The Centres for Disease Prevention and Control (CDC) is in charge of conducting scientific process improvements for CLIA and doing analysis, research, providing technical assistance.
What does a scientific lab do?Unlike the field or factory, a laboratory is just a site where scientific research, production, and analyses are carried out. The majority of laboratories have carefully regulated, standardized settings (constant temperature, humidity, cleanliness).
The laboratory method is what?Laboratory techniques cover all facets of the diagnostic environment, from determining the level of cholesterol in the blood to analyzing your DNA to cultivating microbes that could be the source of an infection. They are founded on well-established scientific methods encompassing biology, chemistry, and physics.
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the nurse is caring for a patient diagnosed with copd. which assessment data requires the nurse to intervene?
Answer:
Rusted-colored sputum in the sputum collection container.
Explanation:
an infant is being seen in the pediatrician's office for a 2-month-old well-child visit. the nurse encourages the mother to allow the infant to suck on a pacifier during a routine immunization. the nurse explains to the mother that the child is at which stage of piaget's cognitive development?
Sensorimotor development is a stage where piaget's cognitive development.
Piaget's theory suggests that children progress through a series of four different stages of cognitive development. These stages encompass numerous aspects of mental development including that of reasoning, language, morals, and memory. Piaget believed that kids take an active role in this cognitive development, building knowledge as they interact with the world.
The sensorimotor stage is the earliest in Piaget's theory of cognitive development. He described this period as a time of tremendous growth and change.
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a client is believed to be in the irreversible state of shock and is unresponsive. the family requests to stay with the patient during this time. what is the best response by the nurse?
The best response by the nurse would be "The healthcare team needs room to do procedures to help your family member, so it would be best if you stayed in the waiting area."
What is irreversible state of shock?
Irreversible state of shock is a terminal phase of shock. When a person goes into this phase, it is the point of no return. This is because there is rapid deterioration of the cardiovascular system and compensatory mechanisms of the patient have failed.
The person will have severe decreases in cardiac output, tissue perfusion bblood pressure.
Blood is shunted away from the kidneys, liver and lungs to maintain perfusion of the heart and brain, in a last-ditch effort to save the core of the body.
So, therefore, the best response by the nurse would be "The healthcare team needs room to do procedures to help your family member, so it would be best if you stayed in the waiting area."
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a pregnant woman calls the clinic and asks if it is suitable to use ofloxacin otic drops that she used prior to pregnancy for a current ear infection. what would be an appropriate response from the nurse?
Ofloxacin is one of the drugs that should not be used during pregnancy.Ofloxacin is a member of the quinolone antibiotics medication class.
Why are medicines advised?Chemicals or other compounds are referred to be "medicines" when they are used to treat, stop, or prevent disease, lessen symptoms, or help with disease diagnosis. Many ailments can now be treated, saving lives, thanks to medical advancements. Various materials are used to create medicines nowadays.
What kinds of drugs are exceptional ones?A specialty drug is a prescription drug that is either an expensive oral medication, a self-administered (non-diabetic) implantable medication, a medication that needs special handling, administration, or monitoring, or a medication that is an expensive injectable or self-administered (diabetic) injectable medication.
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the texas department of health has isolated yersinia pestis from wood rats and prairie dogs in west texas and the texas panhandle. in addition to the fever, chills, and severe headache, this patient has developed hemorrhages under the skin. what disease is this camper likely to have? the texas department of health has isolated yersinia pestis from wood rats and prairie dogs in west texas and the texas panhandle. in addition to the fever, chills, and severe headache, this patient has developed hemorrhages under the skin. what disease is this camper likely to have? septicemic plague pneumonic plague bubonic plague tularemia
The Texas Department of Health isolated plague from wood rats and prairie dogs in West Texas and the Texas Panhandle. In addition to fever, chills, and severe headache, the patient developed bruising. This camper probably has a disease called bubonic plague.
What is bubonic plague today?Bubonic plague is the most common form of plague. This is because infected fleas can bite people. Pestis enters through cracks in a person's skin. Known in the Middle Ages as the Black Death, the plague now affects fewer than 5,000 people worldwide each year. It can be fatal if not treated promptly with antibiotics. The most common form of plague causes swollen and tender lymph nodes (called lumps) in the groin, armpit, or neck.How did the bubonic plague end?It is not clear what caused the bubonic plague to die out. Some scholars claim that cold weather killed disease-carrying fleas, but that wouldn't have stopped the spread of respiratory disease or maybe it was a change in rats.
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while assessing the development of an 8-month-old infant, the nurse finds that the infant is interested in playing with food, water, and sand. which type of content play interests the child?
Infants begin to use their fine-motor abilities between the ages of 6 and 8 months, such as transferring objects from hand to hand, banging objects together, and tugging strings to get an object.
When doing a health maintenance visit for a 15-month-old toddler, which growth and developmental exam would the nurse include?A 15-month-old toddler should have their length, weight, and head circumference measured by the nurse as part of a growth and developmental assessment. BMI is not measured until a child is 24 months old. A 15-month-old toddler should undergo developmental observation rather than screening.
What ought a 6 or 7-month-old to be doing?By this age, your baby can roll both directions and may begin to commando crawl about the house. Your infant may even try to crawl using their hands.
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a nurse mentoring a new graduate nurse informs the graduate that urinary obstructions are usually classified according to which parameters? select all that apply.
A nurse mentoring a new graduate nurse informs the graduate that urinary obstructions are usually classified according to following parameters
Congenital or acquiredPartial or completeAcute or chronicUpper or lowerWhat is urinary obstructions ?Anywhere along the urinary tract, from the kidneys, where urine is produced, to the urethra, where pee exits the body, a blockage (obstruction) can raise pressure within the urinary tube and decrease urine flow. An blockage may grow gradually over days, weeks, or even months or it may happen suddenly. A portion of the urinary system may be entirely or only partially blocked by an obstruction. Although blockage can damage both kidneys, it often only affects one kidney.
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which clinicalmanifestations would be typical in an individual with pernicious anemia quizlet ataxia
Clinical manifestations would be typical in an individual with pernicious anemia symmetrical paresthesias and ataxia on people who abuse at school.
So the correct answer is option b.
The neurological manifestations of pernicious anemia include ataxia and symmetrical paresthesias.
Increased levels of methylmalonic acid are found in those with pernicious anemia (MMA). The buildup of homocysteine and MMA promotes myelin degradation, which results in neurological disorders such ataxia and neuropathy.
Heartburn, intestinal gas and bloating, constipation or diarrhea, nausea (a sense of being sick to your stomach), vomiting, decreased appetite, and weight loss are a few of these symptoms. Another sign is an enlarged liver. A smooth, thick, crimson tongue is an additional indicator of pernicious anemia and a vitamin B12 deficiency.
typical signs of vitamin B12 insufficiency in the nervous system
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The complete question is as follows.
Which of the following people are at highest risk for developing a folate deficiency anemia?
A. Children born with a congenital intrinsic factor deficiency
B. People who abuse alcohol
C. Menstruating women
D. Vegetarians
the nurse is caring for a client who is postoperative 24 hours from an appendectomy. the client is hesitant to get out of bed. how should the nurse respond?
The nurse should respond by saying : " "Can you describe the sensations you have when attempting to move?"
What is appendectomy ?An appendectomy is a surgical procedure to remove the infected appendix. Appendicitis is the name for this condition. An emergency appendectomy is a common procedure.
You will have a cut or incision created in the lower right corner of your tummy. The abdominal cavity will be accessed and your abdominal muscles will be dissected. Your appendix will be cut out and tied off with stitches. Your belly will be rinsed with salt water if your appendix has ruptured or burst (saline).
The appendix could rupture (burst) and result in an infection that could be fatal or life-threatening, hence appendicitis must be surgically treated as soon as possible.
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a pregnant adolescent client asks for information about the pregnancy and the baby because of the inability to afford prenatal care. which action by the nurse is the most appropriate?
Information about services to help with medical care during pregnancy and after birth should be given to the client.
What week should prenatal care begin?
In the first 6 to 12 weeks of pregnancy, the majority of women begin prenatal care. Your gynecological and health history, as well as any potential issues you may have, greatly influence the scheduling of your initial appointment. We provide thorough obstetrics care at Capital Women's Care to safeguard you and your unborn child.
Do husbands attend the initial prenatal appointment?
Ask your partner to attend the initial prenatal checkup with you if you have one. Susan Thorne, department chief of obstetrics and gynecology and medical director of the Maternal Newborn Program at the University of California, San Francisco, says: "It's a lot to take in on one visit."
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the nurse-manager is talking to a new nurse who is thinking about resigning before orientation to the unit is over. the nurse-manager explains that reality shock after graduation is common. which explanation should the nurse-manager use to best describe reality shock to the new nurse?
The explanation which the nurse-manager should use to best describe reality shock to the new nurse is "A period of role adjustment from school into the work force."
Nurse managers are accountable for managing human and monetary resources; guaranteeing patient and workers satisfaction; maintaining a secure setting for workers, patients, and visitors; guaranteeing standards and quality of care are maintained; and orienting the unit's goals with the hospital's strategic goals.
Role adjustment is necessary for nurses as a result of She was having the ability to comfort and support people that are unwell, vulnerable, or scared, is that the key to became a in nurse. She should take the time to form her patients feel needed, supported, and be there as an acquaintance.
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the urinary sediment (ph 5.0) of a patient reveals yellow to reddish-brown crystals, many of which appear as rhombic plates and rosettes. these crystals are most likely associated with:
Monosodium urate crystals in the shape of needles are quite uncommon in urine. They typically occur in acid urine and have a yellow or reddish-brown appearance.
What is Uric Acid?
As the body breaks down purine-containing compounds, uric acid is produced. The majority of uric acid is dissolved in the blood and moves to the kidneys, where it is excreted in urine. You could become ill if your body creates too much uric acid or does not remove enough of it.
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a patient has been diagnosed with acute gastritis and asks the nurse what could have caused it. what is the best response by the nurse? (select all that apply.)
The best response from a nurse to a client diagnosed with acute gastritis who asks the cause is " the cause of acute gastritis is because you consume excessive alcohol, stress, chronic vomiting, or certain drugs."
What is gastritis?Gastritis is inflammation of the stomach wall; this condition is caused by a variety of different factors such as infection. Bile reflux, bacteria, and anemia are also common causes of other gastritis.
The main cause of gastritis is a bacterium called Helicobacter pylori, which can be found in contaminated food or water. The bacteria can also be passed from one person to another. Other common causes include non-steroidal anti-inflammatory drug (NSAID) use, excessive alcohol consumption, as well as drug abuse.
Your question is incomplete, but most probably your full question was:
A patient has been diagnosed with acute gastritis and asks the nurse what could have caused it. what is the best response by the nurse? select all that apply.
" The cause of acute gastritis is because you consume excessive alcohol, stress, chronic vomiting, or certain drugs."'"The cause of acute gastritis is because you eat fruits, vegetables, and whole grains. "Learn more about classified chronic gastritis here :
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FILL IN THE BLANK. instructional training (1) the teacher gives a ____ description. (2) the learner emits the ____ behavior. (3) the teacher ____ it
1) The teacher gives a verbal description
2) The learner emits the instructed behavior
3) The teacher reinforces it
What is instructional training?
Job instruction training, or JIT, is a type of straightforward on-the-job training in which a new hire is guided step-by-step through the process by a manager or a designated coworker. This type of education is typically available for industries demanding manual labour, such manufacturing workers. Information processing, behavioural, social interaction, and personal are the four categories. There are various tactics that can be applied inside each model. Strategies define how a teacher will approach achieving learning goals.
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what teaching points would a nurse provide for families of school-aged children to help prevent substance abuse? select all that apply.
Give the kid hypothetical circumstances they might encounter.Establish clear guidelines for using alcohol and other drugs, and talk about the repercussions of breaking them.Encourage making decisions and talk about family values.
Which seven-year-old displays the development of decentration the best?The child is capable of comprehending other viewpoints.Explanation:At age 7, a child's brain processes change, and magical thinking gradually disappears.
What are the four main theories of child development?Peterson offers four perspectives: social learning, classical learning, cognitive/developmental learning, and psychoanalytic learning (2010).
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a client is receiving rifampin and isoniazid in combination for treatment of tuberculosis. what would the nurse need to monitor closely?
The body's fluids become orange when this medicine is taken. To prevent fear when it happens, the client has to be made aware of this. Any medication may result in an allergic response.
What types of jobs are there for nurses?Registered nurses (RNs) oversee and perform medical operations, assist patients' families emotionally, and educate the public about a range of health concerns. The majority of registered nurses work in a variety of settings with physicians and other healthcare professionals.
One category of candidates is nurses.Their duties also include several post-operative surgical therapy chores. Heart, pediatric, or obstetric surgery is a typical area of specialization for surgical nurses.
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a client with chronic asthma is experiencing a severe asthma attack and is becoming increasingly agitated. the nurse supports the client's ability to move more air in and out of the lungs by instructing the client to stabilize his accessory muscles. the nurse understands that by stabilizing the accessory muscles, the:
accessory muscles can assist in ventilation.
Accessory muscles assist ventilation by elevating the ribs and the sternum, which enlarges the chest cavity allowing more air to flow in. To stabilize the accessory muscles, the client should brace his shoulders by pressing down on a hard surface along with putting his head back to engage the scalene and sternocleidomastoid muscles.
What are sternocleidomastoid muscles?
Sternocleidomastoid (SCM) is a paired superficial muscle in the front region of the neck (synonym musculus sternocleidomastoideus). An important marker in the neck that separates it into an anterior and a posterior triangle is the sternocleidomastoid muscle (SCM). Headaches and soreness in the neck might result from sternocleidomastoid pain. Trigger points on the front or side of the neck may be noticeable by someone with sternocleidomastoid discomfort. However, this muscle's pain frequently spreads, resulting in the ear, eye, or sinus discomfort.
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the nurse is teaching a class at a local community center. which information is the most important fact to discuss with the patients regarding the prevention of chronic obstructive pulmonary disease (copd)?
the nurse is teaching a class at a local community center,the patients regarding the prevention of chronic obstructive pulmonary disease
The appropriate response to the statement is:
It appears that neck muscles have gotten bigger as a result of usage.
The patient slumps and places her hands on her knees.
The anteroposterior and transverse dimensions are same.
Chronic lower respiratory problems include emphysema, chronic bronchitis, and chronic obstructive pulmonary disease (COPD). Overall, chronic lower respiratory illnesses are the leading cause of death in the US.Chronic obstructive pulmonary disease (COPD) affects the lungs and airways when they degenerate and become inflamed. It is typically associated with regular exposure to hazardous substances like cigarette smoke. This section discusses elements that can increase your
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a woman with type 2 diabetes mellitus becomes pregnant, and her oral hypoglycemic agents are discontinued. which intervention is most important for the nurse to implement?
Explain how changing her diet can help her manage her diabetes better. Dietary changes (A) can help manage Type 2 diabetes while pregnant, and they can also describe the required diet.
What constitutes a wholesome diet?highlights whole grains, fruits, vegetables, and low- or fat-fat milk as well as dairy products. consists of several different protein-rich foods, such as seafood, lean meat and poultry, eggs, legumes (beans and peas), soy products, nuts, & seeds. has little cholesterol, sodium, added sugar, saturated fat, or added trans fat.
Which diet is advised?The DASH diet, the flexitarian diet, and the Mediterranean diet are still the top three diets for 2022. Experts strongly advocate them due to the well-known health benefits of all three diets. The Mediterranean diet plan doesn't have a fixed calorie limit with portion size guidelines, so it can meet the demands of almost everybody.
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the nurse is caring for a client in shock who is deteriorating. the nurse is infusing iv fluids and giving medications as ordered. what type of medications is the nurse most likely giving to this client?
The nurse is caring for a client in shock who is deteriorating. the nurse is infusing iv fluids and giving medications as ordered. Adrenergic drugs of medications is the nurse most likely giving to this client.
Drugs classified as "adrenergic drugs" bind to adrenergic receptors found all over the body. Alpha-1, alpha-2, beta-1, beta-2, and beta-3 are some of these receptors. Adrenergic drugs will directly bind to one or more of these receptors in order to have a variety of physiological effects. The Latin word nutire, which means to suckle, is the source of the word nurse. This is because it originally solely referred to a wet-nurse and didn't change to refer to someone who looks after the sick until the late 16th century.
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the nurse prepares to administer acetylcysteine to the child with an overdose of acetaminophen. what is the appropriate action when administering this antidote
Sweating, nausea, and vomiting are possible following an overdose acetaminophen within the first 24 hours. The amount of liver-damaging enzymes in the blood starts to increase. In the following 18 to 72 hours, the patient may experience a reduction in their symptoms and feel better.
What occurs when a kid consumes acetaminophen?Overdosing on acetaminophen can cause the following early signs: nausea, vomiting, stomach pain, paleness, and exhaustion.
Acetaminophen overdose: how to recover?N-acetylcysteine is the remedy for an overdose of acetaminophen (NAC). The eight-hour window following acetaminophen ingestion is when it works best. If given early enough, NAC can really stop liver failure.
If you still have acetaminophen in your stomach, a medication containing activated charcoal may be prescribed.
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a client is diagnosed with severe combined immunodeficiency (scid). what would the nurse expect to integrate into the client's plan of care?
A hematopoietic stem cell transplant will be given to a patient with severe combined immunodeficiency. What would the nurse anticipate beginning? immune-suppressing medicines.
What immunodeficiency is most prevalent?
Low serum levels of immunoglobulins and antibodies, which enhance vulnerability to infection, characterize one of the most often identified primary immunodeficiencies, known as common variable immune deficiency (CVID).
What type of blood test identifies immunodeficiency?
Immunoglobulin levels can be checked by doctors to determine if a patient is infected or immune to infection (is immune to it). Immunoglobulin tests are also used by doctors to identify immunodeficiencies, which occur when the immune system isn't functioning properly.
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why are the caloric and micro/macronutrient needs per kilogram of body weight of children less than the needs of infants
Foods high in protein, fat, or carbohydrates provide energy. The amount of kilocalories, or "calories," required for each unit of a person's body.
Why do newborns require a higher amount of calories from fat in their meals than adults do?Fat is crucial for brain function and neurological development, especially in infancy and early childhood. 40–50% of the energy in mother's milk and newborn formula comes from fat (Fidler et al. 1998). Ingested carbohydrate and protein as well as endogenous metabolism are two possible sources of body fat.
Why do you gain weight when you consume more calories than your body requires?A person can stop burning fat, and when they consume more calories, they become very good at storing fat. A healthy weight should be not by the number of calories you consume, but rather by the kinds of foods you eat and lifestyle adjustments like exercise.
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the nurse is preparing to administer an nsaid to a client for pain relief. the nurse notices that the client is diagnosed with a bleeding disorder. what should the nurse do?
In order to relieve the client's pain, the nurse is getting ready to give them an NSAID. The client has been identified as having a bleeding issue, the nurse observes.
What sort of employment does a nurse have?
Registered nurses (RNs) administer and organize patient care, inform the public and patients about various health issues, and offer counsel and moral support to patients and their families. The majority of nurse practitioners collaborate with physicians and other medical professionals in a variety of situations.
What is a nurse's function?
Nurses tend to patients' injuries, administer medications, perform diagnostic tests, operate medical equipment, draw blood, perform frequent physical exam, record thorough medical histories, monitor heart rate and blood pressure and admit and discharge health care workers in conformance with doctor's orders.
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In order to relieve the client's pain, the nurse is getting ready to give them an NSAID. The client has been identified as having a bleeding issue, the nurse observes.
What sort of employment does a nurse have?
Registered nurses (RNs) administer and organize patient care, inform the public and patients about various health issues, and offer counsel and moral support to patients and their families. The majority of nurse practitioners collaborate with physicians and other medical professionals in a variety of situations.
What is a nurse's function?
Nurses tend to patients' injuries, administer medications, perform diagnostic tests, operate medical equipment, draw blood, perform frequent physical exam, record thorough medical histories, monitor heart rate and blood pressure and admit and discharge health care workers in conformance with doctor's orders.
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after delivery of a pulseless and apneic infant who has a foul odor, skin sloughing, and diffuse blistering, you should:
You should offer the mother emotional support following the delivery of a baby who is apneic, pulseless, and has diffuse blistering, skin sloughing, and an offensive odor.
How many breaths should a child with apnea take?
Open the airway and take two breaths after the initial round of 30 compressions. The tongue may impede the airway and hinder ventilations in an unresponsive baby or child. For both injured and non-damaged victims, use a head tilt-chin lift procedure to open the airway.
What happens during an apneic event?
During an apneic episode, you are unable to breathe in oxygen or expel carbon dioxide. The results in the blood are low oxygen levels and greater carbon dioxide levels. This awakens the brain and tells it to resume breathing.
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when providing care to a client with dementia, which interventions would be most appropriate? select all that apply.
Dementia is a general term for loss of memory, language, problem-solving and other thinking abilities
Which nursing action is most effective for treating dementia in clients?
Nursing interventions for a patient with dementia include: Serve the client. frequently orient client to surrounds and reality. Allow the client to be surrounded by familiar objects; use additional objects, such as a clock, a calendar, and daily schedules, to help the client stay grounded in reality.
Which nursing intervention should be given top priority for a delirious client?
The most effective treatment is to avoid delirium altogether. It is essential to recognise patients who are at risk for delirium and to take extra care to prevent it. A history of an underlying neurological condition, such as dementia, and becoming older are non-modifiable risk factors.
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which assessment findings suggest to the nurse that this patient has characteristics seen in an individual who has reached self-actualization? select all that apply.
Spiritual health, openness and adaptability, fulfilling relationships, and altruism toward others are traits of self actualization. Pay doesn't always correspond to self-actualization.
What is a psychosocial component that has the potential to affect mental health, quizlet?Life experiences—particularly crises and losses—are regarded as having a psychosocial impact on mental health.
Which of the following best describes secondary prevention in community mental health?For instance, by screening individuals for depression , a more serious outcome may be prevented by early intervention. hotlines and crisis centers are examples of secondary prevention, when the disorder already present but can be mitigated before it worsens.
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a nurse caring for a client after epidural anesthesia observes that the client is beginning to present with dry skin and bradycardia with hypotension. what type of shock is the nurse assessing?
Option A neurogenic is the correct answer.
The symptoms of neurogenic shock, which include dry skin, bradycardia, and hypotension in the patient, can be brought on by spinal cord injury, spinal anaesthesia, or other nervous system damage. Patients with compromised heart function may have cardiogenic shock. Reduced intravascular volume is the cause of hypovolemic shock. Clients who have already developed antibodies to a foreign substance (antigen) experience a systemic antigen-antibody reaction, more precisely, an immunoglobulin E-mediated response. Anaphylactic shock is triggered by a severe allergic reaction.
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a 67-year-old client has tested positive for influenza a. the client also has asthma. which drug would the nurse recommend be avoided in this client?
The drug which must be avoided by the client is Zanamivir
Why should an influenza patient avoid Zanamivir ?Infection brought on by the flu virus is treated with zanamivir (influenza A and influenza B). Additionally, swine influenza A may be prevented and treated with this medication.
By one to one and a half days, zanamivir may shorten the duration of flu symptoms, which include fatigue, headache, fever, cough, runny or stuffy nose, and sore throat.
The drug zanamivir belongs to the group of drugs known as neuraminidase inhibitors. It functions by preventing the flu virus's development and spread throughout your body.
Agents called zanamivir and oseltamivir are made specifically to occupy the catalytic site of the neuraminidase enzyme of the influenza virus in order to limit its activity.
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a 40-year-old man presents with a 3-day history of right-sided chest pain. it is gradually increasing in intensity, burning in character, and like a band across his mid-chest and mid-back on the right side. today, he noticed a light rash in this area; out of concern, he visited his doctor. he has no fever, but he is experiencing fatigue and malaise. his past medical history includes gerd, for which he is on lansoprazole daily; asthma, for which he uses albuterol inhaler daily; and knee arthritis, for which he uses over-the-counter low dose naproxen as needed. family history is noncontributory. on examination, he is afebrile with a bp of 128/80 mm hg and a pulse of 70 bpm. oral exam is unremarkable. lungs are clear, and the abdomen is benign. on the right side of his chest, there are small vesicles with surrounding erythema in the mid region. the skin is excruciatingly tender in a dermatomal fashion along the affected area. question: what is the most likely diagnosis?
Herpes Zoster infection: A common ailment observed in the clinic is herpes zoster infection, which is indicated by the dermatomal distribution of burning pain along with a vesicular rash.
What healthcare services are covered under Medi-Cal?Numerous medically required services are covered by Medi-Cal. Prescription medications, eye exams, family planning, mental health treatments, and drug and alcohol rehabilitation are all included in this. Also included are trips to the dentist and doctor.
Do you often receive Medi-Cal benefits?Many consumers who enroll in Medi-Cal are not required to pay a premium, a co-payment, or any out-of-pocket expenses. A modest monthly premium will be one of the prices that some households can pay. With a maximum of $13 for each child, the average monthly Medi-Cal premium for a household is $39 per month.
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