Nature. Cellulitis vs necrotizing soft tissue infection, Dental Management of Adrenal Insufficiency Slides, Perio restorative interelationship(periodontics), Complication and management of tooth extraction or exodontia, CARBUNCLE, MODALITIES OF TREATMENT CASE REPORT, SSR Institute of International Journal of Life Sciences. Surgical history. The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. What Types of Oral Problems Require Emergency Dental Care? Low oxygen saturation and affinity for hemoglobin, the oxygen utilization will be reduced, resulting in less amount of oxygen circulating in the body. The client may need assistance in choosing options that will not worsen their skin condition. H\n0. Educate the client about adaptive practices. Assess for contributing conditions.Chronic conditions such as diabetes or a suppressed immune system can complicate an infectious process as well as predispose the patient to worsening infection. In 2008-9 there were 82 113 hospital admissions in England and Wales lasting a mean length of 7.2 days1; an estimated 133m (170m; $209m) was spent on bed These include redness, swelling, warmth to touch, discoloration, increased wound drainage, and Fever. Otherwise, scroll down to view this completed care plan. Instruct on oral antibiotic use.Oral antibiotics are the usual course for uncomplicated cellulitis. Tap here to review the details. 2. For peripheral arterial disease (PAD), shiny skin, hair loss, thick nails, pallor, cool to touch the skin, decrease or absence of pulses, sharp-rest pain with intermittent claudication, necrosis in ulcers. Now customize the name of a clipboard to store your clips. Medscape Reference. A Brief Comparison Between Acupuncture And Physiotherapy, Everything You Need To Know About PRP Dark Circle, Samitivej Childrens Emergency Clinic in Bangkok, Thailand. If there is recurrence, the presence of an abscess should be considered, with needle aspiration of the site for bacteriology being more accurate than a skin swab.14, Erysipelas (Figure 3), also known as St. Anthony's fire, usually presents as an intensely erythematous infection with clearly demarcated raised margins, and often with associated lymphatic streaking (Table 1). 2. Nursing Assessment Assessment would be performed to check the etiology and the cause of cellulitis. You Are Here: what happened to calista flockhart zta password zip nursing management of cellulitis slideshare Maegan Wagner is a registered nurse with over 10 years of healthcare experience. Expected Outcome: The patient will exhibit a return of effective tissue perfusion as evidenced by adequate peripheral pulses and an intact skin condition. 3. Evaluate the overall condition of the clients skin. This information can be used to determine an appropriate plan of care. We assess the most recent evidence in the diagnosis and management of cellulitis. Cellulitis mostly occurs on the lower legs, but can occur in the arms, face, and other regions of the body. By whitelisting SlideShare on your ad-blocker, you are supporting our community of content creators. The patients pain was reduced at the affected site and can move conveniently with lesser discomfort. Retrieved April 27, 2022, from. Knowing the why behind the patients motivation allows healthcare staff to personalize the care plan further. Adjunctive treatment and complications are the same as for cellulitis. The percentage of office visits for cellulitis was 2.2 percent, and for impetigo, it was 0.3 percent, in a cohort of almost 320,000 health plan members (data taken from primary physician diagnosis codes from January 1, 1999 to December 1, 1999 for Intermountain Health Care, Salt Lake City). Staphylococci will occasionally invade the deeper portion of the follicle, causing swelling and erythema with or without a pustule at the skin surface. The patient will take responsibility and control over their own treatment management. Antibiotics are needed to treat cellulitis. Click here to review the details. Now customize the name of a clipboard to store your clips. General discomfort from swelling and burning can be eased with a cool, damp cloth. Cellulitis commonly occurs near breaks in the skin, such as surgical wounds, trauma, tinea infections (Figure 1), or ulcerations, but occasionally presents in skin that appears normal. Ninety percent of patients presented with dermatitis, 78 percent with itching, 52 percent with rectal pain, and 35 percent with blood-streaked stools. Assess how the cellulitis started.Patients are often unaware of how easily cellulitis can occur. Learn faster and smarter from top experts, Download to take your learnings offline and on the go. Enjoy access to millions of ebooks, audiobooks, magazines, and more from Scribd. The SlideShare family just got bigger. This treatment is followed with a course of antibiotics to treat remaining infection otherwise not drained from the procedure. Look for signs of itching and scratching. You can read the details below. Now customize the name of a clipboard to store your clips. Leading cause of preventable death, surpassing tobacco. Cellulitis can quickly become life-threatening so the nurse must monitor vital signs, lab work, and the skin for complications. Diphtheria. Get ideas for your own presentations. The nurse should monitor closely for systemic signs of infection. Pastorino A, Tavarez MM. The SlideShare family just got bigger. There is an increased risk for infection with open skin lesions. nursing management of cellulitis slideshare cscl star vessel flag autism and narcissism differences . Also. If the infection of the follicle is deeper and involves more follicles, it moves into the furuncle and carbuncle stages and usually requires incision and drainage. A study13 of children with perianal cellulitis found a mean age of onset of 4.25 years. Activate your 30 day free trialto continue reading. Read More Vomiting Nursing Diagnosis & Care PlanContinue. Assess access to care and support.Assess if the patient isnt able to seek treatment due to a lack of accessible providers, transportation issues, or financial barriers. Instruct the patient to take all of their medication, even if the cellulitis has significantly improved or resolved. Do not give fallacious reassurance. To determine the severity of cellulitis and any affected areas that require special attention or wound care. Since an IV (and anything invasive like that) breaks the skin integrity, this offers a pathway for bacteria to enter the skin . Oral antibiotics are usually used in the treatment and include first-generation cephalosporins, penicillinase-resistant penicillins, macrolides, and fluoroquinolones. These lesions may occur anywhere on the body, but have a predilection for areas exposed to friction. Her nursing career has led her through many different specialties including inpatient acute care, hospice, home health, case management, travel nursing, and telehealth, but her passion lies in educating through writing for other healthcare professionals and the general public. extremes of age, immunocompromised status), Blood cultures to detect for the specific organism causing the cellulitis, CBC basic laboratory test to determine blood count levels for proper management, Creatinine to assess baseline kidney function and guide for antibiotic dosing, bicarbonate, creatine phosphokinase to assess for latent muscle injuries caused by infection, C-reactive protein (CRP) laboratory marker for inflammation, Ultrasound to detect hidden sources of infection (occult abscess) and can lead to proper management. Do not sell or share my personal information, bilateral involvement should prompt consideration of alternative causes. This may be accompanied by antibiotic therapy. 2 Cellulitis is usually red, swollen, painful, and warm to the touch. A skin abscess is a collection of pus within the dermis or subcutaneous space. Furuncles rarely appear before puberty. Objectives and methods: A management protocol for specialist nurses was developed for ambulatory management of uncomplicated cellulitis requiring initial intravenous (iv) antibiotic therapy. Educate on the prevention of infection.Handwashing is paramount before touching open areas of the skin. If the patient cannot cognitively comprehend not scratching, apply gloves or mittens to protect the skin. Advise the patient and caregiver to prevent scratching the affected areas. By whitelisting SlideShare on your ad-blocker, you are supporting our community of content creators. In some cases, cellulitis may aggravate in response to changes in the environment. Keep skin moisturized with a lotion or cream as dry, flaky skin is more likely to crack. Their relationship and interaction with others may be affected because of distress and disquietude about other peoples reactions and rejection about their appearance. Why You Shouldnt Let Dental Anxiety Ruin Your Teeth, Why You Should Meal Prep for Weight Loss, Addiction Treatment Center A Hope For Hopeless People. Clipping is a handy way to collect important slides you want to go back to later. Copyright 2002 by the American Academy of Family Physicians. Erysipelas is a superficial form of cellulitis with sharply demarcated borders and is caused almost exclusively by Streptococcus. absence of risk factors for other serious conditions (e.g. (e.g., take a deep breath, hold for 2 seconds, and cough two or three times in succession). As health care providers, we need to acknowledge the clients reaction to the changes in their skin, especially those that are visible due to inflammation reaction. Evaluate the clients understanding of the changes in physical appearance. Extremities are cool due to reduced perfusion in the arteries, secondary to plaque build-up (Ischemia). Note: A risk diagnosis is not evidenced by signs and symptoms as the problem has not yet occurred. The area may or may not be covered with a dressing to prevent further damage. Most cases of superficial cellulitis improve within one day, but patients who exhibit thickening of the dermis usually take several days of parenteral antibiotics before significant improvement occurs. The client will have a more real-life picture of ones body than an impractical one. H\n0GM:@ 5OGD`n8,*utS'wD%wm$ mqxZiO'?|0^YQ;A{{u*C%xNr)Mm|;^\>\MePCqU g`\Yk+WW\7+W-yK=:c 5kkWL_`p72%5sd725 5 5Xc[f)o^R`e#R#{!,aY Also, Extreme temperature (Hot and Cold), stress, and tiredness are contributory factors. Cellulitis can occur on any part of the body. Ultrasound-guided pus, CT imaging or MRI if necrotizing fascitis is a concern, doing this imaging procedure will aid in visualizing the extent of damage the infection has caused. Enjoy access to millions of ebooks, audiobooks, magazines, and more from Scribd. DANIEL L. STULBERG, M.D., MARC A. PENROD, M.D., AND RICHARD A. BLATNY, M.D. Tissue death and necrosis will occur if the cellulitis is left untreated or if treatment is not effective. Pale nail beds are an indication of poor perfusion. Expected Outcome: The patient will attain intact skin integrity with a healthy structure and function. 3. The patient may attempt to self-treat at home not realizing the need for antibiotics. Congestive Heart Failure. Available from. The chance for compliments and accomplishment may speed up the adjustment. 2021. For non-purulent cellulitis, empiric therapy of beta-hemolytic Strep and MSSA. Weve updated our privacy policy so that we are compliant with changing global privacy regulations and to provide you with insight into the limited ways in which we use your data. Complications are uncommon though can be severe resulting in osteomyelitis, sepsis, endocarditis, gangrene, and necrotizing fasciitis. N.H.L.Municipal Medical College, Do not sell or share my personal information, 1. Cellulitis: Practice Essentials, Background, Pathophysiology. Determine possible precipitating factors that may attribute to a compromise in tissue perfusion. Fashion, make-up, and accessories may take away the attention from the skin lesion. She has worked in Medical-Surgical, Telemetry, ICU and the ER. Carbuncles are an aggregate of infected hair follicles that form broad, swollen, erythematous, deep, and painful masses that usually open and drain through multiple tracts. 1. [Updated 2021 Jul 31]. The presentation, etiology, and current management of these diseases are presented. Cellulitis is when there is a local skin and soft tissue bacterial infection. Educate the client about adequate nutrition and hydration. Enjoy access to millions of ebooks, audiobooks, magazines, and more from Scribd. A photograph should be taken for baseline comparison. Using a skin marker, mark the edges of the cellulitic area and observe for its shrinkage or spread. Instant access to millions of ebooks, audiobooks, magazines, podcasts and more. ORBITAL CELLULITIS Orbital cellulitis is inflammation of eye tissues behind the orbital septum Refers to an acute spread of infection into the eye socket from either the adjacent sinuses or through the blood When it affects the rear of the eye, it is known as retro-orbital cellulitis. Answer: B. These patients may benefit from prophylaxis with erythromycin, penicillin, or clindamycin (Cleocin).5,7, Periorbital cellulitis is caused by the same organisms that cause other forms of cellulitis and is treated with warm soaks, oral antibiotics, and close follow-up.8 Children with periorbital or orbital cellulitis often have underlying sinusitis.9 If the child is febrile and appears toxic, blood cultures should be performed and lumbar puncture considered. Nursing Care Plans Related to Cellulitis Impaired Skin Integrity Care Plan Cellulitis causes redness and swelling to the skin that can worsen into blisters and abscesses if untreated. Instruct on basic skin hygiene with bathing and keeping the skin dry from sweat or incontinence. The swelling and redness may not be evident until it has become severe. Animal bites, insect stings, recent surgery, puncture wounds, or even microscopic skin tears can contribute for cellulitis to happen. Encourage the patient to monitor the skin for worsening redness or swelling along with any discoloration or drainage. Use lukewarm water, mild soap, or non-soap cleaners to avoid irritations. You can read the details below. Activate your 30 day free trialto unlock unlimited reading. Assess for any open areas, drainage, and the condition of surrounding skin. Tap here to review the details. If they experience fever or changes in breathing or LOC, they should seek immediate treatment. 3. Impetigo is most commonly seen in children aged two to five years and is classified as bullous or nonbullous (Table 1). Surgical resection. living fire begets cold, impotent ash luka doncic euroleague accolades nursing management of cellulitis slideshare 07 jun 2022. nursing management of cellulitis slidesharerelationship between tiger shark and green sea turtle Cellulitis is an acute infection of the dermal and subcutaneous layers of the skin, often occurring after a local skin trauma. Desired Outcome: The patient will prevent spread of infection to the rest of the body, by following treatment regimen for cellulitis. NurseTogether.com does not provide medical advice, diagnosis, or treatment. Trim the patients fingernails and ensure frequent hand hygiene. This is used for simple cellulitis with presence of pus or abscess to the infected tissue. The wound may be packed (usually with iodoform gauze) to encourage further drainage. The risk factors that increase the likelihood of cellulitis include the following: For most cases, no further evaluation is required for uncomplicated cellulitis that meet the following criteria: For moderate or severe forms of cellulitis, further work up is necessary and they include: Treatment approach of cellulitis involves either or both medical management and surgical intervention: Nursing Diagnosis: Impaired Skin Integrity related to infection of the skin secondary to cellulitis, as evidenced by erythema, warmth and swelling of the affected leg. SUMMARY Cellulitis manifests as erythema, edema, and warmth. Prolonged inadequate ventilation may lead to compromised respiratory function performance, such as providing oxygen to the tissues, removing waste products, and acid-base balance. Take note of any erythema, edema, and tenderness. Cellulitis is preventable and can be easily managed if identified early with prompt treatment. The nurse may assess the presence of comorbid conditions that may increase the risk of cellulitis. Because of developing resistance, erythromycin is no longer the drug of choice.17 Azithromycin (Zithromax) for five days and cephalexin (Keflex) for 10 days have been shown to be effective and well-tolerated.20 Dicloxacillin (Pathocil), oxacillin (Prostaphlin), first-generation cephalosporins, or amoxicillin-clavulanate are also acceptable alternatives.5 Broad-spectrum fluoroquinolones have also been shown to be effective, and several have been approved by the U.S. Food and Drug Administration for treating skin and soft tissue infections.21 These medications have excellent skin penetration and good bioavailability, but no generic forms are currently available, and they are only approved for use in adults. Apply corticosteroids over the affected skin as prescribed by the physician. Changes in lifestyle are recommended to lower the risk of triggers. If cellulitis is a recurrent issue identify a caregiver or family member that can accept the teaching and manage the care and follow-up of the patient. Assess for signs of decreased tissue perfusion. Prop extremities on pillows. This is especially important for a patient who has numbness to their extremities or who cannot visualize their skin as they may be unaware of the damage they are causing. 2021. Cellulitis therefore. Hot tub folliculitis is caused by Pseudomonas aeruginosa contamination of under-treated water in a hot tub or whirlpool. This can occur anywhere on the skin, and is usually caused by a "break" in the skin barrier. Allow skin to air dry after bathing, or lightly pat dry the skin. ThePatient may need assistance in knowing how to respond to questions asked or opinions of others, concerning their skin appearance. Learn new and interesting things. Cellulitis Nursing Diagnosis Cellulitis Care Plans Pathophysiology: Cellulitis is an infection of the skin (epidermis and dermis) or underlying soft tissues (hypodermis); it can spread rapidly and be life-threatening. Extraction of the affected tooth may be required. Tap here to review the details. Dull and continuous pain is because of venous hypertension, ulceration. For it reduces the risk of infection. https://www.cdc.gov/groupastrep/diseases-public/Cellulitis.html, https://www.mayoclinic.org/diseases-conditions/cellulitis/symptoms-causes/syc-20370762, https://emedicine.medscape.com/article/214222-overview, https://www.ncbi.nlm.nih.gov/books/NBK556072/, Small Bowel Obstruction Nursing Diagnosis & Care Plan, Hyperlipidemia Nursing Diagnosis & Care Plan, Injury to the skin (cuts, burns, puncture wounds), Skin conditions (eczema, chickenpox, shingles), Poor hygiene practices when getting a tattoo or piercing, Patient will not experience worsening cellulitis as evidenced by erythema localized to one area, Patient will display skin healing without the formation of blisters or abscesses. This condition can occur anywhere but mainly occurs on the lower leg. If antibiotics are required, one that is active against gram-positive organisms such as penicillinase-resistant penicillins, cephalosporins, macrolides, or fluoroquinolones should be chosen. Additionally, vomiting that often ensues from nausea may cause dehydration due to fluid loss. Promote effective coughing. Treatment is done by eliminating the source of infection, draining and treating the wound. INTRODUCTIO N CHANDLER CLASSIFICATION . Clipping is a handy way to collect important slides you want to go back to later. Nonpurulent cellulitis includes rapidly spreading superficial cellulitis and erysipelas; typically involves groups A, B, C, and G beta-hemolytic streptococci and, occasionally,. Past medical history. It appears that you have an ad-blocker running. Assess the skin.Cellulitis presents as redness and swelling initially. Now customize the name of a clipboard to store your clips. Express positivity and care in daily activities. Guide the patients in determining the ways to improve their appearance. When Do You Need to See a Doctor? Levels. These lesions typically resolve spontaneously. Activate your 30 day free trialto unlock unlimited reading. Cellulitis NCLEX Review and Nursing Care Plans. With the increase of venous blood pressure, there is a pooling of blood that causes valvular damage in the veins. Some medications side effects may act as appetite stimulants, and others might cause a decrease in appetite. Nursing Diagnosis: Impaired Skin Integrity Related to: Injury to the skin Inflammation Edema Poor circulation As evidenced by: Erythema Warmth Swelling Skin on lower legs is most commonly affected, though cellulitis can occur anywhere on . This will lead to sharp, intermittent pain while resting. Keep the skin clean and dry.Proper skin care includes washing the skin with warm water and mild soap. As with other diseases involving Streptococci, there is a small chance of developing glomerulonephritis, especially in children aged two to six years. Nursing Diagnosis: Impaired Skin Integrity. Nursing care plans: Diagnoses, interventions, & outcomes. The patient will exhibit wound healing promptly, and maintain excellence in skin integrity within the limitation of the disease, as manifested by intact skin. Read More Impaired Gas Exchange Nursing Diagnosis & Care PlanContinue, 2022 RNlessons | Disclaimer |Terms & Conditions, Ineffective Breathing Pattern Nursing Diagnosis & Care Plan, Readiness for Enhanced Nutrition Nursing Diagnosis & Care Plan, Imbalanced Nutrition: Less Than Body Requirements Nursing Diagnosis & Care Plan, Impaired Gas Exchange Nursing Diagnosis & Care Plan. 111 will tell you what to do. More than one area may be involved and a mix of bullous and nonbullous findings can exist. In this study guide, learn more about diphtheria, its pathophysiology, causes, signs and symptoms, nursing care management, and . Assess for worsening infection.Life-threatening infections can result from cellulitis such as osteomyelitis, sepsis, and gangrene. It may lead to serious complications if left untreated. Educate the patient and caregiver about proper skin hygiene through washing the skin with soap and water. St. Louis, MO: Elsevier. Feeling tired. Scratching relieves intense skin itching, but it may cause open skin lesions, which increased the risk for infection. Learn faster and smarter from top experts, Download to take your learnings offline and on the go. Clipping is a handy way to collect important slides you want to go back to later. A network of furuncles connected by sinus tracts, Painful, erythematous infection of deep skin with poorly demarcated borders, Fiery red, painful infection of superficial skin with sharply demarcated borders, Papular or pustular inflammation of hair follicles, Painful, firm or fluctuant abscess originating from a hair follicle, Large vessicles and/or honey-crusted sores. Instruct the patient and family members about the correct wound care techniques. Extend hopes within limitations of the patients condition. 1.1 Managing cellulitis and erysipelas Treatment 1.1.1 To ensure that cellulitis and erysipelas are treated appropriately, exclude other causes of skin redness such as: an inflammatory reaction to an immunisation or an insect bite or a non-infectious cause such as chronic venous insufficiency. 1 Cellulitis, impetigo, and folliculitis are the most common bacterial skin infections seen by the family . Have a quick capillary refill (Should have less than 6 seconds). In cases of cellulitis, they may have a specific characteristic pattern of skin changes and lesions. Adequate hydration and nutrition assistance help sustain skin turgor, moisture, and suppleness, which give elasticity to prevent skin damage due to pressure. If the condition does not improve after a few days, have the patient contact their provider for a change in treatment. #}0si (2020, February 6). Provide positive feedback on the clients improvement and motivate the goal in direct attainment of the rehabilitation objectives. 2. Circulation . Management should include supportive measures. The pathogen is usually S. aureus. Arterial predisposing factors may be atherosclerosis or age-related. She earned her BSN at Western Governors University. Clipping is a handy way to collect important slides you want to go back to later. Encourage the patient to adopt skin care routines to decrease skin irritation: One of the first steps in the management of dermatitis is promoting healthy skin and healing skin lesions. All Rights Reserved. Family physicians frequently treat bacterial skin infections in the office and in the hospital. Treatment may include: Oral or intravenous (IV) antibiotics Cool, wet dressings on the infection site Surgical intervention If your child has an extremity (arm or leg) that is affected, his or her doctor may have you elevate the extremity and decrease the amount of activity Rest (2020, May 29). Cellulitis often occurs in the lower leg but can affect the arms, face, and other areas. If the infection is a toxin-producing, phage group II, type 71 Staphylococcus (the same toxin seen in Staphylococcus scalded skin syndrome, a medical emergency where large sheets of the upper epidermis slough off), large bullae will form as the toxin produces intradermal cleavage.18 Otherwise, smaller bullae develop and the honey-crusted lesions predominate. Examine the areas of irritants and in contact with allergens. Monitor for these values trending up as infection worsens. Presenting signs and symptoms of glomerulonephritis include edema and hypertension; about one third of patients have smoky or tea-colored urine. Put limitations on maladaptive behavior. Anna Curran. Incision and drainage. The patient will extract positive feelings about their physical image and will talk about having feelings of increased self-esteem. The most important part of the care plan is the content, as that is the foundation on which you will base your care. The patient will speak freely about their outlook and how they feel with skin lesions, and will carry on with the activities of daily living and socializing with others. It is a common diagnosis in both inpatient and outpatient dermatology, as well as in the primary care setting. Instant access to millions of ebooks, audiobooks, magazines, podcasts and more. Diagnosis is based upon clinical manifestations. By whitelisting SlideShare on your ad-blocker, you are supporting our community of content creators. Bacterial organisms enter a compromised skin barrier and cause infection. Assess the skin color, temperature, and sensation of all extremities. 3. At rest, there is less oxygen demand by the muscles, resulting in decreased blood supply to these areas. 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These chronic conditions must be properly managed to prevent secondary infections. Complications include abscess formation, persistent blindness, limited eye movement, diplopia, and, rarely, meningitis.11 This ocular emergency requires intravenous antibiotics, otorhinolaryngology, and ophthalmologic consultation.12, Perianal cellulitis is caused by group A beta-hemolytic streptococcal infection and occurs most often in children. Cellulitis Symptoms and causes. Cellulitis classically presents with erythema, swelling, warmth, and tenderness over the affected . 1. This is used for simple cellulitis with presence of pus or abscess to the infected tissue. RN, BSN, PHNClinical Nurse Instructor, Emergency Room Registered NurseCritical Care Transport NurseClinical Nurse Instructor for LVN and BSN students. Checking of renal function tests is advisable. Clean the wound according to the Doctors advice. 4. Activate your 30 day free trialto continue reading. Desired Outcome: The client will sustain adequate peripheral perfusion, as evidenced by strong pulses, skin is warm to touch, with a normal capillary refill, and wounds are healed. 1. Changes or worsening in these lung sounds may indicate a decline in ventilation. We've updated our privacy policy. Definition. Expected Outcome: The patient will report satisfactory pain control at a pain score of 3 or less on a pain scale of 1 to 10. These lesions are painful and may scar. Principles. This is the best way to assess if redness is continuing to spread. The skin is considered the biggest organ of the body in terms of surface area. Prevent shearing or further irritation.If the patient is immobile or is unable to guard against further skin breakdown take care when turning and repositioning. _O Tead "To manage is to forecast and plan , to organize ,to compound, to coordinate and to control.". Strengthening teaching can support the patient to attain self-care. Nursing Care Plan for: Cellulitis. You can read the details below. Do Clear Plastic Aligners Adjust The Extraction Of Front Teeth?
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