sally smith was admitted for a laparoscopic cholecystectomy. this would be reported with procedure code .

Answers

Answer 1

The procedure code to be reported when Sally Smith who is admitted for a laparoscopic cholecystectomy will be 0FT44ZZ.

Laparoscopic Cholecystectomy is the surgery carried out to remove the gall bladder. It is usually carried out when the gall bladder is diseased. It is a normal invasive procedure. Gall bladder stones is the most common condition when the removal is done.

Procedure code is the coding system where every medical procedure is given a short term and mentioned in the bills and prescriptions of the patients. This is done for the ease of understanding and prevent miscommunication. The procedure code is usually a numeric or an alphanumeric value.

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Related Questions

The year end balance sheet of Ultimate Medical Center show total liabilities of $5,000,000, which includes a loan to expand services. Net worth at the balance sheet date was $ 4,000,000. Calculate the debt-to-worth ratio.

Answers

Answer:

The total liabilities are $5,000,000 including a loan to expand services.

Net worth at the balance sheet date is given $ 4,000,000.

Hence out of $5,000,000 , $ 4,000,000 is capital and remaining $1,000,000 is loan

Debts to net worth ratio is =  \(\frac{1000000}{4000000} \\ \)* 100

= 0.25 or 25%

Explanation:

A client is extremely anxious while awaiting the results of a biopsy. What action by the nurse will assist the client with progressive relaxation techniques?a. Have the client tighten and release different muscle groups.b. Apply pressure to the temple area to increase the flow of energy.c. Have the client walk around the waiting roomd. Have the client talk about the procedure

Answers

a. Have the client tighten and release different muscle groups. This action helps the client focus on their body and the sensations associated with progressive relaxation, allowing them to release tension and focus on their breathing.

What is relaxation?

Relaxation is a state of mental and physical repose where stress and tension has been released and the body and mind are in a state of calmness and ease. Relaxation techniques are methods used to reduce stress, anxiety and tension, and can include activities such as deep breathing, progressive muscle relaxation, visualization, meditation, yoga, tai chi, and massage. Relaxation is important for both physical and mental health, and can help to decrease stress hormones, reduce inflammation, improve sleep, and boost mood. Regular relaxation can also help to improve concentration and focus, reduce pain, and regulate emotions.

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Cells that produce and accumulate protein in the epidermis

Answers

Answer: Keratinocytes

Explanation:

the combining form that means cause (of disease) is

Answers

The combining form that means "cause (of disease)" is etiology.

The term "etiology" is a noun form that denotes the study of causes of diseases.

Etiology refers to the study of the causes of diseases. It encompasses the factors that lead to the development of a disease, including genetic, environmental, social, and behavioral factors. Etiology has a crucial role in the diagnosis and treatment of diseases.

It is fundamental in identifying risk factors that can be modified or managed to prevent disease and promote good health. Etiology is also important in the development of new treatments and therapies for diseases.

The combining form eti/o derives from the Greek word aitia, which means "cause." Eti/o is a common prefix used in medical terminology. Other terms that use the eti/o prefix include etiology (the study of the causes of diseases), etiopathogenesis (the study of the causes and development of diseases), and etiologic agent (the cause of a disease).

Thus, the combining form that means "cause (of disease)" is eti/o.

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Match the typical characteristics of focus with the appropriate age group.


-
Infant


-
Child


-
Adolescent


-
Adult


-
Older Adult

A.
Present Focus

B.
Present to future

C.
Future focus

Answers

Answer:

Explanation:

Infant,Child,Older Adult- Present Focus

Adolescent-Present to Future

Adult-Future Focus

A multinational pharmaceutical company is faced with the ethical dilemma of telling the general public the truth about a mishap in the company's drug labelling which has resulted in the death of four unborn children and leaves many more at risk if the drugs are not retrieved from the market immediately. But the challenge the company faces is that admitting this truth could attract crippling legal charges drastic reduction in patronage and reputation crisis. Give a reasoned ethical advice to the company showing clearly the Ethical basis of your advice the challenges you envisaged and how to deal with the identified challenges.​

Answers

Answer:

The setback has just brought about the death of four unborn children which is very grievous. The absolute first obligation of a pharmaceutical organization is to save lives.  

As indicated by Deontology/Kantian Ethics, the organization ought to take back all the medications from the market as soon as possible as it is a threat to many unborn lives.

As indicated by Utilitarianism/the best great, an organization should be sensitive towards such issues as it involves one's life.  

There might be the implication of the law of these activities yet at the same time organization ought to take the plunge as it is their obligation and duty.  

On the off chance that the organization doesn't start for it and further numerous other children might lose there lives. The organization may confront significantly more serious activities in the future.

Businesses must be conscious of the __________, or social norms and beliefs in which they operate.

Answers

Answer:

culture

Explanation:

Cultural norms are the shared, sanctioned, and integrated systems of beliefs and practices that are passed down through generations and characterize a cultural group. Norms cultivate reliable guidelines for daily living and contribute to the health and well-being of a culture. They act as prescriptions for correct and moral behavior, lend meaning and coherence to life, and provide a means of achieving a sense of integrity, safety, and belonging. These normative beliefs, together with related cultural values and rituals, impose a sense of order and control on aspects of life that might otherwise appear chaotic or unpredictable.

Businesses must be conscious of the culture or social norms and beliefs in which they operate.

Why cultural norms are very important to be shared?

Cultural norms has been considered as they shared, or sanctioned, and the integrated systems of the beliefs as well as practices that has been passed down just through the generations as well as characterize the cultural group. Norms that cultivate the reliable guidelines for the daily living as well as it contribute to the health and well-being of the culture.

They will act as the prescriptions for correct and the moral behavior, that lend meaning as well as the coherence to life, and the provide the means of the achieving a particular sense of the integrity, safety, and the belonging. These normative beliefs, that all together with the related cultural values along with the rituals, has been imposed the sense of order and the control on the aspects of the life that would might otherwise appear chaotic or it is unpredictable.

Therefore, Businesses must be conscious of the culture or social norms and beliefs in which they operate.

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Why we do neck examination in the supraventricular tachycardia?

Answers

A symptom of SVT is pain in the neck, so it is important to examine the neck.

Regarding mechanical ventilation, what ventilator settings are the primary determinants of oxygenation?

Answers

Answer:

The ventilator is not called a magical therapy that provide relaxation to the patient but now it is a simple supportive therapy that help a patient to get up well soon.

Explanation:

Ventilation is used when a patient have hypoxemia and when increased the work before the breathing. The main goal of ventilator is to provide the oxygenation and ventilation to the patients. It reduces the lung injury during ventilation.

Oxygenation is a process that controlled by the positive end expiratory pressure and the fraction in the inspired oxygenation. It also controlled by RR and Vt. There is the fact that help us to understand the mechanical ventilator but later on it limited our understanding the advanced modes of machine.

Answer:

Ventilator are machines to provide mechanical ventilation to a patient, it works by moving air into and out of the lungs  and delivering breaths to the patient if he/she is unable to breathe or having breathing difficulty.

\(FiO_2\) and mean airway pressure are two factors that determine oxygenation.  

The average pressure your lung is exposed to during inspiration and expiration during mechanical ventilation is called mean airway pressure.  

\(FiO_2\) is the concentration of oxygen in the air that we breathe.  

a premature newborn, born 24 hours ago, is diagnosed with a patent ductus arteriosus (pda) and placed on high flow nasal cannula for oxygenation. the parents visit the nursery and ask to hold her. which response should the nurse provide to the parents?

Answers

The response which the nurse should provide to the parents is that the oxygen hood is holding the baby's oxygen level just at the point which is needed and is denoted as option B.

What is Patent ductus arteriosus?

This is referred to as a medical condition in which the ductus arteriosus fails to close after birth which is responsible for the blood skipping the circulation to the lungs.

During the treatment, it is best for a  high flow nasal cannula to be used to provide the right amount of oxygen. In a scenario where the parents wants to carry the child, the nurse has to tell them that oxygen hood is holding the baby's oxygen level just at the point which is needed.

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The options are;

Studies have shown that handling a sick newborn is not good for the baby and upsets the parents.The oxygen hood is holding the baby's oxygen level just at the point which is needed. You may stroke and talk to her.Since your baby has been doing well under oxygen for 24 hours, I can let you hold the baby without oxygen.You can hold the baby with the oxygen blowing in the baby's face since the level is very close to room air.

The answer that the nurse should give to the parents is option B, which states that the oxygen hood is keeping the baby's oxygen level exactly where it ought to be.

The definition of patent ductus arteriosus

This is referred to as a medical disorder when the ductus arteriosus does not shut after birth, causing blood to bypass the lungs' blood supply.

It is advisable to utilize a high-flow nasal cannula throughout the procedure to provide the ideal volume of oxygen. The nurse must advise the parents that the baby's oxygen level is being maintained precisely at the right level by the oxygen hood in a situation when the parents desire to carry the kid.

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CQ

a premature newborn, born 24 hours ago, is diagnosed with a patent ductus arteriosus (pda) and placed on high flow nasal cannula for oxygenation. the parents visit the nursery and ask to hold her. which response should the nurse provide to the parents?

The options are;

Studies have shown that handling a sick newborn is not good for the baby and upsets the parents.

The oxygen hood is holding the baby's oxygen level just at the point which is needed.

You may stroke and talk to her.

Since your baby has been doing well under oxygen for 24 hours, I can let you hold the baby without oxygen.

You can hold the baby with the oxygen blowing in the baby's face since the level is very close to room air.

You can hang a bladder bag anywhere it clips onto, as long as its out of the way

Answers

Answer:

You can hang a bladder bag anywhere it clips onto, as long as its out of the way

It's true.

The answer it is True!

patient r s medical report indicates that he has arthralgia, which is ______ pain

Answers

Patient r s medical report indicates that he has arthralgia, which is joint pain,  which is typically characterized by discomfort, soreness, or aching in one or more joints of the body.

It can be caused by a variety of factors, including injury, inflammation, infection, or certain medical conditions such as arthritis. Joint pain is a common medical symptom that can affect any joint in the body, including the knees, hips, shoulders, wrists, and ankles.

It is usually characterized by discomfort, soreness, or aching in one or more joints, and can be caused by a variety of factors, including injury, inflammation, infection, or certain medical conditions such as arthritis. Joint pain can also range in severity from mild to severe, and can be acute or chronic depending on the underlying cause.

Treatment for joint pain can vary depending on the cause, but may include medications, physical therapy, rest, and in some cases, surgery.

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dentify the true statement.
a.
PK is not a good predictor of how quickly the PD effect will start.
b.
How quickly a drug is distributed in the body is a study of pharmacodynamics of a drug.,
c.
How slow (or fast) a drug is metabolized can allow us to determine the dosing schedule of a drug.
d.
Both b and c

Answers

The true statement is b. How quickly a drug is distributed in the body is a study of pharmacodynamics of a drug.

Pharmacodynamic actions of a drug include stimulating activity by directly inhibiting a receptor and its downstream effects. Depressing activity by direct receptor inhibition and its downstream effects. Antagonistic or obstruction a receptor by binding to that, however not activating it.

4 stages of pharmacodynamics are Absorption: Describes however the drug moves from the location of administration to the location of action. Distribution: Describes the journey of the drug through the blood to varied tissues of the body. Metabolism: Describes the method that breaks down the drug. Excretion: Describes the removal of the drug from the body.

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The 2015-2020 Dietary Guidelines for Americans advise that you A) keep your intake of sodium to no more than 10% of total Calories. B) keep your intake of cholesterol to no more than 10% of total Calories. C) keep your intake of alcohol to no more than 10% of total Calories. D) keep your intake of added sugars to no more than 10% of total Calories.

Answers

The 2015-2020 Dietary Guidelines for Americans advise that you ) keep your intake of cholesterol to no more than 10% of total Calories.  Thus, option "B" is correct.

What are the dietary guidelines for Americans?

According to the dietary guidelines for Americans total fat intake should not exceed 35% of the total calories and the saturated fat intake should be limited to 10 % only.

The amount of carbohydrates, fats and proteins is allotted in case of the total energy that is obtained from the food that we eat.

More than the required amount of fat and saturated fat in the body can cause cardiovascular diseases.

Thus, option "B" is correct.

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Channels in a cell membrane are made of

Answers

Answer:

Protein

Explanation:

What caused the change to the photosensitive paper

Answers

which react to light waves and particles when exposed to light. When you place objects on the paper, they block the light and turn white while the paper around them remains blue. Water stops the process and fixes your images on the paper.

anna has insomnia, however she has a problem with both sleep onset and maintenance (falling asleep and staying asleep). what drug would the np prescribe for anna’s insomnia?

Answers

A class of medications such as non-benzodiazepine hypnotics like zolpidem should be prescribed.

What should be prescribed?

There are many kinds of drugs that are frequently prescribed for insomnia. One class includes benzodiazepines, which have sedative effects and can aid in the onset and maintenance of sleep. Examples include diazepam and lorazepam.

However, because to the possibility of dependence and other negative effects, they are normally only prescribed to patients for short-term usage.

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A nurse is caring for a postoperative client who is at risk for thrombus formation. Which of the following interventions should the nurse delegate to an assitive personnel (AP)?
A). Apply thromboembolic stockings?
B). monitor the circulation in all four extremities
C). Record the condition of the clients skin
D). Reinforce teaching about performing range-or-motion exercise

Answers

Answer:

A). Apply thromboembolic stockings

Explanation:

A thrombus formation is one of the dangerous action that happens in the body of an individual.  This could led to death if care is not taken. A thrombus is known as a blood clot that happens in the arteries, or vein of a person as a result so many factors with the most significant factor being atrial fibrillation.

In-order to reduce thrombus formation, there are various approach to adopt like raising your legs 6 inches above your heart from time to time, wearing special stockings (called compression stockings) if your doctor prescribes them doing exercises your doctor gives you. as well as changing your position often, especially during a long trip.

Thrombus formation is defined as a dangerous phenomenon that takes place in the body of an individual. The thrombus is a formation of a blood clot that interferes with blood flow and circulation.

The correct option is:

Option A. Apply thromboembolic stockings

A thrombus formation is the clotting of the blood, which under severe circumstances can lead to death.

In order to reduce the formation of thrombus, special stockings or thromboembolic stockings are used. There are several other techniques to reduce the thrombus such as exercising, changing the position ofter especially during a continuous sitting.

Therefore, option A is correct.

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what replaces the glycerol molecule in the fat replacer olestra

Answers

Olestra is a fat replacer that replaces the glycerol molecule in fat. Olestra is also referred to as Olean. Olestra is an oil-like fat substitute that has no calories, no fat, and no cholesterol.

Because olestra is not absorbed by the body, it cannot be digested and is eliminated unchanged from the body through feces.Olestra is synthesized from sucrose (sugar) and eight to ten fatty acids. Olestra molecules are identical to triglycerides except that they have between six and eight of their fatty acid chains missing, with sucrose molecules replacing glycerol as a backbone in olestra. It is a non-digestible compound that is made up of sucrose and fatty acids in a esterified manner, and it is 8-calorie-free fat replacer.

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The brain you are born with __. *

Answers

Answer:

I had a migraine just trying to read this.

Explanation:

Answer: The brain i was born with is a fully sized brain

The brain you are born with isn’t fully grown because when your brain will be fully grown when your 21

an individual was found at home in the fetal position reporting a severe, sudden onset headache. assessments in the emergency department reveal confusion, disorientation, and one dilated pupil. while waiting for the primary health care provider, respirations have now changed to a cyclic rhythm from increasing depth and rate to periods of apnea. hiccups have begun. which response appropriately addresses the family concerns?

Answers

The appropriate response to address the family's concerns is to inform them that the individual is experiencing a severe headache, confusion, disorientation, and changes in respiratory patterns .

The family concerns regarding an individual found at home in the fetal position reporting a severe, sudden onset headache with symptoms of confusion, disorientation, and one dilated pupil is as follows: Based on the symptoms described, it is possible that the individual is experiencing a medical emergency, such as a stroke or intracranial hemorrhage.

The family should call an ambulance or go to the nearest emergency room as soon as possible.  These symptoms may indicate a serious medical condition that requires urgent attention from the primary healthcare provider. The healthcare team will be working to identify and treat the underlying cause to provide the best possible care for the patient.

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which of the following is the name given to the condition in which fluid accumulates in the lungs?

Answers

The condition in which fluid accumulates in the lungs is called pulmonary edema.

Pulmonary edema is a medical condition characterized by the accumulation of fluid in the lungs. It occurs when there is an abnormal leakage of fluid from the blood vessels into the lung tissues and air sacs (alveoli). This fluid buildup interferes with the normal exchange of oxygen and carbon dioxide, leading to respiratory distress and difficulty breathing.

Pulmonary edema can have various causes, including heart failure, kidney problems, lung infections, high altitude exposure, and certain medications. When the heart is unable to pump blood effectively, fluid can back up into the lungs, resulting in pulmonary edema. Additionally, conditions that increase the permeability of blood vessels or disrupt the normal balance of fluid in the body can contribute to fluid accumulation in the lungs.

Symptoms of pulmonary edema may include shortness of breath, coughing, wheezing, rapid breathing, chest pain, and frothy pink sputum. Prompt medical attention is necessary as pulmonary edema can be a life-threatening condition. Treatment typically involves addressing the underlying cause, administering oxygen therapy, diuretics to remove excess fluid, and medications to improve heart function and reduce fluid buildup.

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After four days of​ development, the zygote is known as​ a/an:
A. embryo.
B. gamete.
C. fertilized egg.
D. gonad.

Answers

In the given statement, after four days of development, the zygote is known as an embryo. The correct option is A.

The zygote is the first cell that forms when the sperm fertilizes the egg. After the zygote undergoes several cell divisions, it develops into a ball of cells known as a blastocyst. The blastocyst contains an inner cell mass that will eventually develop into the embryo, and an outer layer of cells that will form the placenta. Around day 4 of development, the blastocyst begins to implant into the uterine lining, where it will continue to grow and develop. At this stage, the embryo is still very small and has not yet developed any recognizable features. Over time, however, it will continue to differentiate and grow into a fully formed human being.

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Specify or define one of the periods of ontogenesis:​

Answers

Answer:

A number of researchers have tried to detect these correlations in various ways but failed to successfully provide any proper association. Like human beings, the Wistar rats go through the ontogenetic developmental stages «Prenatal → Birth → Infancy → Childhood → Adolescence → Adulthood → Death».

Explanation:

Dr's order is 7.5 mg, the bottle on hand reads 5mg tabs how many tables are given?

Answers

Answer:

1.5 tablets

Explanation:

if you were getting one dose of 7.5mg but are given in the form of 5mg then it'll be 1 and 1/2 tablet to equal 7.5mg.

Connective tissues are the tissues that help to bind or connect other tissues in the body. They have widely spaced cells embedded in a matrix having a variety of proteins, polysaccharides and mineral salts. Connective tissues of animals serve the functions of binding and joining one tissue to another forming protective sheath and packing material around the various organs separating them so that they do not interfere with each other activities, Carrying materials from on part to another in the body, forming a supporting from work of cartilage and bones for the body etc . Can you identify the connective tissues among the following? (i). Ligament (ii). Epithelium (iii). Tendon (iv). Blood

Answers

Answer:

Blood is the connective tissues

as it pertains to organizational leadership, the best description of systems thinking is:A. Determaining responsibility for the problem at handB. Finding quick solutions to challenging problemsC. Identifying root causes, bottlenecks, and constraintsD. Plunging deeply into a single component of an issue

Answers

Answer:

As it pertains to organizational leadership, the best description of systems thinking is identifying root causes, bottlenecks, and constraints.

Explanation:

The best description of systems thinking in organizational leadership is C: identifying root causes, bottlenecks, and constraints. Systems thinking involves examining how different components of an organization or system interact and influence each other.

By identifying the root causes of a problem, leaders can better understand the underlying issues and develop more effective solutions. This approach requires a holistic view of the organization or system, recognizing that changes in one area may have unintended consequences in another.

It also involves looking beyond immediate symptoms to uncover the underlying causes of a problem. By doing so, leaders can develop more sustainable solutions that address the root causes of the problem, rather than simply treating the symptoms. Systems thinking can help organizations become more efficient, effective, and adaptable in the face of complex challenges.

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Within the cell, the cleanup crew is/are the
A) endoplasmic reticulum
B) nucleus
C) lysosomes
D) cytoplasm

Answers

Within the cell, the cleanup crew is/are the C) lysosomes.

Lysosomes are membrane-bound organelles containing various enzymes that function primarily in breaking down and recycling cellular waste and debris. They are considered the "waste disposal system" of the cell. These organelles digest excess or worn-out cell components, bacteria, and other foreign particles that enter the cell. This process is essential for maintaining cellular health and proper functioning.

Lysosomes are produced by the endoplasmic reticulum (A) and further processed in the Golgi apparatus. They are not to be confused with the endoplasmic reticulum, which is involved in protein and lipid synthesis, or the nucleus (B), which houses genetic material and controls cellular activities. Additionally, lysosomes are distinct from the cytoplasm (D), which is the fluid matrix that fills the cell and contains various cellular structures.

In summary, (option c) lysosomes serve as the cell's cleanup crew by breaking down and recycling waste materials, contributing to the overall health and efficiency of the cell.

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q.1. the two actions that drive your response when reacting to a physical altercation is evade and deflect TRUE \ FALSE

Answers

The statement "the two actions that drive your response when reacting to a physical altercation is evade and deflect" is True. These two actions can help you protect yourself from physical harm during a physical altercation.

Here's a further explanation:

Evade and deflect are two critical actions that people can use to protect themselves from physical harm when involved in an altercation. When facing an attacker, one can use these actions to escape from the attacker's path and avoid physical harm. The primary goal of the evading action is to get out of the attacker's way, making it hard for them to reach you. This means moving away from the danger as quickly as possible. While evading, one can use their peripheral vision to monitor the attacker's movements and intentions. Deflect, on the other hand, is another technique that can help you protect yourself from an attacker. This technique involves using your hands or arms to block the attacker's punches, kicks, or other offensive moves. You can deflect the attacker's arm, leg, or other body parts to protect yourself from the harm. Additionally, you can deflect a weapon like a knife, gun or club, away from you. Thus, the two actions that drive your response when reacting to a physical altercation are evade and deflect, and the statement is true.

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Early defibrillation is a link in the adult Chain of Survival. Why is this important to survival?​

Answers

Answer:

it is important because it stable breathing

Early defibrillation is a link in the adult survival chain because it increases the chances of survival after experiencing a cardiac arrest because it is the process of delivering an electrical shock to the heart.

What is the significance of defibrillation?

It is significant because it can help someone recover from a cardiac arrest by restoring a normal heart rhythm, which is a life-saving procedure that uses an electrical shock to restore the heart's normal rhythm. Through this process, a shock is given to the chest that stops the abnormal rhythm, and allows the normal rhythm to return, and makes the heart pump again.

Hence, early defibrillation is a link in the adult survival chain because it increases the chances of survival after experiencing a cardiac arrest because it is the process of delivering an electrical shock to the heart.

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Increasing the quality of capital requirements for financial institutions. B. Ensuring that the final documentation for Basel 3 is complex and as detailed as possible. C. Establishing new rules on the use of credit ratings. D. Requiring financial institutions to have more stable funding. E. Allocating assets and off-balance sheets activities into four main categories. The financial records of Sunland Inc. were destroyed by fire at the end of 2020. Fortunately, the controller had kept certain statistical data related to the income statement as follows. 1. The beginning merchandise inventory was $75,440 and decreased 20% during the current year. 2. Sales discounts amount to $18,700. 3. 17,108 shares of common stock were outstanding for the entire year. 4. Interest expense was $18,000. 5. The income tax rate is 30%. 6. Cost of goods sold amounts to $440,000. 7. Administrative expenses are 20% of cost of goods sold but only 8% of gross sales. 8. Four-fifths of the operating expenses relate to sales activities.Required:From the foregoing information prepare an income statement for the year 2020 in single-step form. What are two characteristics of Modernism? A bowl of grapes has a total mass of 265g. The bowl has a mass of 121g. What is the mass of the grapes? How can classical conditioning be compared to operant conditioning? Give an example of a negative externality and a positive externality that is not listed in your book. a spring escape to pittsburgh offers a rich dining-and-drinking scene. which hipster-favorite beer hall did we visit with an eclectic lager-forward list of drafts and sharable food menu that encourages laid-back community drinking? The image below represents what characteriistic of a civilization._________.it is called__________. A design always involves a client who wants to communicate a message My guess:My reason:I learned: The man have/has a cane? When polling individuals about who they will likely vote for in the next election, what additional question should also be asked to avoid a biased sample?The number of people in their householdTheir employment statusWhether they plan to vote in the upcoming electionThe location of their next planned vacationWhether they voted in the last election an open market purchase of securities by the fed will tend to a) increase yields on the bonds the fed buys. b) decrease yields on the bonds the fed buys. c) increase coupon rates on the bonds the fed buys. d) decrease coupon rates on the bonds the fed buys. e) have no effect on either yields or coupon rates