The nurse presenting a program on safe and effective exercises for older adults with rheumatoid arthritis will focus on activities that promote joint mobility, flexibility, and strength while minimizing pain and inflammation.
Here are some steps the nurse may take:
1. Assessing the participants: The nurse will start by evaluating the participants' physical abilities, medical history, and current condition. This helps tailor the exercise program to meet individual needs and avoid any potential risks or exacerbation of symptoms.
2. Educating about rheumatoid arthritis: The nurse will provide information about rheumatoid arthritis, including its causes, symptoms, and impact on joint health. Understanding the condition will empower participants to make informed decisions and take an active role in managing their condition.
3. Demonstrating range of motion exercises: Range of motion exercises are gentle movements that help maintain joint flexibility. The nurse will demonstrate exercises such as wrist circles, ankle pumps, and shoulder rolls. These exercises can be done daily to reduce stiffness and maintain joint mobility.
4. Introducing low-impact aerobic exercises: Low-impact aerobic exercises, such as walking, swimming, or cycling, help improve cardiovascular health without putting excessive stress on the joints. The nurse may recommend incorporating these exercises into the participants' routine to enhance overall fitness and endurance.
5. Highlighting strengthening exercises: Strengthening exercises target specific muscle groups to support joint stability and reduce the strain on affected joints. The nurse may demonstrate exercises using resistance bands, light weights, or bodyweight, focusing on major muscle groups like the quadriceps, glutes, and upper back.
6. Recommending balance and coordination exercises: Balance and coordination exercises can help improve stability and prevent falls, which are common concerns for older adults with rheumatoid arthritis. The nurse may introduce exercises like heel-to-toe walk, standing on one leg, or using balance boards to enhance proprioception and control.
7. Emphasizing proper technique and modifications: The nurse will stress the importance of using correct technique during exercises to prevent injury. Additionally, they will provide modifications or alternatives for participants with specific limitations or joint restrictions. This ensures that everyone can safely participate and benefit from the program.
8. Offering resources and support: The nurse may provide handouts or online resources that participants can refer to for additional exercises, tips, and information. They may also encourage participants to join support groups or seek further guidance from healthcare professionals, fostering a sense of community and ongoing support.
By following these steps, the nurse can deliver a comprehensive program that addresses the unique needs of older adults with rheumatoid arthritis, promoting safe and effective exercises to improve their overall well-being.
learn more about nurse
https://brainly.com/question/30623211
#SPJ11
A female client who reports recurring headaches, accompanied by increased irritability, photophobia, and fatigue is asked to track the headache symptoms and occurrence on a calendar log. Which is the best nursing rationale for this action
The rationale behind this action are to track the occurrence of the headache and to give a proper diagnosis on the type of headache the female patient has.
What is headache calendar log?The headache calendar log is a type of calendar that is used to monitor the duration, severity and episodes of your headaches over time which can be used to arrive at it's causes and possible diagnosis.
Therefore, the rationale behind this action are:
to track the occurrence of the headache; and to give a proper diagnosis on the type of headache the female patient has.Learn more about headache here:
https://brainly.com/question/2638155
#SPJ4
Knowledge of (blank) helps identify drugs that act in a similar fashion and can be used to treat a similar condition.
1) analgesics
2) drug classes
3) anesthesia
4) antibiotics
Answer:
DRUG CLASSES
Explanation:
Knowledge of drug classes helps in identifying drugs that act in a similar fashion and can be used to treat a similar condition. Thus, the correct option is 2.
What are drug classes?A drug class is a set of medications and compounds which have a similar chemical structures and the same mechanism of action, with a related mode of action, and are widely used to treat the same kind of disease.
In several dominant drug classification systems, four types of classifications form a hierarchy of drugs. The knowledge of these drug classes helps in identifying the drugs that act in a similar fashion and can be used to treat conditions.
Therefore, the correct option is 2.
Learn more about Drug classes here:
https://brainly.com/question/25192272
#SPJ2
List 4 instructions that you would give to a Total Hip Arthroplasty patient to care for their new hip:
please help! :)
Answer:
DO NOT cross your legs or ankles when you are sitting, standing, or lying down. DO NOT bend too far forward from your waist or pull your leg up past your waist. This bending is called hip flexion. Avoid hip flexion greater than 90 degrees at a right angle.
Explanation:
In cases of doubt, courts have held that tax relief provisions should be broadly construed against the IRS.
True
False
The statement "In cases of doubt, courts have held that tax relief provisions should be broadly construed against the IRS" is true.
In cases of doubt, the courts have held that tax relief provisions should be construed in favor of taxpayers and that any ambiguity in the statute should be resolved against the IRS. This is referred to as the rule of statutory interpretation known as "strict construction."In other words, tax relief provisions should be broadly construed in favor of taxpayers in cases of doubt, and any ambiguity in the statute should be resolved against the IRS. This is to ensure that taxpayers are not held accountable for taxes they do not actually owe. Therefore, the given statement is true.
To know more about tax relief provisions visit:
https://brainly.com/question/17482952
#SPJ11
Which of the following is NOT included as an objective in a Psychological Health and Safety management system? Multiple Choice: a. Identification of psychological hazards b. Promotion of psychological health. c. Control of risks that cannot be eliminated d. Recognition and reward.
Among the following choices, the objective that is NOT included in a Psychological Health and Safety management system is Recognition and reward. Thus, the correct answer is Option D.
Psychological Health and Safety refer to the idea of taking a strategic and systematic approach to address employees' mental health issues, concerns, and well-being. Psychological Health and Safety Management System (PHSMS) is a set of practices that helps organizations to develop policies and practices to provide a safe and healthy work environment.
The following are the objectives of a Psychological Health and Safety management system:
Identification of psychological hazards: A PHSMS aims to identify and assess all the psychological hazards that employees may face in the workplace, such as workplace stress, harassment, etc.Promotion of psychological health: The promotion of mental health in the workplace includes raising awareness of mental health issues, providing support, and offering training to employees to manage stress and cope with workplace challenges.Control of risks that cannot be eliminated: PHSMS aims to prevent harm to employees' mental health by taking all necessary measures to control the risks that cannot be eliminated.Recognition and reward: Though it's a crucial element, recognition and reward is not considered an objective of PHSMS. Instead, it is part of a broader effort to promote psychological health and well-being in the workplace.Learn more about Psychological Health from the given link:
https://brainly.com/question/30631503
#SPJ11
A client is ordered 30mg of lovenox by subcutaneous injection. 5mg in 1ml of liquid for sq injection available. how many ml will you administer?
To administer 30mg of lovenox, you need to divide the total dose by the concentration of the liquid available. In this case, 5mg of lovenox is present in 1ml of liquid. Therefore, to get 30mg, we need to divide 30 by 5, which equals 6. This means that you need to administer 6ml of the liquid for the subcutaneous injection to deliver 30mg of lovenox to the client.
It's essential to be precise when measuring the liquid and following the correct procedure for subcutaneous injections to ensure the safe administration of medication. Before administering the injection, ensure you verify the prescription with a colleague or supervisor and confirm the client's identity. Remember to dispose of the needle and syringe correctly, following the healthcare facility's disposal guidelines.
To determine how many ml to administer for a client ordered 30mg of Lovenox by subcutaneous injection with 5mg in 1ml of liquid available, follow these steps:
1. Identify the ordered dose: 30mg of Lovenox.
2. Identify the available concentration: 5mg in 1ml of liquid for subcutaneous injection.
3. Use the formula: (Ordered dose) / (Available concentration) = (Volume to administer)
In this case: (30mg) / (5mg/ml) = (Volume to administer)
4. Divide the ordered dose by the available concentration: 30mg / 5mg/ml = 6ml
So, you will administer 6ml of Lovenox to the client by subcutaneous injection.
To know more about lovenox visit
https://brainly.com/question/31723021
#SPJ11
1. Conduct research to find four different food sources that could be part of a high-protein diet. For each food source, indicate the major amino acids and other nutritional benefits that are present, then indicate the recommended minimum daily intake of protein for adults. Cite the sources of your research. BBoldIItalicsUUnderlineBulleted listNumbered listSuperscriptSubscript
Answer:
1. Tuna (Protein content: 32g per 100g)
2. Breast chicken (Protein content: 31g per 100g)
3. Cheddar (Protein content: 25g per 100g)
4. Walnuts (Protein content: 16g per 100g)
Explanation:
1. Tuna. Tuna is rich in essential amino acids (i.e., lysine, methionine, cysteine, threonine and tryptophan), and omega-3 fatty acids, which helps to prevent cardiovascular diseases. Moreover, this food is an important source of vitamin A, B Group vitamins (i.e., thiamin, riboflavin, niacin) and minerals (i.e., calcium, phosphorus, iron, etc.) (Fatimah et al. 2019).
2. Chicken breast. Chicken breast is low in fat and an excellent source of protein, vitamins (vitamin B6, niacin), and many essential minerals (selenium, phosphorus,iron, calcium). Chicken is a rich source of methionine, the precursor of homocysteine (Bansal and Joshi 2017).
3. Cheddar. Cheddar cheese is produced from milk, which has a good content of calcium that helps to prevent osteoporosis and vitamin K. This food has significant quantities of essential amino acids (e.g., lysine, threonine, and tryptophan) (Gueimonde et al. 2019).
4. Walnuts. Walnuts are rich in fats (lipids), especially omega-3 fatty acids, which are required for normal brain function (Haider, Saida, et al. 2011). Moreover, walnuts have a high content of arginine amino acid.
A six minth old patient is seen at the clinic for a routine visit and vaccinations. During th
I dont think you pit the entire question there.
order for dicloxacillin 50 mg p.o. q6h for a patient who weighs 36 lbs. recommended dose is 12.5 mg/kg/day in equally divided doses q6h. is the dosage safe?
The prescribed dosage of dicloxacillin is 50 mg p.o. q6h for a patient weighing 36 lbs (16.3296 kg) can be considered safe.
To determine if the dosage of dicloxacillin is safe for the patient, let's calculate the recommended dose based on the patient's weight.
The recommended dose of dicloxacillin is 12.5 mg/kg/day in equally divided doses every 6 hours (q6h).
First, we need to convert the patient's weight from pounds to kilograms. Since 1 pound is approximately 0.4536 kilograms, we can calculate:
Weight in kg = 36 lbs * 0.4536 kg/lb = 16.3296 kg
Now, we can calculate the recommended daily dose:
Recommended daily dose = 12.5 mg/kg/day * 16.3296 kg = 204.12 mg/day
The recommended dose is 12.5 mg/kg/day, so for a 16.4 kg patient, the total daily dose would be 205 mg. This would be divided equally into four doses;
204.12 mg/day / 4 doses = 51.03 mg/dose
Comparing the recommended dose of 51.03 mg/dose to the prescribed dose of 50 mg p.o. q6h, we can see that the prescribed dose is very close to the recommended dose. Therefore, based on the information provided, the prescribed dosage of dicloxacillin is 50 mg p.o. q6h for a patient weighing 36 lbs (16.3296 kg) appears to be within the recommended range of 12.5 mg/kg/day in equally divided doses q6h and can be considered safe.
Learn more about dosage calculation: https://brainly.com/question/24793154
#SPJ11
Can i bath my cath with anti lice shampoo for fleas?
Answer:
yes you can
but I give you some pictures for it
Medical transcription might be an appropriate career for someone who enjoys keyboarding and attention to detail.
A. True
B. False
Answer:
B
Explanation:
Which of the following pathways of cross-contamination is depicted in this case?
a. Client to DHCP
b. DHCP to client
c. Client to client
d. Community to client
The pathway of cross-contamination depicted in the case where the number of individuals who are affected with a foodborne illness in a food establishment is "Client to client." The correct option is C.What is cross-contamination?Cross-contamination is the spreading of germs or pathogens from one location or source to another.
It happens when germs transfer from a contaminated surface, object, or person to a clean surface, object, or person. In foodservice, cross-contamination may arise in several ways, including: Equipment that hasn't been cleaned properly or thoroughly used for multiple food products Dirty clothing or aprons carried by employees from one area of the establishment to another Employees who are infected with pathogens and touch food products without wearing gloves or washing their hands after using the restroom or after sneezing or coughing in their hands
The following pathway of cross-contamination is depicted in this case: Client to client: When customers get sick because of contaminated food and infect other customers with the bacteria. More than 100 individuals have reported getting sick with a foodborne illness after eating at a restaurant.
To know more about pathogens visit:
https://brainly.com/question/31958773
#SPJ11
Which statement best describes morphology
“AIDS” is a(n)_
Select one:
A. Abbreviation
B. Eponym
C. symbol
D. Acronym
A bottle contains 70 milliliters (mL) of liquid medication. If the average dose is 0.5 mL, how many doses does the bottle hold?
Round to the nearest whole number.
Answer: The bottle holds 140 doses
what causes an orbital blow out fracture?complications?
An orbital blowout fracture is caused by blunt force trauma to the eye or the surrounding area. It can result in displacement or fracture of the bones surrounding the eye, particularly the floor or the medial wall of the orbit.
Complications of orbital blowout fracture include double vision, eye muscle dysfunction, and enophthalmos (sunken eye). In severe cases, the optic nerve may be compressed, leading to vision loss. Prompt medical attention is required to prevent long-term complications. Surgery may be necessary to repair the fracture and restore normal eye function.
Other potential complications of orbital blowout fracture include infection, bleeding, and damage to nearby structures such as the sinuses or the brain. Recovery time may vary depending on the severity of the fracture and the presence of associated injuries.
To learn more about orbital follow the link:https://brainly.com/question/30771213
#SPJ4
Hipaa requires disclosure logs and policies and procedures to be maintained for how many years?
Answer:
6
Explanation:
The Health Insurance Portability and Accountability Act (HIPAA) requires Covered Entities and Business Associates to maintain required documentation for a minimum of six (6) years from the date of its creation, or the date when it last was in effect, whichever is later.
HIPAA (Health Insurance Portability and Accountability Act) requires disclosure logs and policies and procedures to be maintained for a minimum of six years. The HIPAA law contains provisions that set the standards for protecting and securely maintaining electronic health information.
In addition, HIPAA privacy rules require healthcare providers to maintain a written set of policies and procedures that outline how protected health information (PHI) is handled and protected. This includes policies related to electronic data exchange, secure data storage, access, and management of PHI.
Also, the privacy rule requires disclosure logs that capture any disclosures of PHI that is made. These disclosure logs must be maintained for a minimum of six years.The reason behind maintaining these policies and procedures and disclosure logs for such an extended period is to ensure that an organization's information is not lost or destroyed and that they are able to produce this information when required, especially if they are required to defend themselves in a lawsuit.
To know more about Health Information visit:-
https://brainly.com/question/26370086
#SPJ11
the nurse is discussing disorders of the hematopoietic system when a client asked about erythrocytosis. what disease will the nurse mention with a primary characteristic of erythrocytosis?
According to the research, the correct option is Polycythemia Vera. The nurse will mention Polycythemia Vera as a primary characteristic of erythrocytosis.
What is erythrocytosis?It is a syndrome or clonal disorder characterized by manifesting symptoms of hyperviscosity due to an abnormal increase in red blood cells. Those who suffer from it present a reddish cyanosis of the skin and mucous membranes.
In this sense, it can be congenital or acquired (polycythemia vera) which is the chronic myeloproliferative syndrome characterized by uncontrolled proliferation of the erythropoietic lineage.
Therefore, we can conclude that according to the research, the correct option is Polycythemia Vera. The nurse will mention Polycythemia Vera as a primary characteristic of erythrocytosis.
Learn more about Polycythemia Vera here: https://brainly.com/question/14632418
#SPJ1
What equipment is generally used to make lyophilized medications suitable for administering to the patient? a) Test tubes or sterile ampules b) Petri dishes and sterile droppers c) Sterile syringes or graduated cylinders d) Measuring cups and clean, warm water
\(\huge\underline\mathtt\colorbox{cyan}{B.}\)
Petri dishes and sterile droppers are generally used to make lyophilized medications suitable for administering to the patient
A client taking epoetin alfa requests changing the medication from the subcutaneous route to the po route. how should the nurse respond?
A client taking epoetin alfa requests changing the medication from the subcutaneous route to the PO route. The nurse respond this medication is destroyed in the stomach and can only be given by injection.
One of the digestive system's organs. By combining food with digestive juices and churning it into a thin liquid, the stomach aids in food digestion. Storing food and releasing it to the intestines at a pace that allows the intestines to process it is the stomach's primary job. The stomach's lowest third is known as the antrum.
The lower esophageal sphincter, a muscle valve, allows food to enter the stomach as it approaches the end of the esophagus. The stomach releases digestive enzymes and acid. In order to expand the food's surface area in preparation for digestion, the stomach mixes and grinds the food into a finely split chime. The upper, rounded region to the left of the cardia is known as the fundus. The stomach's largest and most important component is its body. Here, food is combined and begins to degrade.
Learn more about stomach here:
https://brainly.com/question/2920920
#SPJ4
A patient using epoetin alfa requests that the drug be switched from the subcutaneous to the oral route. According to the nurse, this drug is destroyed in the stomach and can only be administered through injection.
One of the organs of the digestive system. The stomach assists in food digestion by mixing food with digestive fluids and churning it into a thin liquid. The stomach's principal function is to store food and release it to the intestines at a rate that permits the intestines to digest it. The antrum is the lower portion of the stomach.As food near the end of the oesophagus, the lower oesophagal sphincter, a muscular valve, permits it to enter the stomach.
Epoetin injection is a synthetic form of erythropoietin (EPO). EPO is naturally created in the body, mostly by the kidneys.
It increases the production of red blood cells in the bone marrow.Severe anaemia can result if the body does not create enough EPO. This is common in people with a chronic renal disease whose kidneys are failing. Epoetin is used to treat severe anaemia in dialysis patients and those who are not on dialysis.Learn more about epoetin here,
https://brainly.com/question/9082942
# SPJ4
Which of the following MOST accurately describes a mass-casualty incident?
A. an incident that involves more than five critically injured or ill patients
B. an incident where patients have been exposed to hazardous materials
C. an incident in which at least half of the patients are critically injured
D. an incident that greatly taxes or depletes a system's available resources
An incident that greatly taxes or depletes a system's available resources accurately describes a mass-casualty incident. So, option D is accurate.
A mass-casualty incident (MCI) is an event that overwhelms the capacity of a healthcare system or emergency response system, causing a significant strain on available resources. It typically involves a large number of injured or ill patients requiring immediate medical attention and can occur due to various causes such as natural disasters, terrorist attacks, transportation accidents, or public health emergencies.
While the specific criteria for defining an MCI may vary based on local protocols and resources, the primary characteristic of an MCI is the overwhelming demand for resources. This can include personnel, medical supplies, equipment, hospital beds, and other necessary resources required to provide appropriate care to the patients.
The other options presented (A, B, C) describe specific scenarios that can be encountered within a mass-casualty incident, but they do not encompass the overall concept of an MCI itself. A mass-casualty incident can involve various degrees of patient injuries or illnesses, exposure to hazardous materials, and varying proportions of critically injured patients. However, the defining factor of an MCI is the significant strain it places on available resources.
To know more about mass-casualty incident
brainly.com/question/28235969
#SPJ11
What toothbrushing method would a toddler who has gum disease use?
Answer:
It's important to note that gum disease in toddlers is rare and usually only occurs in severe cases of poor oral hygiene or other underlying medical conditions. If you suspect that your toddler has gum disease, you should consult a pediatric dentist for a proper diagnosis and treatment plan.
Assuming that your toddler has been diagnosed with gum disease and your pediatric dentist has recommended toothbrushing, the most appropriate method to use would depend on the severity and location of the gum disease. In general, gentle and thorough brushing is recommended, with a soft-bristled toothbrush and a pea-sized amount of fluoride toothpaste.
One commonly recommended toothbrushing method for toddlers is the modified Bass method. Here are the steps to perform this method:
Hold the toothbrush against the teeth at a 45-degree angle, with the bristles pointing towards the gum line.
Gently vibrate the brush back and forth, making small circular motions.
Gradually move the brush along the gum line, cleaning two to three teeth at a time.
Brush the chewing surfaces of the teeth with a back-and-forth motion.
Brush the tongue and the inside surfaces of the front teeth with a gentle back-and-forth motion.
It's important to supervise your toddler while they brush their teeth to ensure that they're using the correct technique and not swallowing the toothpaste. You may also want to consider using an electric toothbrush or a gum massaging toothbrush, as recommended by your pediatric dentist.
How does TFR correlate with child mortality?
TFR, or Total Fertility Rate, is the average number of children born to a woman during her reproductive years. It is often used as an indicator of population growth.
Child mortality refers to the number of deaths of children under the age of 5. There is a correlation between TFR and child mortality, although it is not a direct one. Generally, a higher TFR is associated with higher child mortality rates. This is because in countries with high fertility rates, there may be limited access to healthcare, sanitation, and education, which can lead to higher child mortality. However, it's important to note that this correlation can vary depending on factors such as socioeconomic conditions and healthcare infrastructure.
Learn more about Total Fertility Rate here :-
https://brainly.com/question/14565330
#SPJ11
Assuming all blood types are equally common, people with what blood types would have the best and worst odds of finding a donor?
Drugs of abuse trigger the release of dopamine within our brain, which allows the user to experience a temporary feeling of pleasure.a. Trueb. False
True. Drugs of abuse trigger the release of dopamine within our brain, which allows the user to experience a temporary feeling of pleasure.
What do you mean by Drug abuse?
Drugs abuse is defined as substances that are taken for non-medical purposes, and in amounts or in a manner that can lead to physical and/or psychological harm. These include illegal drugs such as cocaine, heroin, and marijuana, as well as prescription drugs taken for non-medical purposes such as painkillers and sedatives.
What is Dopamine?
Dopamine is a neurotransmitter that helps regulate movement, emotion, motivation, and pleasure in the brain. It is involved in many important functions, including reward-motivated behavior, such as learning and memory formation. Low levels of dopamine may be associated with depression and other mood disorders.
To know more about Drugs abuse,
https://brainly.com/question/24117003
#SPJ4
An absence of contractions of the heart is called
Answer:
What is 'Asystole'
Explanation:
Asystole is the absence of contractions of the heart.
If it helps please click thank you or brainly.
<3Miss Hawaii
1. Explain why you think the office would have a "no cell phones" policy for employees
D
Answer:
hipaa violations
Explanation:
The office would have no cell phones policy for employees to increase the concentration during the working hours and increase the productivity of work.
What is no cell phone policy?No cell phone policy is the policy in which the use of cell phone is strictly prohibited and it is implemented in offices or working place to increase the productivity and concentration in workings hours.
Excessive use of cell phone at work can reduce the quality of work because while using phone brain stops to generate the good ideas and limit yourself.
During working hours mobile devices are could to be in the desk and advised not to keep the mobile phone in hand or nearby working table.
Cell phone policies is a set of guidelines regarding use of cellphone in the workplace. The employees of that workplace should be read cell phone policies before joining.
Several countries banned cell phone on working place to avoid distraction during work. It helps to maintain the productivity and total working are utilized properly in order to achieve the target.
Learn more about "no cell phone" here:
https://brainly.com/question/21108877
#SPJ2
2,620 men were enrolled in the study of prostate cancer and 930 of those had confirmed by biopsy prostate cancer. The sensitivity of the Prostate-Specific Antigen (PSA) test was 86% and the specificity was 33%. Calculate positive predictive value (PPV) and negative predictive value (NPV) of the PSA test given this information and interpret (explain) the results. (Show your calculations to get credit)
Answer:
81%
Explanation:
0.86 · 930 = 799.8 ⇒ 800 men
Other 130 men have negative PSA test
2620 - 930 = 1690 ⇒ 1690 without cancer
0.33 · 1690 = 557.8 ⇒ 558 men no cancer + negetive PSA tests
1690 - 558 = 1132
*view attachment below*
Positive perdictive value = 800/1932 = 0.42 = 42%
Negative predictive value = 558/688 = 0.81 = 81%.
The probability of not having prostate cancer among men with a negative PSA test is 81%
Sorry if it's very unclear, Good luck <3
Sigmoid Volvus on xray
What next?
Sigmoid volvulus is a medical condition characterized by the twisting of the sigmoid colon, as observed on an X-ray. It is a surgical emergency requiring prompt intervention.
When sigmoid volvulus is identified on an X-ray, the next course of action typically involves immediate medical attention and intervention. The patient may need to be prepared for surgery, which could involve bowel decompression using a rectal tube or sigmoidoscopy. The primary goal is to alleviate the obstruction and restore blood flow to the affected area. In some cases, a contrast enema may be performed to attempt manual reduction of the volvulus. However, if these measures are unsuccessful or if there are signs of bowel ischemia or perforation, surgery becomes necessary. The surgical procedure usually involves repositioning the sigmoid colon and securing it to prevent future volvulus episodes. Overall, the specific steps taken would depend on the severity of the volvulus and the patient's condition.
To learn more about intervention, Click here: brainly.com/question/28235244
#SPJ11
how do yo scramble somebody