5. Included below are affiliate links from Amazon at no additional cost from you. Check and monitor the hemoglobin, hematocrit, RBC counts, and reticulocyte levels. 3. The nursing care planning goals for patients with anemia may include assessing risk factors, addressing the underlying cause of the anemia, managing symptoms such as fatigue and shortness of breath, maintaining adequate nutrition, promoting adequate tissue perfusion, adhering to the prescribed treatment regimen, and being free from complications. Nursing Diagnosis: Risk for Bleeding related to low hemoglobin and bone marrow malfunction secondary to aplastic anemia. your express consent. Hemodial Int. Administer medications as needed.Patients with low hemoglobin may be given erythropoietin-stimulating drugs to help generate more red blood cells. Desired Outcome: The patient will express comprehension of energy conservation. 3. identify if the intervention is independent, dependent or collaborative. It is critical to compare serial laboratory values to evaluate the clients progression or deterioration and identify changes before they become life-threatening. Examples of hemolytic anemia are the following: Based on the following indicators, it is usually feasible to determine whether anemia is caused by the destruction or decreased production of erythrocytes. Examples of hypoproliferative anemia are the following: Hemolytic Anemia this anemia is due to hemolysis of the red blood cells, causing hemoglobin to be released into the plasma. Iron is necessary for the production of hemoglobin, which carries oxygen in the blood. The Hb determination is part of a complete blood cell count. Medical-surgical nursing: Concepts for interprofessional collaborative care. A patient who is experiencing signs of activity intolerance and reduced tissue oxygenation may show symptoms including dyspnea on exertion, headaches, dizziness, and palpitation which should be monitored. Women with menstrual periods and pregnant women commonly have low hemoglobin counts. Treating H. pylori infection improves the benefit of iron supplementation in anemia. Assess the degree of activity intolerance.Assess the severity of activity intolerance. Patient will discuss and demonstrate interventions to prevent bleeding. Nursing care includes patient education of the cause, prognosis, and complications of the condition, provision of iron supplementation, adherence to an iron-rich diet, monitoring of symptoms, and lifestyle modifications. Please read our disclaimer. may email you for journal alerts and information, but is committed such as citrus fruits and fresh raw vegetables such as dark green leafy vegetables. If you have a condition that affects your bodys ability to make red blood cells, your hemoglobin levels may drop. 1. Maegan Wagner is a registered nurse with over 10 years of healthcare experience. Ask the patient and the family members about their knowledge about the condition, the disease process, possible causative factors, and treatment. Clients with severe anemia should curtail their activity until the anemia is partially corrected. This will develop the patients endurance and will help prevent complications due to prolonged bed rest. Nursing Diagnosis: Ineffective Tissue Perfusion (Renal) related to low levels of cellular components required for oxygen delivery secondary to chronic anemia as evidenced by hemoglobin level of 6.9 g/dL. Abstaining from rectal procedures if possible (e.g., suppositories or enemas, rectal temperature checks, and use of enemas). The patient will be free from bruises and petechiae. The etiology of anemia depends on whether the anemia is hypoproliferative or hyperproliferative. Epub 2017 Apr 12. She is a clinical instructor for LVN and BSN students and a Emergency Room RN / Critical Care Transport Nurse. Testing the stool and the urine for the presence of occult blood helps in identifying the site of bleeding. Precautionary measures for bleeding should be taught to the patient these measures include: Instruct the patient to avoid using a razorUse a toothbrush that is soft when brushing the teethRectal procedures should be avoided such as suppositories, enemas, and temperature taking in the patients rectum. However, the most typical manifestation is activity intolerance. The patient will be able to express decreased fatigue, as evidenced by increased energy and ability to do desired activities and tasks. ; Iron deficiency is defined as a decreased total iron body content. Food such as green leafy vegetables, tofu, red meat, raisins, and dates contain a lot of iron (Xiao, 2022). Take note of the location of abdominal pain and characteristics. Option B:Milk and cheese are rich in protein that can strengthen the muscles. Insist on the need to take frequent breaks from each task. The severity of anemia should be considered before administering medications. Instruct the patient and the family members about the replacement therapy with folic acid and iron. This article has made it easy for me to understand. A collection of Practice Guidelines published in AFP is available at https://www.aafp.org/afp/practguide. She found a passion in the ER and has stayed in this department for 30 years. Use of electric shaver rather than a razor. Nursing Diagnosis: Risk for Infection related to low hemoglobin secondary to pernicious anemia. C. Organ meats. Cleveland Clinic. e) Walk through the length of the house, adding steps until the patient reaches the outdoors, conserving energy when returning. Her experience spans almost 30 years in nursing, starting as an LVN in 1993. There are numerous forms and representations of anemia, each with its own variability and cause. Rationale: Bleeding precautions should be put in place as soon as a patients platelet count dips below 50,000mm3. For more information, please refer to our Privacy Policy. A low hemoglobin level may be a sign of several conditions, including different kinds of anemia and cancer. 1. S&S EKG peaked t waves, widen QRS, Depressed ST segment; irritability, nausea, vomiting, intestinal colic, bradycardia, decreased UO, numbness, tingling, 2. Erythrocyte destruction intravascular hemolysis resulting from RBC destruction can indicate anemia of certain origins (intrinsic or extrinsic), and this is made possible by the presence of end products within the blood circulation. Your message has been successfully sent to your colleague. B. Coverage of guidelines from other organizations does not imply endorsement by AFP or the AAFP. Nursing Diagnosis: Risk for Bleeding related to loss of red blood cells, secondary to anemia. Nursing Diagnosis: Deficient Knowledge related to inadequate resources and information with the condition secondary to anemia, as evidenced by verbalizations on the lack of understanding of the disease, inability to follow directions, constant inquiries, and conveyed incorrect information. Although there are several tests to directly determine the RBC mass, these tests are expensive and somewhat cumbersome. There are a few easily distinguishable symptoms of low hemoglobin and anemia, which are as follows. Your body produces enough red blood cells, but the cells are dying faster than your body can replace them. A slightly low hemoglobin count isn't always a sign of illness it can be normal for some people. 4. Nursing2020 Critical Care15(4):34-35, July 2020. 3. Additionally, researchers will find new suggestions for enhancing the terminology. & pulse, redness, swelling, drainage, tenderness4. St. Louis, MO: Elsevier. A severe low hemoglobin level for men is 13.5 gm/dL or lower. To enhance the patients endurance and strength. What is considered low will vary between facilities and patients. Oral iron supplementation should be provided for most patients with iron deficiency. Reviewed: May 245, 2022. To promote compliance with prescribed therapy: Included in the expected patient outcomes are the following: Health education is the main focus during discharge and for the home care. Copyright 2023 American Academy of Family Physicians. Locate the cause and stop the bleeding.Early identification and intervention through imaging, procedures, or surgery can prevent internal bleeding and worsening complications. Please try after some time. What activities can they no longer perform? Stress the need for regular medical and laboratory follow-up to evaluate disease progression and response to therapies. Increased reticulocyte count is associated with hemolytic anemia. Normal hemoglobin levels are different for men and women. Iron deficiency anemia is a common type of anemia that is caused by a lack of iron in the body. 5 Nursing care plans for anemia | Anemia nursing interventions January 29, 2022 by R K SIR BSN RN Anemia is a condition in which the hemoglobin concentration is lower than normal. She is a clinical instructor for LVN and BSN students and a Emergency Room RN / Critical Care Transport Nurse. Anemia is a condition that is slowly rising in cases across all countries. Without anemia, the ferritin threshold for iron deficiency is uncertain. Anemia might develop as a result of routine blood testing due to blood loss. 2. Yes, Published source:Gastroenterology. She has worked in Medical-Surgical, Telemetry, ICU and the ER. This is very beneficial to the nursing students so thank you for supplying this info. Energy conservation techniques may help the patient learn new skills and priorities for the desired activities of daily living. Helicobacter pylori infection is associated with iron deficiency caused by atrophic gastritis and hypochlorhydria, which reduce iron absorption. 1. Precautionary steps that decrease the risk of skin breaking would also reduce the likelihood of bleeding. Administer medications as indicated.Medications like iron supplements and erythropoietin replacement can help improve low hemoglobin and iron, reducing symptoms of fatigue and activity intolerance. If required, adjust O 2 levels. Assess the clients ability to perform activities of daily living (ADLs) and the demands of daily living.Fatigue can limit the clients ability to participate in self-care and perform their role responsibilities in family and society, such as working outside the home. Assessing the patients current knowledge and perceptions about the condition will help the nurse in facilitating the plan of individualized teaching. In most cases, anemia has more than one cause. Decrease in the reticulocyte count. However, the universal treatment scheme is through careful medical management and supportive therapy. Cleveland Clinics Robert J. Tomsich Pathology & Laboratory Medicine Institute touches virtually every patient at Cleveland Clinic and thousands of patients across the world. Nursing Interventions Nursing interventions are based on the data assessed by the nurse and on the symptoms that the patient manifests. Agarwal R. Iron deficiency anemia in chronic kidney disease: Uncertainties and cautions. Hello, am a student nurse at Kamuzu College of Nursing in Malawi, this article helped me a lot. A strict vegetarian diet requires iron and vitamin B12 supplementation (Maakaron & Besa, 2021). If a disease or condition affects your bodys ability to produce red blood cells, your hemoglobin levels may drop. Anna began writing extra materials to help her BSN and LVN students with their studies and writing nursing care plans. Some error has occurred while processing your request. b) Take three or more deep breaths a day. Polycythemia is the term used to describe an abnormal increase in the number of RBCs. Healthcare providers diagnose low hemoglobin by taking samples of your blood and measuring the amount of hemoglobin in it. White blood cells are part of the persons immune system because white blood cells help in fighting infection and other diseases. 2. Attainment or progress toward desired outcome. 2023 Nurseslabs | Ut in Omnibus Glorificetur Deus! Aerobic exercise significantly reduces fatigue; however, the role of resistance training and alternative forms of exercise are less clear (Shambhavi & Lobo, 2021). Hullo, I am a student at the Aga Khan University in Uganda, Kampala doing BScM. 2. Nursing Diagnosis: Risk for Infection related to reduced internal defenses, secondary to anemia as evidenced by compromised status, presence of fever, and abnormal laboratory findings. Advise the patient and the visitors to do proper hand washing. Answer: B. D. Hypertension. It has been so helpful. Monitor hemoglobin, hematocrit, RBC counts, and reticulocyte counts.Decreased RBC indexes are associated with the decreased oxygen-carrying capacity of the blood. Advise and educate the patient to eat foods rich in iron, folic acid, and vitamin B12. Anemia has been associated with negative health and development outcomes and delayed child development (Chaparro & Suchdev, 2019). 1. Saunders comprehensive review for the NCLEX-RN examination. This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment. 3. The patient will demonstrate improved wellness as indicated by the absence of fever and within the normal WBC count. Cleveland Clinic Cancer Center provides world-class care to patients with cancer and is at the forefront of new and emerging clinical, translational and basic cancer research. The nurse should explain to the patient that these sites are the most common site for bleeding. The AGA suggests serologic testing for celiac disease in patients with iron deficiency, especially those with a family history of the disease, a personal history of autoimmune diseases, or gastrointestinal symptoms. A. Nursing Care Plan for Low Hemoglobin 1 Fatigue Nursing Diagnosis: Fatigue related to low hemoglobin secondary to iron deficiency anemia as evidenced by dyspnea, inability to maintain usual level of physical activity, increased rest requirements, and patient's report of fatigue and lack of energy. Ineffective Tissue Perfusion Nursing Care Plan 2. Normal: 0.4% - 1.0%FXN: Phagocytic antigen/antibody responce-Alergic responce Asthma. The ultimate reference for nursing diagnoses from experts at NANDA-I has been updated in a new edition. 1. 2. For patients with decreased WBC &/or neutrophils, protect them from infection. B. The nurse should use words and languages that the patient and the family members will easily understand. Patient will demonstrate hemoglobin, hematocrit, and coagulation values within acceptable limits. 1. Monitoring the WBC is important because changes in the result of WBC will help in diagnosing infections. doi: 10.1136/bmjgast-2021-000759. Iron deficiency anemia occurs when iron deficiency is . What is the hemoglobin level of a patient with anemia? ), Anemia due to extrinsic causes (e.g., lead poisoning, hypersplenism, spur cell hemolytic anemia, autoimmune diseases, etc.). RN, BSN, PHNClinical Nurse Instructor, Emergency Room Registered NurseCritical Care Transport NurseClinical Nurse Instructor for LVN and BSN students. 7. In ambulatory clients, lower hemoglobin concentration is associated with increased fatigue. 5. Patient will identify interventions to reduce activity intolerance. Some factors that affect that lifespan include: Healthcare providers treat low hemoglobin by diagnosing the underlying cause. 2014. 4. Low Hemoglobin NCLEX Review and Nursing Care Plans. H. pylori can also cause atrophic gastritis, but it can be diagnosed noninvasively. In general, the more rapidly the anemia develops, the moreaggressive is its symptoms. D. 35 to 40 g/dL. Nursing Diagnosis Risk for bleeding related to low iron and abnormal RBC production as evidenced by low hemoglobin, hematocrit, and platelets. Instruct the client about medications that may stimulate RBC production in the bone marrow.Recombinant human erythropoietin (rHuEPO), a hematological growth factor, increases hemoglobin and decreases the need for RBC transfusions. Instruct the patient to consume iron-rich foods to help build-up hemoglobin stores. Causes decreased dietary intake, IV fluid deficit, burns, diarrhea, vomiting, diuretics, hyperaldosteronism, renal disease, ascites, 3. Nursing Diagnosis: Fluid Volume Deficit related to blood volume loss secondary to bleeding as evidenced by hematemesis, low platelet count, HB of 70, skin pallor, blood pressure level of 85/58, and lightheadedness. Silvestri, L. A. These conditions that affect the red blood cell production are as follows: In addition, there are also additional factors that affect the lifespan of the erythrocytes that will lead to low hemoglobin levels. This encourages the client to still do as much as possible while conserving limited energy and preventing fatigue. The client will verbalize the reduction of fatigue, as evidenced by reports of increased energy and ability to perform desired activities. Yoga tailored for cancer clients with anemia aims to be a gentle practice that appropriately accommodates the needs of the client, but will still require approval from the oncologist (Shambhavi & Lobo, 2021). Educate and develop a regimen of activity and rest with the patient. If the patients platelet counts drop, bleeding precautions should be advised to the patient to avoid spontaneous bleeding. The patient will be able to express understanding about the use of energy conservation principles and techniques. B. Ecchymosis. Hypoxia from normocytic anemia and other medical problems and situations may cause fatigue in the patient and may compromise the patients activity tolerance. 2. iron deficiency, thalassemia, pernicious anemia, hemoglobinopathies, reactions to physical agents (severe burns, artificial heat valves), occurs after transfusions, hemorrhages, burns. 3rd Edition. B. Educating the patient and their family and helping them better comprehend their illness and course of treatment is critical if we want to raise their level of awareness and comprehension of what theyre dealing with. Alcoholism, exposure to toxic chemicals, dietary problems, and the use of medication that may affect red blood cell production are some of the causative factors of low hemoglobin levels. Very Well Health. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Desired Outcomes: You often lose some blood during hemodialysis treatments and blood testing. Get to know the nursing assessment cues, goals, related factors, and interventions with rationale in this care plan guide. PMID: 28403561. B. Dyspnea. 2. Encourage the patient to verbalize feelings about his or her limitations. Hello! It is more than a feeling of drowsiness or sleepiness. Option C:Decreased hemoglobin is one of the signs that form the diagnosis of anemia. Her experience spans almost 30 years in nursing, starting as an LVN in 1993. These medications treat certain viruses. Range of motion ROM) exercises is important to patients with activity intolerance because ROM exercise will strengthen the muscle and joints of the patient. Assist the patient in an upright (30 to 45 degrees) position as their . Assist the client in developing a schedule for daily activity and rest. Check for activity intolerance symptoms. 1. Assess the specific cause of fatigue.The specific cause of fatigue is tissue hypoxia from normocytic anemia. Based on the assessment data, major nursing diagnosis for patients with anemia include: The major goals for a patient with anemia include: Nursing interventions are based on the data assessed by the nurse and on the symptoms that the patient manifests. It can also be due to trauma or injury inflicted to the RBC membrane that causes liberation of its contents. Annals of the New York Academy of Sciences,1450(1), 1531. Oral iron formulations appear to be similarly effective and tolerated. Thanks, Oxygen saturation should be kept at 90% or greater. See your doctor if you suspect that you have anemia. And determine if the patient or their family members are able to comprehend the new medical terminology. When there is increased erythrocyte destruction, anticipate the development of tissue hypoxia and the production of erythropoietin as a compensatory response of the body. Hypoproliferative anemias are corrected reticulocyte count of < 2%, and are further divided by the mean corpuscular volume into microcytic anemia (MCV <80 fl), normocytic anemia (MCV 80 to 100 fl), and macrocytic anemia (MCV >100 fl). When taking deep breaths, the exchange of oxygen with the outgoing carbon dioxide increases more effectively. Get new journal Tables of Contents sent right to your email inbox, Caring for hospitalized patients with alcohol withdrawal syndrome, Privacy Policy (Updated December 15, 2022). Assess if there are certain times or other factors that contribute to fatigue. Patient will demonstrate interventions to reduce fatigue. Treatment give a concentrated glucose source & a long acting CH2O, do not skip meals, check for S&S of hypoglycemia nervous, weak, confusion, cold, clammy skin, tachycardia, Increased Values diabetes mellitus (DM), acute stress response, Cushings disease, acute pancreatitis, drug therapy with diuretics or corticosteroids, 1. In certain pathophysiologic states such as severe anemia, the rate of adequate oxygen delivery is impaired. 2. be sure to make the interventions specific for the pt. Instruct the patient and their visitors on proper handwashing techniques. Generally speaking, a balanced diet with a focus on important nutrients is the best way to maintain healthy red blood cells and hemoglobin. Other causes of low hemoglobin include: Signs and symptoms of low hemoglobin include: A complete blood count, including red blood cell count and hemoglobin level, can help confirm low hemoglobin and other blood cell abnormalities. Explain that this increases their risk of injury and will further worsen activity intolerance and fatigue. NurseTogether.com does not provide medical advice, diagnosis, or treatment. McGraw Hill Education. Changes in O 2 percentages should be in 5% to 10% increments. 2. Complete blood count This blood test measures a wide range of blood components. Minimum hemoglobin levels are associated with fatigue while hospitalized and may help identify clients for interventions to address anemia-related fatigue (Prochaska et al., 2017). If your test results show low hemoglobin levels, your healthcare provider will explain why you have this symptom, what it means and how it will be treated. Hemoglobin is a protein in your red blood cells. Your body cant absorb iron, which affects your bodys ability to develop red blood cells. The environment is important to patients with low neutrophil counts and protective isolation precautions should be practiced. Record and document the patients response to the activities. 2017 Jun;21 Suppl 1:S78-S82. Increased LDH 5 hepatitis, cirrhosis, liver cancer, NV: 8 - 38 u/lDecreased Values acute renal disease, beriberi, DM, ketoacidosis, pregnancy, Increased Values MI, post cardiac surgery, liver disease ( hepatitis, cirrhosis, cancer, tumor); skeletal muscle disease, pancreatitis, Interventions for Increased Values check patients medication list for liver toxic drugs, IM injections cause false high values, assess patient for S&S of liver disease & MI, 1. Usually, fatigue hinders the patients capacity to participate and fulfill their societal and familial responsibilities (e.g., working away from home), which makes it difficult to perform certain tasks. Low hemoglobin is often caused by low iron levels in the blood or iron deficiency anemia and may lead to severe health conditions, including heart problems. 2. For initial investigation, laboratory tests for blood may be employed for such as measurements of: Treatment of anemia usually depends on the type of anemia and its cause. Ferritin testing is less accurate in patients with chronic inflammatory conditions or chronic kidney disease, and additional tests including serum iron, transferrin saturation, soluble transferrin receptor, and C-reactive protein can help diagnose iron deficiency. Monitoring the patients response to the activities and interventions will serve as a guide for the optimal progression of the activity and condition. Treatment for iron deficiency anemia may include iron supplements or changes in diet to increase iron intake. A value greater than 20 g/dL (200 g/L) can lead to obstruction of the capillaries as a result of hemoconcentration. 8. From: Low Hemoglobin: Everything You Need to Know. Your body produces red blood cells and white blood cells in your bone marrow. Nursing Interventions for Abnormal Platelet Values Definition Decreased Values At risk for bleeding Apply pressure to venipuncture sites for at least 5 mins. And the remaining CBC parameters are useful to determine whether anemia is associated with another hematologic condition. 2018. Inability to maintain the usual level of physical activity. Treatment Potassium replacement po or in IV fluid bag, check patient for S&S of overhydration, monitor K level for patients taking diuretics, increase dietary intake of high K foods bananas, tea, dried fruits, meat, nuts, 1. After negative bidirectional endoscopy results, the AGA suggests noninvasive testing and treatment for H. pylori in IDA by urea breath testing, although stool antigen testing and serology can also be used. A patient with thrombocytopenia or low platelet count is caused by the patients bone marrow deficiencies that happen because of nutritional deficiencies, drugs, viral causes, or aplastic anemia. If thats your situation, theyll treat your anemia with supplements. 2. Healthy adult hemoglobin values are generally 13.2 to 16.6 grams per deciliter for men and 11.6 to 15 grams per deciliter for women. Thresholds in the US are slightly higher. 4. I am a student nurse from Kenya this article is so helpful Bleeding gums. She found a passion in the ER and has stayed in this department for 30 years. Many things can cause low hemoglobin, and most of the time you cant manage low hemoglobin on your own. Symptoms of iron deficiency anemia can include fatigue, weakness, shortness of breath, pale skin, and dizziness. Treatment Low K diet, Kayexalate po or enemas, Lasix , Check I&O, IV infusion of glucose & insulin solution to move K back into the cells, create, study and share online flash cards, Click here to study/print these flashcards, Normal: 80 - 98/um3 (cubic micro meters) Size of RBC. As a result, the amount of oxygen delivered to body tissues is also lessened. Take temperature q4hrs 101or 101.5 Doc may give Tylenol3. Anna Curran. Exercise and physical activity. Hemoglobin is a protein in your red blood cells. Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Turner J, Parsi M, Badireddy M. Anemia. Suzanne M. Burns, MSN, RRT, ACNP, CCRN, FAAN, FCCM, FAANP. Hb also serves as an important buffer in the extracellular fluid. Significantly increased - hepatitis, liver necrosis or ischemia, 2. Reticulocytes are immature red blood cells, and due to their lack of biconcave shape, their stability cannot be guaranteed in the sheer stress it would be subjected to in the blood circulation. Eat plenty of vitamin C-rich foods. Desired Outcome: The patient will be able to explain his/her own illness and treatment options verbally. A patient with anemia has decreased hemoglobin levels of 9 to 11 g/dL. Red blood cells live about 120 days in your bloodstream. Fatigue. It is the iron pigment that combines readily with oxygen and gives blood its characteristic red color. 2023 Nurseslabs | Ut in Omnibus Glorificetur Deus! Hello!,I am a nurse from Jimma University this article had prepared well and it helped me,thank you for ur preparation. Check and monitor the patient platelet count and check for the presence of thrombocytopenia. Nursing Diagnosis: Deficient Knowledge related to low hemoglobin level secondary to aplastic anemia evidenced by inaccurate follow-through of instructions, questioning members of the health care team, and verbalization of inaccurate information. Acute Pain Nursing Diagnosis and Care Plan, Acetaminophen Nursing Considerations and Implications, Anemia due to intrinsic causes (e.g., hereditary spherocytosis, G6PD deficiency, Sickle cell anemia, HbC disease, etc. C. Decreased hemoglobin. ; Iron equilibrium in the body normally is regulated carefully to ensure that sufficient iron is absorbed in order to compensate for body losses of iron. Each gram of Hb can carry 1.34 mL of oxygen per 100 mL of blood. Get useful, helpful and relevant health + wellness information. Men: 14.0 to 17.4 g/dL or 140 to 174 g/L. Normal hemoglobin levels are 14 -18 g/dL for adult males and 12 16 g/dL for adult females. Sometimes, women have low hemoglobin levels when they have their periods. The oxygen-combining capacity of the blood is directly proportional to the Hb concentration rather than to the RBC count because some RBCs contain more Hb than others. 6. Anemia is the most common hematologic disorder. Refer the client and family to an occupational therapist.The occupational therapist can teach the client about using assistive devices. Term MCV - Mean Corpuscular Vol The 12th edition has been extensively revised and updated with the latest NANDA-I approved nursing diagnoses from 2018-2020.
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