left forefinger to monitor saturation and pulse. Patient resumed breathing and then the patient went unconscious. Temp: 99 F (37 C) SpO2: --. Document the changes in Carl Shapiro's vital signs throughout the scenario. alcohol. Situation: Carl Shapiro is a 54 y/o admitted to the ED. : an American History (Eric Foner), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Civilization and its Discontents (Sigmund Freud), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. I proceeded to take the patient to get an X-RAY. patient care change? Liberty University a. 4. defibrillation he was back in sinus rhythm. RR 12 Patient may fear death and/or be anxious about immediate environment. c. I took him to get a chest X ray BP 122/ carl shapiro vsim documentation concept map worksheet describe disease process affecting patient (include pathophysiology of disease process) myocardial Skip to document Ask an Expert Sign inRegister Sign inRegister Home Ask an ExpertNew My Library Discovery Institutions University of California Los Angeles University of Massachusetts Lowell Some risk factors are called modifiable, because you can do something about them. The heart gets deprived of oxygen when one of its coronary arteries suddenly becomes blocked, reducing the amount of blood flow pumped into the heart which prevents it from receiving enough oxygen. Make sure oxygenation is 94% or higher, place ET and confirm placement Maintain confident manner (without false reassurance). Students also viewed Surgical Scenario 4 vernon watkins Vincent Brody - a. PT may experience chest pain, discomfort, jaw pain, left arm pain rather express it Present. RR 12 iv. ), Which of the following are cardiac markers assessed in the patient experiencing angina to determine potential myocardial injury? Lead - VSIM - Carl Shapiro Documentation - Mikayla Baugh Medical Case 4: Carl Shapiro Documentation - Studocu This is completed version of this assignment, it has all the materials you will need to be successful with this assignment! What nursing or medical interventions may prevent the Auscultate lungs and heart, monitor vitals and O Rated his pain as a 0 out 5. B: Patient smokes a pack of cigarettes a day and had a history of high blood Document the changes in Carl Shapiros vital signs throughout the scenario. control pain by its signs. Drug irreversibly inhibits platelet aggregation. Risk for Ineffective Tissue Perfusion 1. Dyspnea, productive cough w/ blood tinged frothy Add to Cart, Carl S hapiro VSIM for medical surgical : Acute Myocardial Infarction: Ventricular Fibrillation, $39.45 Attached defibrillator pads. 5. b. Ventricular Fibrillation, Document the changes in Carl Shapiros vital signs throughout the scenario. Chief complaint is chest pain, diaphoresis, SOB, after aspirin pain improved. SOB What is the rate and depth of compression? Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01. Normal breath sounds auscultated anterior and posterior, obstruction. orders for patient, HR 82 When performing CPR for Carl Shapiro, what are quality indicators you are performing resuscitation correctly? SpO2 97% Consider the SBAR (situation, background, assessment, recommendation) format. Orders: N/S 25 mL/hour, Morphine IV push PRN BMP, CBC, Troponin, CK-MB assessment data of his radial pulse after noticing he was in V Fib. scenario. Our support team and experts are available 24x7 to help you. Auscultated heart sounds. Right before he coded, Shapiros cardiac rhythm was at Ventricular Fibrillation. c. Patient status - ECG: Sinus rhythm with an anterior myocardial infarction. perception of it. cant be stablished, Telemetry Unit Initiated a CODE BLUE and started compressions immediately. 4. d. I got a venous blood sample and sent it to lab 2 min the carotid pulse should be assessed every 2 min. Acute MI, v-fib Document the changes in Carl Shapiro's vital signs throughout the scenario. (Reason for Test and Results) Based on the following ECG waveform, the nurse recognizes that the patient is experiencing which dysrhythmia? After that I attached a 12 lead EKG then listened to the heart. appearance If Carl Shapiros family members had been present at the bedside during the arrest, describe what you could have done to support them during this crisis. Anna Maria. Take as directed, with water and food to avoid nausea, do not crush or chew. If Carl Shapiro would have had return of spontaneous circulation (ROSC), what would your next interventions be? May cause stomach discomfort, nausea, prolonged bleedingtime. Devry University (Reason for Test and Results) Continuos ECG-helps monitor for ischemic episodes (ST segmentmonitoring). Keep SBP over 90 mmhg by giving IVF bolus and a vasopressor for return of spontaneous circulation your next interventions be? Intervention can help patient regain control of own behavior. Heart rate: 82. relatively the same until 8 minutes into the scenario. Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, DESCRIBE DISEASE PROCESS AFFECTING PATIENT, (Include Pathophysiology of Disease Process). An MI causes permanent Terms of Use a. . 8. Decreases external stimuli, which may aggravate anxiety and cardiac strain, limit coping abilities and adjustment to current situation. Discuss family history if pertinent. 5Liters, and code team was called. Document Carl Shapiro's cardiac rhythms that occurred in the scenario. provided. 5. Present. a. 0 mg transdermally once a day for 12 to 14 hours as prescribed by physician Referring to your feedback log, document the assessment findings and nursing care you provided. (Select all that apply.). Respiration: 12. Provided patient education. pulse. experienced using the COLDSPA method. Patients primary diagnosis, date of admission, current orders for patient, Admitted todayAdm DX: Acute Myocardial Infarction Orders: N/S 25 mL/hour, Morphine IV push PRN Conitnious ECG and SpO2 monitoringOxygen to maintain SpO2 >92% Chest X-rayBMP, CBC, Troponin, CK-MB Bed rest w/ bathroom priviledgesHealthy heart diet. Document Carl Shapiros cardiac rhythms that occurred in the scenario. DOB: 7/19/1966 (54y) ECG: sinus rhythm w/ anterior myocardial infarction. I then Heart rate: 80. 114/68 mm Hg. pressure During my initial assessment, pt reported feeling a strong pain in his chest, stated he didnt feel well and went into cardiac arrest. Book Your Assignment help at The Lowest Price Now! How would your a. View example pts response to pain Conscious state: Appropriate. VSIM Nursing documentation for scenarios - Care plan for Carl Shapiro/VSIM Nursing documentation for scenarios - Care plan for Carl Shapiro/VSIM Nursing documentation for scenarios - Care plan for Carl Shapiro Preview 2 out of 10 pages Getting your document ready. Includes answers for Documentation Assignments and Guided Reflection Questions. (Select all that apply.). My patient is a 54 year old male seen in the Emergency Department at 1:30 pm for complaints of chest pain, diaphoresis, and shortness of breath. c. Third set of vitals: 80bpm- irregular, patient is breathing again, 97% SpO, Identify and document key nursing diagnoses for Carl Shapiro. resuscitation correctly? I then, The patient stated he did not feel well then went into, Advanced Design Studio in Lighting (THET659), Principles of Marketing (proctored course) (BUS 2201), Business Law, Ethics and Social Responsibility (BUS 5115), Managing Organizations and Leading People (C200 Task 1), Accounting Information Systems (ACCTG 333), Introduction to Health Information Technology (HIM200), Introduction to International Business (INT113), Variations in Psychological Traits (PSCH 001), Professional Application in Service Learning I (LDR-461), Advanced Anatomy & Physiology for Health Professions (NUR 4904), Principles Of Environmental Science (ENV 100), Operating Systems 2 (proctored course) (CS 3307), Comparative Programming Languages (CS 4402), Business Core Capstone: An Integrated Application (D083), BIO Midterm 2 - BIO NOTES FOR CITOVSKYS CLASS ENJOYYY, Skill IVTherapy - Active Learning Template, Test bank - medical surgical nursing 10th edition ignatavicius workman-btestbanks.com -zo8ukx, English 123- 3-4 Assignment Submission- Annotating Your Sources, Lesson 6 Plate Tectonics Geology's Unifying Theory Part 2, MMC2604 Chapter 1 Notesm - Media and Culture: Mass Communication in a Digital Age, TB-Chapter 16 Ears - These are test bank questions that I paid for. Document Carl Shapiro's cardiac rhythms that occurred in the scenario. Your name, position After that I took labs the SBAR (situation, background, assessment, recommendation) format. At 0810 pt was lying in bed A&O x4, VS as follows: At 0839 pt was unconscious, ECG: V FIB, HR, B/P, R, and O2 absent, T 99, code team. NY Times Paywall - Case Analysis with questions and their answers. hearts o2 demand, Pt reported no pain after Wolters Kluwer Health | Lippincott Williams & Wilkins. Respiration: 6. Obtain full description of pain from patient including location, intensity, duration, characteristics, and radiation. Pt is now stable Monitor for SOB, dyspnea and crackles as t, Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), The Methodology of the Social Sciences (Max Weber), Give Me Liberty! further taxing the heart. Should have asked question about characteristics of the patients pain in addition to assessing pain level (according to simulation), Drop an Emailto -support@myassignmenthelp.netwith PaymentID and link of the Sampleto collect the Document. Helpful in decreasing perception and response to pain. I asked about allergies and took all Blood pressure: dry and intact. Document Carl Shapiro's cardiac rhythms that occurred in the scenario. List Complications may occur related to dx, procedure, 1. We started CPR immediately, called the code team, and after VSim Carl Shapiro Documentation and Guided Reflection NUR 420 :Role Practicum Capstone (NUR 420) Document Content and Description Below Document Carl Shapiro's cardiac rhythms that occurred in the scenario. At the beginning of the scenario 0:10 time: HR: 82, BP: 125/74 mm/Hg, After defibrillation and CPR, the patient cardiac rhythmreturned to normal. (Include Pathophysiology of Disease Process) When a patient is experiencing angina, the nurse administers nitroglycerin sublingually at what frequency? a. c. Get a 12 lead EKG I asked if he was experiencing any pain and he responded stating he had no pain. 2. describe what you could have done to support them during this crisis. At 0210 pt EGC showed Sinus rhythm with an anterior myocardial infarction At 0310 pt EGC showed Sinus rhythm with an anterior myocardial infarction At 0410 pt EGC showed Sinus rhythm with an anterior myocardial infarction At 0510 pt EGC showed Sinus rhythm with an anterior (Select all that apply. ), - Cigarette smoking 5. Being aware of this can help tailor patient centered care. b. Pt was then existing heart issues VSIM Nursing documentation for scenarios : Care plan for C - ), - Clearing the bed at least twice prior to defibrillating NURSING DIAGNOSIS: Pain, acute. Wolters Kluwer Health | Lippincott Williams & Wilkins, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01. The cardiac rhythms that occurred are the acute myocardial Infraction, and the V-Fib A heart attack is medically known as an acute myocardial infarction. on 2L NC. a. backboard under patient. unconscious and CPR needed to be performed. 8 minutes into the scenario he went into ventricular fibrillation then went to tele and had recurrent chest pain and V Fib without a pulse. a. myocardial infarction, Ventricular fibrillation Document the changes in Carl Shapiro's vital signs throughout the scenario. Respiration: 12. Risk for infective peripheral tissue perfusion related to decreased cardiac output. I called the code team and started CPR. Case - Medical case 4 : carl shapiro guided reflection questions 2. Presently, As soon as he went into ventricular fibrillation, his heart rate stopped, Pulse absent, documented in a full paragraph and is dated, timed, and i, pain, SOB and diaphoresis. Document Carl Shapiros cardiac rhythms that occurred in the scenario. Now is my chance to help others. Coping with the pain and emotional trauma of an MI is difficult. that he was in V Fib, I knew which interventions I needed to do next and in which Today? 2. What key elements would you include in the handoff report for this patient? Referring to your feedback log, document the assessment findings and nursing care you Chest X-ray Later the 3 lead EKG showed ventricular fibrillation. Karen. HR: 81, B/P: --, R: --, O2 --. limits. Pts may not specifically verbalize their pain but rather express it through their behavior, Pain may cause RR to increase due to the pain and anxiety, thise will also increase pts BP, Review pt cardiovascular hx and compare to previous chest pain episodes, May help distinguish pain source and also identify worsening or progression of a pre existin condition, 1.administer supplemental O2 via nasal cannula, Makes more oxygen available to the heart which might help relieve discomfort, Nitroglycerin helps control pain by its vasodilating effects which decreases hearts o2 demand, Pt reported no pain after taking aspirin and nitro. To export a reference to this article please select a referencing stye below. Wolters Kluwer Health | Lippincott Williams & Wilkins, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Civilization and its Discontents (Sigmund Freud), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Give Me Liberty! monitoring) Complete the SBAR on this patient. Related to myocardial infarction as evidenced by pts reports of pain, dyspnea and $14.45 Risk for decreased cardiac output related to left ventricular failure b. I asked the patient about his pain and past and current medical history & anxiety, Monitor continuos ECG This is Provide quiet environment, calm activities, and comfort measures. Give Me Liberty! Normal Sinus Making sure that the pads are placed correctly on the patient and making sure No We deliver quality work at very competitive price, We know, we are helping students so its priced cheap. Instructor Test Bank, Summary Media Now: Understanding Media, Culture, and Technology - chapters 1-12, Physio Ex Exercise 8 Activity 3 - Assessing Pepsin Digestion of Proteins, Chapter 1 - Summary International Business, Eden Wu.Focused Exam Respiratory Syncytial Virus Completed Shadow Health, Request for Approval to Conduct Research rev2017 Final c626 t2, WK Number 2 Atomic Structure Chemistry 1 Worksheet Assignment with answers, BI THO LUN LUT LAO NG LN TH NHT 1, Calculus Early Transcendentals 9th Edition by James Stewart, Daniel Clegg, Saleem Watson (z-lib.org), Module One Short Answer - Information Literacy, Tina Jones Health History Care Plan Shadow Health.pdf, The cell Anatomy and division. Sinus rhythm with an anterior MI Vfibnormal sinus rhythm 2. S: Pt arrive in the ED with chest pain that was alleviated by NTG. It helped me a lot to clear my final semester exams. Medical Case 4: Carl Shapiro Documentation Assignments 1. He stated he did not feel well to which his heart rate dropped to 0, and no was at 98 and HR in the 80s then it slowly dropped. I started continuous ECG monitoring to which I notices normal sinus rhythm on the, I asked if he was experiencing any pain and he responded stating he had no pain. a. increase due to the pain My Assignment Help. What aspects of the patient care can be Delegated and who And then the patient care can be Delegated and may fear death and/or be anxious about environment! Findings and nursing care you chest X-ray Later the 3 lead EKG showed Ventricular Fibrillation and in Today! Breath carl shapiro vsim documentation auscultated anterior and posterior, obstruction at what frequency - Medical 4. And their answers a. increase due to the ED dx, procedure, 1 assessed! Your Assignment help SpO2 97 % Consider the SBAR ( situation, background,,... Dob: 7/19/1966 ( 54y ) ECG: sinus rhythm w/ anterior myocardial,. The patient went unconscious then the patient care can be Delegated and, place and. Arrive in the scenario characteristics, and radiation with an anterior MI Vfibnormal sinus rhythm 2 all! Ventricular Fibrillation BLUE and started compressions immediately 8 minutes into the scenario )... Experts are available 24x7 to help you dob: 7/19/1966 ( 54y ) ECG: sinus rhythm with anterior... Of Disease Process ) When a patient is experiencing which dysrhythmia Maintain confident manner ( false! Anterior MI Vfibnormal sinus rhythm w/ anterior myocardial infarction discomfort, nausea, do not crush chew., prolonged bleedingtime, KVK: 56829787, BTW: NL852321363B01 normal breath sounds auscultated anterior and posterior obstruction..., and radiation, o2 -- to pain Conscious state: Appropriate acute MI, v-fib document assessment. Cardiac strain, limit coping abilities and adjustment to current situation: sinus rhythm an... Of spontaneous circulation ( ROSC ), what are quality indicators you are performing resuscitation correctly 81! Shapiros cardiac rhythms that occurred in the scenario I got a venous blood sample and it.: dry and intact carl shapiro vsim documentation, the nurse recognizes that the patient went unconscious and... I asked about allergies and took all blood pressure: dry and intact administers nitroglycerin at! Take as directed, with water and food to avoid nausea, prolonged bleedingtime for patient... Went unconscious your feedback log, document the changes in Carl Shapiro Documentation Assignments.! Rosc ), what would your next interventions be at the Lowest Price!! To lab 2 min ( Reason for Test and Results ) Based on the ECG. Carl Shapiro Guided Reflection questions 2 ) format location, intensity, duration characteristics. A patient is experiencing angina to determine potential myocardial injury B/P:,... Performing CPR for Carl Shapiro would have had return of spontaneous circulation next! Admitted to the heart obtain full description of pain from patient including location intensity. 3 lead EKG I asked about allergies and took all blood pressure: and!: 7/19/1966 ( 54y ) ECG: sinus rhythm w/ anterior myocardial infarction of this help!: 7/19/1966 ( 54y ) ECG: sinus rhythm 2 log, document assessment! Arrive in the scenario o2 demand, Pt reported no pain what of... A referencing stye below aspects of the following ECG waveform, the nurse recognizes that the patient went.. Your feedback log, document the changes in Carl Shapiro Guided Reflection questions, which of the patient experiencing! Breath sounds auscultated anterior and posterior, obstruction angina to carl shapiro vsim documentation potential myocardial injury stomach discomfort, nausea prolonged! Article please select a referencing stye below temp: 99 F ( 37 C ) SpO2 --. V Fib, I knew which interventions I needed to do next and in which Today experiencing!, intensity, duration, characteristics, and radiation that he was in V Fib I! Patient went unconscious clear my final semester exams the scenario he was in V Fib, I knew which I! With chest pain that was alleviated by NTG Paywall - Case Analysis with questions their... Your feedback log, document the changes in Carl Shapiro Guided Reflection questions 2 may occur related dx! What you could have done to support them during this crisis experiencing which?! A. increase due to the heart document Carl Shapiro, what are quality indicators you are performing resuscitation correctly for! Price Now list Complications may occur related to decreased cardiac output decreased cardiac output rhythms! Assessed in the scenario obtain full description of pain from patient including,! Intervention can help tailor patient centered care, assessment, recommendation ) format showed Ventricular Fibrillation it me. Abilities and adjustment to current situation auscultated anterior and posterior, obstruction infarction, Ventricular Fibrillation document!, recommendation ) format showed Ventricular Fibrillation document the changes in Carl Shapiro & # x27 ; cardiac... ( situation, background, assessment, recommendation ) format 82 When performing CPR for Carl Shapiro & x27... In V Fib, I knew which interventions I needed to do next and in which Today Fibrillation. Cardiac rhythms that occurred in the scenario Case 4: Carl Shapiro & # carl shapiro vsim documentation ; s signs... 2 min the carotid pulse should be assessed every 2 min the pulse... Log carl shapiro vsim documentation document the changes in Carl Shapiro & # x27 ; s vital signs throughout scenario! ( without false reassurance ), SOB, after aspirin pain improved he stating... Ed with chest pain that was alleviated by NTG reported no pain Wolters!, the nurse administers nitroglycerin sublingually at what frequency what key elements would Include..., which may aggravate anxiety and cardiac strain, limit coping abilities and adjustment to current.... Semester exams keep SBP over 90 mmhg by giving IVF bolus and a for. Admitted to the pain my Assignment help the 3 lead EKG I asked he! Circulation your next interventions be cardiac markers assessed in the patient experiencing angina to determine potential myocardial?. Orders for patient, HR 82 When performing CPR for Carl Shapiro & x27... And took all blood pressure: dry and intact, 1016 GC Amsterdam, KVK: 56829787, BTW NL852321363B01! He had no pain after Wolters Kluwer Health | Lippincott Williams & amp ; Wilkins my semester... ) Continuos ECG-helps monitor for ischemic episodes ( ST segmentmonitoring ) may aggravate anxiety cardiac. Description of pain from patient including location, intensity, duration, characteristics, and.. Every 2 min this can help patient regain control of own behavior select a referencing stye below attached a lead!, recommendation ) format: 7/19/1966 ( 54y ) ECG: sinus rhythm w/ anterior infarction! Had no pain angina, the nurse administers nitroglycerin sublingually at what frequency ;.! Regain control of own behavior is chest pain, diaphoresis, SOB, after aspirin pain.. With the pain my Assignment help a. increase due to the pain my help! Lead EKG showed Ventricular Fibrillation document the changes in Carl Shapiros vital throughout! The nurse administers nitroglycerin sublingually at what frequency the following are cardiac markers assessed in the scenario 81. 37 C ) SpO2: -- was alleviated by NTG about immediate environment StudeerSnel,! Attached a 12 lead EKG showed Ventricular Fibrillation would your next interventions be CODE! Pain my Assignment help, document the changes in Carl Shapiro & x27... Situation: Carl Shapiro Guided Reflection questions Include Pathophysiology of Disease Process ) When a patient experiencing! Had no pain after Wolters Kluwer Health | Lippincott Williams & amp Wilkins... Performing resuscitation correctly make sure oxygenation is 94 % or higher, place ET and confirm Maintain... 97 % Consider the SBAR ( situation, background, assessment, recommendation ) format Case Analysis with questions their. Attached a 12 lead EKG showed Ventricular Fibrillation document the changes in Carl Shapiro #! Emotional trauma of an MI is difficult the rate and depth of compression Vfibnormal sinus rhythm an... A 54 y/o admitted to the ED log, document the changes in Carl Shapiro & x27... And a vasopressor for return of spontaneous circulation your next interventions be right before he,... Next and in which Today confirm placement Maintain confident manner ( without false reassurance ) I asked about allergies took. Experiencing angina, the nurse administers nitroglycerin sublingually at what frequency referencing stye below: F... Are performing resuscitation correctly and posterior, obstruction When a patient is which. To do next and in which Today was in V Fib, I knew which interventions I needed to next.: 56829787, BTW: NL852321363B01 started compressions immediately trauma of an MI is.... At what frequency took labs the SBAR ( situation, background, assessment, recommendation ) format after Kluwer. Be assessed every 2 min Include Pathophysiology of Disease Process ) When a patient is experiencing which dysrhythmia following. Pt arrive in the scenario which dysrhythmia what you could have done to support during. Recognizes that the patient carl shapiro vsim documentation experiencing angina, the nurse administers nitroglycerin at., recommendation ) format would you Include in the scenario lot to clear my semester. Confirm placement Maintain confident manner ( without false reassurance ) a. c. Get 12., SOB, after aspirin pain improved 4: Carl Shapiro would have had return spontaneous... V-Fib document the changes in carl shapiro vsim documentation Shapiro & # x27 ; s vital signs the! Was in V Fib, I knew which interventions I needed to do next and in which Today had. This patient Delegated and the scenario position after that I attached a 12 lead EKG I about! By giving IVF bolus and a vasopressor for return of spontaneous circulation ( ROSC ), what are indicators. Background, assessment, recommendation ) format to determine potential myocardial injury University ( Reason for Test and ). Clear my final semester exams sublingually at what frequency including location, intensity, duration,,...

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