In which dysrhythmia does the p wave disappear or occur just before or after the qrs complex?

Answers

Answer 1

There are no P waves. A lack of sinus beats is indicated by the absence of visible P waves before QRS complexes; this can happen when the sinuses are dysfunctional or when fibrillation or flutter waves are present. The QRS complex may potentially conceal the P wave.

What is dysrhythmia?

Dysrhythmia is the term for an irregular heartbeat rhythm, and it may be harmful. Discover the definitions, signs, and treatments for the many cardiac dysrhythmia types. If you play an instrument or dance, you are likely aware of how crucial rhythm is to keeping a song or dance in time. The heart operates on a similar principle. Its heartbeat has a particular rhythm. The term dysrhythmia comes from the Greek words "dys-," which means "bad," and " -rhythmia ," which implies "rhythm." While dysrhythmia can refer to brainwaves, it's most frequently used to refer to heart rhythm. If that rhythm is disturbed, we refer to it as an arrhythmia, irregular heartbeat, or dysrhythmia.

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Related Questions

A primary care physician is concerned with the course of a disease in an individual, while an epidemiologist is concerned with the course of disease in a population. True or false?.

Answers

Answer:

true

Explanation:

A nurse is caring for a patient who is newly admitted to the facility for chest pain. at which time should the nurse begin teaching about drugs and discharge planning?

Answers

A nurse is caring for a patient who is newly admitted to the facility for chest pain. Nurses begin teaching about drugs and discharge planning As soon as possible.

A nurse is a person who has finished a basic, generalist nursing education program and has been given permission by the relevant regulatory body to practice nursing in their nation. Nurses plan and deliver medical and nursing care to patients with acute or chronic physical or mental illness in hospitals, at home, or in other settings. Important qualities of a nurse include compassion, empathy, and the capacity to handle stressful and emotionally intense situations.

Today's nurses are vital members of society because they promote health, educate the public and their patients on how to avoid illnesses and injuries, take part in rehabilitation, and offer care and support.

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When an animal receives a vaccine, about how long will it take before the aniimal's immune system will protect the animal from disease?

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Vaccinations cause organisms to develop active immunity. The immunity that occurs when an organism's immune system is actively producing antibodies against an encountered antigen is known as active immunity. Weakened antigens are given to the organism through vaccination, which causes the immune system to produce antibodies against it. This antigen exposure and antibody release results in lifetime immunity to that specific antigen. It takes the animal about two weeks to develop immunity to the vaccination after it is administered.

What is animal Vaccination?

Animal vaccination is the vaccination of livestock, or wild animals. The practice is related to veterinary medicine. The first invented animal vaccine was developed in 1879 by Louis Pasteur against chicken his cholera. The production of such vaccines encounters problems related to the economic hardships faced by individuals, governments and companies. Animal vaccination is less regulated than human vaccination. Vaccines are divided into conventional vaccines and next-generation vaccines. Animal vaccines have proven to be the most cost-effective and sustainable method of controlling infectious diseases in animals. The animal vaccine industry was valued at $7 billion in 2017 and is projected to reach $9 billion by 2024

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Answer: About 2 weeks

A nurse is providing care to a client with uterine fibroids (uterine myomas) who is prescribed a progestin antagonist. which medication would the nurse most likely expect the client to receive?

Answers

Mifepristone medication would the nurse most likely expect the client to receive.

What do you mean by the Mifepristone?

Mifepristone is a synthetic steroid. When combined with misoprostol, the Mifeprex brand of mifepristone is indicated for the medical termination of intrauterine pregnancies up to 70 days gestation. Up until week 10 of pregnancy, it is utilized (up to 70 days after the first day of your last menstrual period). A natural chemical (progesterone) that is required for the continuation of your pregnancy is blocked by mifepristone. Mifepristone is used to induce an abortion in the early stages of pregnancy. It is typically used in conjunction with another drug called misoprostol. Up until week 10 of pregnancy, it is utilized (up to 70 days after the first day of your last menstrual period). A natural chemical (progesterone) that is required for the continuation of your pregnancy is blocked by mifepristone.

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your patient is considerably overweight. as you measure the patient's body weight, what should you do?

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Your patient is considerably overweight. As you measure the patient's body weight, you should record the patient's weight in the form and let the doctor consult it with the patient.

An overweight person is defined as irregular or disproportionate fat collection that might harm health. Body mass index (BMI) is a simple index that is usually used to categorize overweight and obese adults. A body mass index (BMI) of over 25 is regarded as overweight, and above 30 is obese.  For a healthy body to function a minimum amount of fat is required. Excessive fat can impair the functioning of the hormonal, reproductive, and immune systems. Fat aids in thermal regulation, shock absorption, and energy reserve for future use, but the collection of excessive fat can reduce locomotion and flexibility.

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According to the pediatric client's bill of rights, the nurse manager should privately counsel a staff nurse to change her behavior in which situation(s)? select all that apply.

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According to the pediatric client's bill of rights, the nurse manager should privately counsel a staff nurse to change her behavior in situations are-

-The nurse manager hears the staff nurse call the patient "kiddo."

-The nurse manager hears the parents ask the name of the surgeon that has been consulted and the staff nurse responding, "I'm not sure, it's best if you ask your doctor."

Bill of Rights- The Bill of Rights is the collective name for the first 10 Amendments of the Constitution. It describes Americans' constitutional rights in relation to their government. People are granted civil freedoms and rights, such as the freedom of expression, the press, and religion.

"The full question is not available"

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Administration of canagliflozin most directly increases urinary output by increasing the:____.

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Answer:A.osmotic pressure of the tubular filtrate

i'm not sure if this is what u were asking sins u didn't give answer choices but  from the research i did this is what i found. hope this helps.

Explanation:

Hydrostatic pressure and osmotic pressure are two opposing forces that regulate fluid movement between capillaries and the tissues that surround them. Hydrostatic pressure is the force exerted by a liquid on the walls of its container. Accordingly, the hydrostatic pressure of blood, or blood pressure (BP), is the force exerted by blood on the vessel walls. This pressure pushes fluid through capillary wall pores and into the interstitial fluid (the extracellular fluid surrounding cells of a tissue). The kidneys regulate BP by increasing water reabsorption (thereby increasing blood volume and, consequently, BP) when BP is low and by decreasing water reabsorption when BP is high.

In contrast, osmotic pressure causes a solution to take in water by osmosis, the passive movement of water molecules from an area of low to an area of high solute concentration. Osmotic pressure increases as solute concentration (osmolarity) increases. When blood osmolarity is high, the kidneys respond by increasing water reabsorption and decreasing solute reabsorption. Conversely, when blood osmolarity is low, the kidneys react by decreasing water reabsorption and increasing solute reabsorption.

The passage states that SGLTs transport glucose out of the proximal tubule so it can be returned to circulation through the peritubular capillaries. Administration of a SGLT inhibitor prevents glucose reabsorption, increasing solute concentration within the tubule and consequently increasing the osmotic pressure of the tubular filtrate. As a result, water is drawn back into the renal tubule, increasing urine output.

What should the nurse do to prevent catheter-associated urinary tract infection? select all that apply.

Answers

Drink water or Gatorade and flush

The first committed precursor in the pathway for the synthesis of cholesterol is?

Answers

The building block for the synthesis of cholesterol is HMG-CoA. HMG-CoA synthase catalyzes the condensation of acetyl-CoA and acetoacetyl-CoA to produce HMG-CoA.

In both the cytoplasm and the endoplasmic reticulum, cholesterol is produced (ER). The 3-hydroxy-3-methylglutaryl (HMG)-CoA synthase (HMGCS) pathway has two stages, the first of which takes place in the cytosol and the second of which happens in the ER. Thus, the primary location for cholesterol synthesis is the ER.

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A client receives 10 mg of morphine orally at home for pain management. The client is in the emergency department and is to receive 4 mg of morphine iv for severe pain. The client asks the nurse why they are only getting 4 mg of iv morphine when at home they take 10 mg of morphine. What is the best response by the nurse?.

Answers

Intravenous medications go directly into the bloodstream while oral medications must first go through the liver and some of the medication is made inactive.

Using a syringe and a needleless port on an existing IV line or a saline lock, intravenous (IV) therapy injects concentrated drugs straight into the vein. When treating urgent issues, IV medications are typically given sporadically.

Oral administration of several drugs is common. They can be taken orally as drops, syrups, solutions, chewable tablets, lozenges, or solid tablets that can be eaten whole or su/cked on.

The components of oral medications often enter the circulation only after they have reached the stomach or colon. As is the case with lozenges, sometimes the medicine is absorbed by the mouth's lining.

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The pharmacologic actions of a drug that determine its therapeutic effects are called?

Answers

Answer:he pharmacologic actions of a drug that determines its therapeutic effects are called.

Explanation:

Which substance may cause violent behavior?
a. marijuana
b. methaqualone
c. fentanyl
d. inhalants

Answers

Inhalants are substances that can cause violent behavior.

Inhalants can be described as substances that produce chemical vapors which a person can become addicted to. There are various inhalants found commonly such as spray paints, and cleaning liquids.

A person can become addicted to inhalants and there are serious adverse effects of it. If an inhalant is used for a prolonged time then it can cause improper brain functioning, bleeding of the nose, and violent behavior. The levels of violent behavior can be intense for an inhalant addict person.

Other options, such as fentanyl are not correct as fentanyl is an opioid that does not trigger violent behavior.

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A client with a diagnosis of schizophrenia has confided in the nurse that he has the ability to manipulate the exchange rates between foreign currencies. what is the nurse's most appropriate action?

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A client with a diagnosis of schizophrenia has confided in the nurse that he has the ability to manipulate the exchange rates between foreign currencies.

The nurse's most appropriate action would be to recognize that the client is exhibiting omnipotence and choose interventions accordingly.

Schizophrenia is a severe mental illness in which reality is perceived by sufferers strangely. Schizophrenia may include hallucinations, delusions, and severely irrational thinking and behaviour, which can make it difficult to go about daily activities and be incapacitating. Schizophrenia patients require ongoing care.

Less than 1% of Americans are affected with schizophrenia, a chronic brain condition. Delusions, hallucinations, confused speech, difficulty thinking, and a lack of desire are all possible signs of schizophrenia.

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Which clinical manifestation differentiates myocardial infarction (mi) from angina pectoris? (select all that apply.)

Answers

Clinical manifestation differentiates myocardial infarction (mi) from angina pectoris:

Radiating chest painST segment changes on the ECGElevated serum levels of troponin

A clinical manifestation is the outward sign of a disease or condition. All infections included in an AIDS-defining categorization are considered opportunistic infections linked to HIV.

Articles were divided into one of the following four research topics based on the primary research goals: epidemiology, causation, clinical manifestation and diagnosis, or prevention and control.

Epidemiology includes research on the distribution of epidemics (when, where, and who), causes research on virology, pathogenesis, and transmission patterns, clinical manifestation and diagnosis research on clinical features (signs and symptoms), and prevention and control research on measures for prevention, control, and treatment.

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When entering orders via orders activity, what does clicking on the order name do?

Answers

The ED Quick List is the default for the Orders Activity.

Order kinds utilised in the ED include lab, imaging, and others. The preferred order will appear when you click on it in the

Searching in the "Place new order" field of the Manage Orders sidebar will typically provide any orders not present on any of the accessible Quick Lists.

the search field for orders or order sets .

Order Sets: Click the Order Sets button in the top right if you want to place an order set. Pick the set order.

and then decide what to do in the order that has been established. The side bar will populate with orders that can be signed.

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The time component of the fitt principle for overload for a muscular strength program is?

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The time component of the FITT principle for overload for a muscular strength program is the quantity of sets and reps performed during a particular workout.

FITT Principle- The FITT principles are a collection of instructions that participants may use to choose how long and how hard to exercise. FITT stands for Frequency, Intensity, Time, and Type. Under FITT, exercise can be categorized as either general or specific.

The F.I.T.T. Principle is important since it explains how to modify our program to get in shape and increase results. Additionally, it teaches us how to change our routines to avoid becoming bored, developing overuse injuries, and reaching weight loss plateaus.

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How does a nurse know a client is experiencing an adverse reactions or allergic reaction

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Answer:Adverse drug reaction (ADR, or adverse drug effect) is a broad term referring to unwanted, uncomfortable, or dangerous effects that a drug may have. Side effect is an imprecise term often used to refer to a drug's unintended effects that occur within the therapeutic range.

Explanation:

Describe how the excretion process of pharmacokinetics may place patients at risk for adverse drug effects.

Answers

Most frequently, the kidneys are used in the process of excreting medicines from the body. This excretion will be altered by renal impairment, which puts the patient at risk for negative drug effects, frequently drug poisoning.

Drug side effects may also occur in patients with impaired respiratory effort or respiratory diseases since gaseous drug forms are removed through respiration. Infants of breastfeeding moms may be at risk for negative medication effects if the drug crosses via the milk in sufficient amounts, as water-soluble drug forms may be removed through breast milk.

The process of excreting a drug and its metabolites from the body is called excretion. Typically, the kidneys generate urine that causes this in the body. Bile, saliva, perspiration, tears, and faeces are additional pathways that could be used.

The movement of drugs to produce drug effects is known as pharmacokinetics. Absorption, distribution, metabolism (or biotransformation), and excretion are the four processes. When evaluating the patient for potential negative drug effects, the nurse employs her understanding of pharmacokinetics.

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A 45-year-old male patient is receiving interferon alfa-2a therapy for hepatitis c. the nurse should teach the patient that he may experience which adverse effect?

Answers

Answer:Flu-like symptoms

Explanation:

At a chemical synapse, the release of neurotransmitter occurs in response to a graded depolarization of the synaptic terminal. True or false?.

Answers

True: At a chemical synapse, the release of neurotransmitters occurs in response to a graded depolarization of the synaptic terminal.

A neuron is the basic unit of the nervous system. Neurons in the nervous system are connected through a junction called synapses. The neurons communicate through the release of chemicals, called neurotransmitters, into the synapses.

A presynaptic neuron is activated by a signal that triggers the resting potential of this nerve. The presynaptic nerve then carries the action potential. Neurotransmitters are the chemicals that carry action potential through the synaptic terminals and get released into the synapses.

When action potentials are carried through the axon at the synaptic terminal, it results in the depolarization of these terminals. Depolarization opens the ion channels in the synaptic vesicles. Ions like calcium ions, then release the neurotransmitter from the vesicles into the synapses. Released neurotransmitters then bind to receptors of the postsynaptic nerve cell and release the action potentials. Action potentials are then carried by axons and the same process continues. The inactivated neurotransmitters are returned to the presynaptic vesicle.

Therefore, we can now say that at a chemical synapse, the release of neurotransmitters occurs in response to a graded depolarization of the synaptic terminal.

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A client presents to the emergency department in anaphylactic shock after a bee sting. what should the nurse do? select all that apply.

Answers

Answer:Administer diphenhydramine-Insert an IV-Have RT provide an albuterol treatment

Explanation:

Option B and C are the appropriate responses, Administer Diphenhydramine and Insert an intravenous line.

Severe allergic reactions are known as anaphylaxis. Examples include responses to particular foods, bee sting or bug bites.

Give Diphenhydramine to the patient. A molecule called histamine is released during an allergic reaction, and diphenhydramine is an antihistamine that can help to counteract its effects.

Activate the intravenous line. The nurse will be able to give drugs fast and simply thanks to an intravenous line. This is crucial since the patient's health can quickly go worse in anaphylactic shock.

Because albuterol is a bronchodilator and is used to treat asthma, option (a) is wrong. Anaphylactic shock could not be treated with it.

Therefore, Administering Diphenhydramine and inserting an intravenous line are the things that can be done for anaphylactic shock.

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The complete question is

A client presents to the emergency department in anaphylactic shock after a bee sting. What should the nurse do? Select all that apply.

a. Have respiratory therapy provide an albuterol treatment.

b. Administer Diphenhydramine.

c. Insert an intravenous line.

When considering the immunosuppressed client, which assessment finding has the greatest significance?

Answers

When considering the immunosuppressed client, fever assessment finding has the greatest significance.

what is a fever?An abrupt increase in body temperature is known as a fever. It's a portion of the immune system's whole reaction.Infections frequently result in fever.Most kids and adults find having a fever uncomfortable.However, it often isn't a reason for alarm. However, in newborns, even a modest temperature might indicate a dangerous illness.In most cases, fevers subside within a few days. Many over-the-counter medicines reduce fever.A fever, however, should not be treated if it is not uncomfortable.Body temperatures vary slightly from person to person and at different times of day.

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While performing a healthcare provider adult cpr skill evaluation, the scene is safe and the victim is assessed and found to be unresponsive and not breathing normally. what is the next step?

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While performing a healthcare provider adult CPR skill evaluation, the scene is safe and the victim is assessed and found to be unresponsive and not breathing normally. The next step is to call 911.

CPR- In an emergency, chest compressions and artificial ventilation are used as part of cardiopulmonary resuscitation (CPR), which aims to keep the brain active until further actions are taken to restore a cardiac arrest victim's breathing and blood circulation on their own.

Artificial ventilation- Artificial ventilation (sometimes referred to as artificial respiration) is a method of assisting or encouraging respiration. It is a metabolic process that refers to the total exchange of gases in the body through pulmonary ventilation, external respiration, and internal respiration.

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After the first 20 minutes, the main fuel your body uses during low-intensity exercise is?

Answers

Carbohydrates When you work out, you burn a lot of carbs, which are your muscles' primary fuel source. Your muscles can store carbohydrates and protein for use as energy and to aid in recovery in the 20–60 minutes following your workout.

What are Carbohydrates?

A biomolecule known as a carbohydrate is made up of carbon (C), hydrogen (H), and oxygen (O) atoms, often with a hydrogen-oxygen atom ratio of 2:1 (as in water). This gives it the empirical formula Cm(H2O)n (where m may or may not be different from n). The term "carbohydrate" is most frequently used in the context of biochemistry, where it is used as a synonym for "saccharide," a class of chemicals that includes sugars, starches, and cellulose. However, not all carbohydrates adhere to this exact stoichiometric definition (e.g., uronic acids, deoxy-sugars like fucose), nor are all chemicals that do adhere to this definition automatically classified as carbohydrates. Monosaccharides, disaccharides, oligosaccharides, and polysaccharides are the four chemical subgroups that make up the saccharides.

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A patient complains of a new skin lesion on her face that is flat, waxy and smooth, and slightly red. you explain that the appearance of this lesion is consistent with:_________.

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A patient complains of a new skin lesion on her face that is flat, waxy and smooth, and slightly red. you explain that the appearance of this lesion is consistent with Squamous cell carcinoma, or basal cell carcinoma.

Basal cell carcinoma and squamous cell carcinoma, sometimes known as nonmelanoma skin cancer, are the two most prevalent types of skin cancer.

The most prevalent cancer in the US is basal cell carcinoma, which accounts for more than 90% of all skin cancer cases. It typically progresses slowly and seldom spreads to other body areas.

Similar to basal cell carcinoma, squamous cell carcinoma seldom spreads but does so more frequently. Early detection and treatment of skin cancers are crucial because they have the potential to infiltrate and harm adjacent tissue. Squamous cell carcinoma is 65 times more likely to occur in organ transplant recipients than in the general population.

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Which are etiologic agents? select all that apply. vaccinations microorganisms congenital defects inherited disorders environmental factors nutritional deficiencies

Answers

Microorganisms, congenital defects, inherited disorders, environmental factors, and nutritional deficiencies are etiologic agents.

Materials that are known to contain a pathogen or are logically predicted to do so must be handled carefully in a variety of ways. The ability of microorganisms to cause disease makes them etiologic agents. Because many persons acquire illnesses as a result of congenital problems that are present at birth, congenital defects are etiologic agents.

Because many persons have diseases or disorders that have a variety of inheritance patterns, inherited disorders are etiologic agents. Because many illnesses are linked to environmental exposure to poisons, chemicals, and pollution, environmental variables are etiologic agents.

People can get illnesses from having inadequate nutrition, such as low iron or excessive salt levels, making nutritional deficits etiologic agents.

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Chris is being seen for lower back pain that radiates into his left leg. He notes the pain worsens with standing and bending over, and the pain is better with laying down and applying heat. He describes the pain as a "hot poker" in his back. This an example of

Answers

This is an example of A. verbal information. B. visual information. C. objective information. D. subjective information.

Explanation: This is an example of: subjective information: Chris is being seen for lower back pain that radiates into his left leg. He notes the pain worsens with standing and bending over, and the pain is better with laying down and applying heat. [ He describes the pain as a "hot poker" in his back. ]

Which medication may cause ebstein anomaly as a teratogenic effect and is contraindicated in breast-feeding clients?

Answers

a. Lithium

Lithium has teratogenic effects due to the Ebstein anomaly. Additionally, this medicine should not be used by women who are nursing.

Teratogenic Effect- Teratogens are substances, including medications, chemicals, and even viruses, that can impair the fetus' development. Only a few compounds have been discovered to have teratogenic effects, despite the fact that there are billions of potential teratogens. As a result of these effects, an infant may be born with a genetic anomaly.

Ebstein anomaly- The Ebstein anomaly is a condition in which the tricuspid valve is created incorrectly and positioned lower than usual in the heart. Atrial septal defect refers to a gap between the two upper chambers of the heart. About half of those with Ebstein abnormalities have atrial septal defects.

The given question is incomplete, find below the complete question,

Q. Which medication may cause Ebstein anomaly as a teratogenic effect and contraindicated and breast-feeding clients?

a. Lithium

b. Ibuprogen

c. Vitamin A

d. Nitrofurantoin

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Which ppe are necessary when preparing, giving, or disposing of chemotherapy drugs?

Answers

Double gloves (latex or nitrile) PPE are necessary when preparing, giving, or disposing of chemotherapy drugs.

PPE- Personal Protective Equipment (PPE) includes clothing and breathing apparatus designed to shield a person from physical, chemical, and biological risks.

Chemotherapy drugs- Chemotherapy is a medical treatment that uses strong chemicals to destroy the body's rapidly multiplying cells in patients. Chemotherapy is the most popular kind of cancer treatment because cancer cells grow and divide far more quickly than the majority of other body cells. There is a large selection of chemotherapeutic drugs.

Cancer- Cancer develops when aberrant cells proliferate uncontrollably, invade neighboring bodily tissues, and/or spread to other organs.

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The lpn is assisting with a newly admitted client who reports taking 800 mg ibuprofen (advil) four times daily for chronic back pain. which action by the nurse is most appropriate?

Answers

Action by the nurse is most appropriate s that the client if he's experienced any abdominal pain.

What do you mean by chronic back pain?

Acute low back pain from an initial injury or other underlying cause that persists for 12 weeks or more is referred to be chronic low back pain. One year after experiencing acute low back pain, about 20% of sufferers experience chronic low back pain with ongoing symptoms. Even if pain persists, this does not always indicate that there is an obvious or treatable underlying medical condition. Chronic low back pain can sometimes be successfully treated, but in some situations, the pain persists even after receiving medical and surgical care.

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Other Questions
geothermal,wind,and solar are some of the energy resources in which Nevada has an abundant supply.What would be a benefit of their usage compared to other energy sources Exercise 1 Write run-on next to each run-on sentence.The Pulitzer Prize is awarded each year, it awards excellence in journalism, letters, and music. Exercise 2 Rewrite the sentences below by inverting the order of the subjects and predicates. Across the sky twinkled the light of the satellite. The act of reducing taxes in ways that are legal and compatible with the intent of congress is called:________ The british opium monopoly in china was challenged in the ______ by opium imported from persia and cultivated in china itself. Margot draws a shape with one pair of parallel lines that are four centimeters apart. She then flips the shape across a horizontal line.How many pairs of parallel lines are in the flipped shape? There are many atoms of Hydrogen in the water on the planet. Do you think those atoms will still be inexistence a million years from now? Why was the president elected by the house of representatives in the election of 1824? How does the wealth inequality during the Gilded Age compare to modern day wealth inequality? When the payment for an annuity is made at the end of each period, such an annuity is referred to as a(n) _____. The nurse cautions the client taking nitroglycerin to avoid the use of which vitamin? Political strife, war, and suffering in a country tend to ___________ the rate of psychological disorders in the country. The quality of the caregiving that you received while growing up is an example of __________ and your potential ability to learn how to use language is an example of __________. Which of the two pieces of testimony would make their case stronger? ______ Explain. What was one of the key goals for which striking workers fought in the late nineteenth century? Select all the correct answers. what are three critical questions that entrepreneurs need to ask themselves while starting a business? which location would be the most advantageous for my business? what business structure would best suit my business? which recruitment agency should i use for hiring workers? how many paid leaves can i give my employees in a year? what is the total cost of ownership of my capital purchases? SOMEONE HELP PLEASE PLEASE Your bank offers you a 36-month, 3 pr car loan for a $50000 new mercedes slk300 roadster. what will your monthly payment be? A bumblebee flies with a ground speed of 15.3 m/s . calculate its speed in kilometers per hour (km/h). The government should extend the duration of unemployment benefits to those workers who lost their jobs due to outsourcing. This statement is best described as.