of preparing amalgam tray setups that will be placed in each of the operatories. These setups will be used by different dentists and dental assistants. It is important to have all of the trays set up in the same manner for convenience and efficiency. What specialized instruments are used to place an amalgam restoration? WhaT variations of each of the instruments are available? What accessory items should be included to complete an amalgam restoration tray setup?

Answers

The specialized instruments are used to place an amalgam restoration is Amalgam Carrier.

The variations are double ended, single ended with 15, 45 degrees.

The accessory items that  should be included to complete an amalgam restoration tray setup are;

Spoon excavatorGingival margin trimmer. cavity preparation.

What is Amalgam carriers?

Amalgam carriers serves as instruments used to fill dental cavities with amalgam.

According to this question, we are asked about  the restorative materials of choice to use such Amalgam as a dental expert.

As a result of this we can see that this Amalgam comes with different variations and some accessories such as Spoon excavator and Gingival margin trimmer can be used during the process.

Learn more about Amalgam at;

https://brainly.com/question/25605883

Susan knows that there are laws that govern the refilling of diazepam, which is a controlled substance. How do these laws affect Mr. Lehmke?

Answers

Answer:

Schedule 2 pharmaceuticals include diazepam. Because of its addictive nature, this scheduling drug often does not allow refills. Mr. Lehmke may be affected because obtaining medication without a provider's order will be difficult.

Explanation:

Exercising Pearson Physicians Group's medicine refill line is managed by Susan Schultz, CMA (AAMA). Adam Lehmke has asked for a diazepam refill. When she looks over Mr. Lemke's chart, she discovers that Dr. Penningworth wrote a prescription for diazepam three months ago with two refills, and she realizes that Mr. Lemke should still have two weeks of medication left based on the date.

Is this helpful?

__________ supported the claim that diagnosis of mental illnesses is often influenced by context and subjective evaluations.

Answers

Answer: David Rosenhan study

Explanation:

David Rosenhan conducted a study which supported the claim by diagnosing the mental illnesses. This diagnoses is supported by subjective evaluations. He conducted the experiment to judge whether the psychiatric disorders are reliable and valid to help mentally ill patients. The experimenters were provided with hallucinogens and then provided with antipsychotic drugs when were admitted to psychiatric hospital.

Answer:

b on edge

_____________________________

if you are RCA dominant, what does that also supply?

Answers

If you are RCA (right coronary artery) dominant, it means that your right coronary artery supplies the majority of blood flow to your heart. In a person with RCA dominance, the RCA also supplies the posterior descending artery (PDA) and the posterolateral branch (PLB), which are crucial for providing blood to the posterior and lateral walls of the heart.

The PDA is responsible for supplying blood to the interventricular septum and the posterior part of both ventricles. The PLB provides blood flow to the posterolateral part of the left ventricle. RCA dominance is the most common coronary artery distribution pattern, occurring in about 70% of individuals.

In summary, RCA dominance indicates that the right coronary artery plays a major role in supplying blood to the heart, particularly the posterior and lateral regions, by providing blood flow through the posterior descending artery and the posterolateral branch.

For more such questions on right coronary artery, click on:

https://brainly.com/question/30435466

#SPJ11

Which of the following is not a function of the subcutaneous layer of skin ?

Answers

which of the following is NOT A FUNCTION of the subcutaneous layer? lubricates body surfaces.

If a patient becomes dehydrated, the percentage of plasma in a centrifuged sample of his or her blood would likely.

Answers

Answer:

If a patient becomes dehydrated, the percentage of plasma in a centrifuged sample of his or her blood would likely decrease. This is because dehydration causes a decrease in fluid volume in the body, which can lead to an increase in the concentration of red blood cells and other formed elements in the blood. As a result, the percentage of plasma in the blood would decrease, while the percentage of formed elements would increase.

Why do you think parasites are a public health concern? How can humans reduce this danger?

Answers

Answer:

yes

Explanation:

because they will craw inside of you and kill you

they’re definitely a big public health concern especially considering the fact that you can’t see them and they can harm animals as well. the danger can be reduced through necessary vaccines

Select the correct answer. A herniated disc can occur when the _____ ruptures. A. Intervertebral disc B. Vertebral column C. Lordotic curve D. Osteomalacia

Answers

Answer:

C. Lordotic curve.

Explanation:

Lordosis can occur in both the lower back and neck. Some may experience an accident or injury that can cause the disc to rupture.

Answer:

A.

Explanation:

According to Vaughn, any research conducted on human beings needs to adhere to the following three moral principles: autonomy, beneficence, and __
O nonmaleficence O mercy O personhood O justice

Answers

The three moral principles that Vaughn identifies as important in any research conducted on human beings are autonomy, beneficence, and nonmaleficence. The correct answer is nonmaleficence.

Autonomy refers to the principle of respecting an individual's right to make their own decisions and choices regarding their participation in research. This includes obtaining informed consent from participants, and ensuring that they have the ability to freely and voluntarily consent to or refuse participation in research.

Beneficence refers to the principle of acting in the best interest of the research participant, by maximizing potential benefits and minimizing potential harms. This includes designing studies that are scientifically valid and likely to produce important results, as well as ensuring that the risks of harm to participants are minimized.

Nonmaleficence refers to the principle of avoiding harm to research participants. This includes minimizing risks of physical, psychological, or social harm, and ensuring that the benefits of research outweigh any potential risks.

For more such questions on autonomy

https://brainly.com/question/30389583

#SPJ11

According to Vaughn, any research conducted on human beings needs to adhere to the following three moral principles: autonomy, beneficence, and nonmaleficence.

These principles are often referred to as the "principles of biomedical ethics" and are widely recognized as essential in guiding ethical research practices. Autonomy refers to respecting individuals' rights to make their own decisions and to give informed consent. Beneficence refers to the obligation to maximize benefits and minimize harm to research subjects.

Nonmaleficence refers to the obligation to not intentionally cause harm to research subjects. In addition to these three principles, some scholars also argue that justice should also be considered when conducting research on human beings. Justice refers to ensuring that the benefits and burdens of research are distributed fairly among all participants. By following these principles, researchers can ensure that their research is conducted in an ethical manner and that the rights and welfare of participants are protected.

To know more about research practice

https://brainly.com/question/2900188

#SPJ11

Finish
Which of the following guests should be cared for by providing supplemental oxygen using a
non-rebreather mask?
19
Select one:
11
A guest who is dehydrated, suffering from a bad sun burn
A guest who may be having an asthma attack, with a pulse ox reading of 98%
A guest with a pulse, but not breathing normally
O A guest with labored breathing and a pulse ox reading of 89%
Clear my choice

Answers

Answer: A guest with labored breathing and a pulse ox reading of 89%.

Explanation:

A non-rebreather mask refers to a device that's used in delivering oxygen therapy. They re used in case of emergency situations to deliver high oxygen concentrations.

We should note that a pulse oximeter readings that range between 94% to 99% shows a normal oxygen saturation, while a reading below 90% indicates low blood oxygen.

Therefore, the guests should be cared for by providing supplemental oxygen using a non-rebreather mask is a guest with labored breathing and a pulse ox reading of 89%.

an informatics nurse is discussing the implementation of a new documentation system with a group of staff nurses who are using the system. which response by the group would indicate to the nurse that the system's usability is effective? select all that apply.

Answers

The response that indicates to the nurse that the system's usability is effective is using the system is highly intuitive, We've noticed that this system really helps to save us valuable time, and fits into how we work.

The correct answer are option(a),(d), and (e).

Informatics nurse gives care teams the best chance for effective care delivery by disseminating knowledge about new workflows, assisting with the deployment of new technology and procedures, and evaluating the quality of data. One of the main responsibilities of an informatics nurse is to examine a wide range of data to identify solutions that will assist nurses to deliver higher-quality care.

The analysis of patient data, which can originate from a variety of sources and modalities, including electronic health records, the results of diagnostic tests, and medical scans, is the goal of the science and engineering field known as health informatics.

To know more about informatics nurse refer to: https://brainly.com/question/26543511

#SPJ4

The question was incomplete. Check below the complete question.

An informatics nurse is discussing the implementation of a new documentation system with a group of staff nurses who are using the system. Which response by the group would indicate to the nurse that the system's usability is effective? Select all that apply.

a. "Using the system is highly intuitive."

b. "This system makes it challenging to complete tasks."

c. "The screen has a lot of confusing information on it."

d. "We've noticed that this system really helps to save us valuable time."

e. "This system fits nicely into how we work."

what should be lewis's immediate concern and action on hearing the emergency tornado warning announcement?

Answers

concern: keeping himself safe from the tornado
action: staying indoors or evacuating, depending on what the local gov recommends, staying low to the ground and waiting out the storm

Why is it good for scientists to share information from their investigation

Answers

Answer: See below.

Explanation:

The reason why it is good for scientists to share information because when a scientist publishes a result such as in research projects or in peer-reviewed journals, it enables the scientific and medical community to evaluate on the findings and also provides instructions for other researchers to do the same thing in order to experiment and verify the results from the former.

Hat modifier is used for medically-directed crna services?

Answers

no.

This is because no is the correct explanation of no.

a person has recently started experiencing memory problems, difficulty in making facial expressions, and trouble with emotional expression. the person has also started hearing imaginary voices and having delusions. based on this information, which of the following diagnoses is a doctor most likely to make?

Answers

The patient is likely to be suffering from schizophrenia

Delusions (false beliefs), hallucinations (observing or hearing things that are not there), strange bodily behaviour, and disorganised thinking and speech are typical symptoms of schizophrenia.  One is that those who have the disorder frequently aren't aware they are ill and believe their hallucinations to be true and are therefore unlikely to seek medical attention. Another problem is that a lot of the prodrome, or changes that precede schizophrenia, can resemble other typical life changes.

To learn more about schizophrenia click here:

https://brainly.com/question/3471929

#SPJ4

3
When handling and packaging a bullet from a crime scene, investigators must be careful to preserve any trace evidence that might be present, such as paint or fibers,
True or false

Answers

Answer:

True

Explanation:

Because you need all the evidence you need to find what was the cause of the crime scene and how could you detained it from anymore victims and suspects .

True because they need every set of evidence to trace back to someone

Cual ha sido el impacto de la ciencia y las tecnologias para curar el cancer de mama y otras emfermedades del sistema endocrino

Answers

Answer:

el desarrollo de terapias hormonales ha permitido enlentecer y/o detener el crecimiento de tumores, incluyendo tumores en tejidos mamarios

Explanation:

La terapia hormonal, también conocida como terapia endócrina, es un tratamiento utilizado enlentecer y/o detener el crecimiento de células y tejidos defectuosos. La terapia hormonal se divide en dos (2) clases de acuerdo a su modo de acción en el cuerpo: 1-terapias con el objetivo de bloquear la capacidad del cuerpo para producir hormonas y 2-terapias que bloquean la función normal de las hormonas en el cuerpo. La terapia hormonal permite controlar el desarrollo de células cancerosas que se dividen formando tumores y aquellas que se desprenden del tumor para viajar a través del cuerpo formando nuevos tumores, es decir, produciendo metástasis. En cáncer de mama, la terapia hormonal posee múltiples beneficios: 1-reduce el riesgo de formación de tumores en otro tejidos mamarios, 2-previene la reaparición de células tumorales, 3-detiene el crecimiento de células tumorales y 4-reduce el tamaño de tumores previamente a la realización de una cirugía, haciendo más fácil la tarea de extirparlo. Por otra parte, diferentes metodologías desarrolladas con el objetivo de matar células tumorales mamarias también incluyen la quimioterapia, la cual usa drogas para reducir el número de células cancerosas, y la radioterapia, que consiste en el uso de altas dosis de radiación para destruir las células tumorales.

the obstetrical nurse is caring for a client who is three hours postpartum. the client tells the nurse that nearly a dozen family members will be soon arriving to visit her and her infant. the client assures the nurse that this is the norm in her culture. what is the nurse's best action?

Answers

It is also important for the nurse to make sure that the mother is at ease and can interact with her family members during this special time.

The obstetrical nurse's best action in response to a client who has informed her that nearly a dozen family members will soon be arriving to visit her and her infant would be to allow them access, with the agreement of the client, but ensure that only those persons who are necessary for the patient's emotional and physical well-being are present in the room. The nurse should assess the client's cultural background and values to better understand the client's request. This entails determining if the patient has a special medical requirement and if the family members can meet them. It's also essential to determine if the family members are healthy and if they're at risk of passing on any communicable illness to the baby. The obstetrical nurse should give a clear statement regarding the patients and their families' visiting guidelines. She should clarify the hours during which visitors are allowed and the number of guests permitted in the patient's room at any one moment. It is also important for the nurse to make sure that the mother is at ease and can interact with her family members during this special time.

To know more about nurse visit:

https://brainly.com/question/14555445

#SPJ11

Cynthia begins the medication administration process. Which safety protocol should take place before the medications are removed from the package? Select all that apply.
a. Confirm the medication label with the medication administration record (MAR).
b. Check the client's allergies.
c. Check the expiration date of the medication.
d. Confirm the correct dose.
e. Verbally check the client's identifier.

Answers

Before the medications are removed from the package, the safety protocol that should take place includes confirming the medication label with the medication administration record (MAR),

checking the client's allergies, checking the expiration date of the medication, confirming the correct dose, and verbally checking the client's identifier. Thus, options (a), (b), (c), (d), and (e) are the correct answer options.

The administration of medication involves preparing and providing medications that have been ordered by a licensed practitioner for a patient to take at home, in a nursing home, or in a hospital. It's an important duty that necessitates strict adherence to safety procedures and rules for the benefit of the patients.

To know more about medication administration record visit:

https://brainly.com/question/31596266

#SPJ11

the term arm in anatomy refers to the region?

Answers

Answer:

The term "arm" in anatomy refers to the region between the shoulder and elbow.

PLZ HELP! WILL GIVE BRAINLIEST!
Why do you think teenagers
use e-cigs/vapes?
list 8 responses

Why do you think teenagers don't use e-cigs/vapes?
list 8 responses

Why do you think adults use ecigs/vapes?
list 8 responses

Answers

I think vapes drugs

the nurse in the emergency department is preparing to instill fluorescein into the eye of a client with the complaint of eye pain. fluorescein dye is used to detect which conditions? select all that apply.

Answers

Foreign object, abrasion to the cornea. A water-soluble pigment called fluorescein creates a vivid shade of green.

What about fluorescein dye?This substance is used on the eye's surface to identify lesions of the corneal epithelium; intact corneal regions remain colorless, whereas abrasions and other flaws tint the cornea brilliant green. Additionally, the color will gather around an unnatural object.Several ocular procedures, such as checking for any corneal or vascular abnormalities, use fluorescein as a diagnostic contrast agent. Fluorescein can also be used to bioimage entire anatomical structures, and in immunohistological labeling, it can even be used to image individual cellular components.A xanthene dye with intense fluorescence that can be seen even in trace amounts is fluorescein (lactone). used in microscopy, analytical chemistry as an indicator in silver nitrate titrations, and forensics to find blood traces. It serves as a fluorescent dye as well as a radioopaque medium.

Learn more about fluorescein dye here:

https://brainly.com/question/15183395

#SPJ4

34. Which is NOT a hazard of immobility?
a. Pneumonia
b. Diabetes
c. Contractures
d. Bed sore

Answers

Answer: C. contractures

crushing disease is manifestated by the excessive secretion of corticisteroids. Which hormones Involve are?​

Answers

Answer:When adrenal glands produce excessive amounts of certain hormones, they ... An overproduction of corticosteroids can lead to Cushing's syndrome (see below). ... Treatment of overactive adrenal glands depends on the cause of the disease manifestated ‎Involve Explanation:

Answer: Adrenal gland endocrine system

Explanation:

Signals from the pituitary gland stimulate the adrenal glands' production of cortisol. Cortisol levels are sensed by the pituitary gland. Excess levels of the hormone cortisol are responsible for Cushing syndrome.

according to the national asthma education and prevention program (naepp) expert panel guidelines, a client prescribed a short-acting beta2 agonist may take this medication how often during an acute exacerbation of asthmatic symptoms?

Answers

The National Asthma Education and Prevention Program (NAEPP) Expert Panel Guidelines recommend that a client prescribed a short-acting beta2 agonist may take this medication every 4 to 6 hours during an acute exacerbation of asthmatic symptoms.

Short-acting beta2 agonists are commonly used to provide quick relief of asthma symptoms by relaxing the airway smooth muscles and improving breathing.

However, it is important to note that the frequency and dosage of medication should be individualized based on the patient's needs and response to treatment.

Patients should be instructed to use the medication as directed by their healthcare provider and seek medical attention if their symptoms do not improve or worsen despite medication use. Regular follow-up with healthcare providers is also important to monitor and adjust the treatment plan as needed.

Know more about asthmatic here

https://brainly.com/question/31819534#

#SPJ11

what is the common name for Proctalgia Fugax?

what is the common name for Proctalgia Fugax?

Answers

Proctalgia fugax, or levator spasm syndrome: more common in men than women. Symptoms: searing pain near coccyx or rectum that is brief but intense; usually resolves on its own; awakes patient from sleep but may occur anytime.

A nurse is teaching a postpartum client and her partner about caring for their newborn's umbilical cord site. Which statement by the parents indicates a need for additional teaching

Answers

The statement "The cord stump should change from brown to yellow" by the parents indicates a need for additional teaching. Thus, the correct option is A.

What is Postpartum?

Postpartum may be defined as the immediate period after the birth of a child or newborn.

The options under this question are given below:

The cord stump should change from brown to yellow. Exposing the stump to the air helps it to dry. We can put him in the tub to bathe him once the cord falls off and is healed. We need to call the primary care provider if we notice a funny odor.

Therefore, the correct option for this question is A.

To learn more about Postpartum, refer to the link:

https://brainly.com/question/6348731

#SPJ1

Other Questions
a child is prescribed gentamycin and develops acute kidney injury. which etiology is the most likely cause of the childs acute kidney injury all plant cells have a ____________ made up of noncellulose and cellulose fibrils that allow for both flexibility and strength. PLS HELP I WILL EVEN BRAINLY (even tho I need two answers for that) I WILL EVEN BE UR FRIEND PLSSS HELPPPP!!!!What are all the factors of the number 33. 1, 3, 14, and 33 1, 6, and 33 1, 3, 11, and 33 1, 2, 16, and 33?! Pleasee help me on my bellwork!!!! i will mark you BRAINLIEST!!! I might give brainliest, please help down below. A standard die is rolled. Find the probability that the number rolled is less than 2 The area of a rectangle is equal to its length times its width. If the area of a rectangle is 4x +20 which options could be the length and width of that rectangle "But whereas -- after an injunction had been judicially intimatedby this Holy Office, to the effect that I must altogether abandon the falseopinion that the sun is the center of the world and immovable, and thatthe earth is not the center of the world, and moves, andthat I must nothold, defend, or teach in any way whatsoever, verbally or in writing, thesaid false doctrine, and after it had been notified tome that the saiddoctrine was contrary to Holy Scripture." (1633]2.Who made this statement?A) CopernicusB) Newton0) GalileoD) Kepler Question 1A. There different contemporary approach on Information System. Explain the difference between the technical approach and approach and the technical approach and the behavioural approach.B. Explain the concept of Business Process Reengineering (BPR) and state TWO (2) steps in effective BPR.C. Micheal Porter mentioned that there are five competitive forces that shape the fate of a firm. State what these FIVE (5) completive forces are and show how EACH can be used to shape the fate of a firm. Can we always see the same amount of the illuminated side of the Moon from Earth? Explain. Thanks so much for everyone's help! :) whats is 1+1 *i cant figure it out * Select the correct answer from each drop-down menu. Read the excerpt from "Thoughts on the Works of Providence" by Phillis Wheatley and complete the sentence that follows. Arise, my soul, on wings enraptur'd, rise To praise the monarch of the earth and skies, Whose goodness and beneficence appear As round its centre moves the rolling year, Or when the morning glows with rosy charms, Or the sun slumbers in the ocean's arms: Of light divine be a rich portion lent To guide my soul, and favour my intent. The excerpt has the characteristics of a poem, including its usage of and its style of language. word count 1000Question 2 Why did UK productivity growth slow in the period after the global financial crisis and in what ways did this lead to the failure of the 2010 austerity plan? Which angles measure is equal to the sum of the measures of BAC and BCA?CBACBEDACBCF Side PanelExpand side panel Week 3 Discussion For each of the following situations, the market system has failed and/or just will not allocate resources efficiently: Situation 1: Firm A produces cement sifters. The process includes the melting of metals and chemicals which give the sifters strength. In the production process, waste is produced and released into the river that runs alongside of the plant. Situation 2: Some states allow students to attend certain universities within the state tuition free if they are a resident of that state. As a result of this policy, the states population is more educated and more productive in the workplace than many other states. Situation 3: You live in a small subdivision with several residents. The subdivision has one short dirt road that provides access to all the homes. Bob, one of the residents of the subdivision, just inherited a large sum of money and decides to have the road in the subdivision paved. After the paving, Bob asked the other residents to pay their fair share of the costs for the paving, but they all refused. Situation 4: The President of the United States has determined that the cost associated with national defense has become too expensive. In an effort to reduce costs and balance the budget, the President has asked the public to voluntarily pay for their fair share of the costs associated with national defense. One of his advisors insists that this would not work, another advisor thinks its good policy. Which advisor is correct? Deliverables: Using the scenarios above, prepare a 2-3 page Microsoft Word document that addresses 2 of the above scenarios and meets APA standards. Include a summary section in your report that contains 5-7 bullet points identifying your major findings or conclusions of your paper. A 40-N force acts on an 80-kg object, initially moving at 20 m/s. How far will the object travel in the next five seconds? At a school there are six lessons in a day. In total, the six lessons last for 4 hours.a) Assume that each lesson lasts the same amount of time How many minutes long is the final lesson? 1. How can you help prevent being a target of cyberbullying?2.What can you do if someone you know is cyberbullying others? When you upload, you: A. make multiple analog copies of files, videos, or music. B. take information from your computer and put it on the internet. C. copy information from the internet to your computer's hardware. D. give people online too much information about yourself. FILL THE BLANK. the ___ keyword is often used with the primary key to generate a unique id for each new row in a table.