Spanish for med-surg nurses — the patient who won’t push the call light, the fall it was supposed to prevent, and the diagnosis the doctor delivered and left behind

Patricia Mendoza, 68, had her right total hip replacement yesterday morning. She is on post-operative day one. Her pain management orders include scheduled oral acetaminophen and an as-needed opioid for breakthrough pain. The nurse who ended the 7 PM shift told the night nurse that Patricia had been doing well — comfortable, ambulated with physical therapy that afternoon, ate dinner. It is now 4:11 AM. The night nurse, Rebeca, comes into Patricia’s room for her routine check and finds the room dark, the call light cord coiled unused on the mattress, and Patricia lying very still on her back.

Rebeca turns on the low lamp and asks how she is doing. Patricia opens her eyes. She says: Bien, bien. Perdón, no quería molestar.

Fine, fine. I am sorry. I did not want to be a bother.

Her face when she says it is the face of someone who has not been fine for some time.


What this post covers

This post covers three conversations that happen on the medical-surgical floor when the patient speaks Spanish. The first is about Patricia and two hours of uncontrolled pain she did not report because she did not want to bother the nurse — what Rebeca says to give Patricia permission to call, and the phrase that makes the call light something Patricia will actually use for the rest of the shift. The second is about José Contreras, 74, admitted for decompensated heart failure, found unsteady at the bedside at 2 AM after getting up alone to the bathroom — the fall-risk explanation that names the diuretic mechanism rather than his frailty, and the one sentence that makes calling feel like the strong man’s choice. The third is about María Elena Torres, 52, who was told through a phone interpreter that the CT scan showed a mass, the interpreter call ended, the doctor left, and the night nurse walks in to find her staring at the ceiling saying she did not understand what the doctor said — what the nurse can say, what must wait for the physician, and what to do before leaving the room.

Med-surg nursing is the widest floor in the hospital: one shift can include a fresh post-op, a decompensated heart failure, a new oncology finding, a CIWA protocol, a discharge teaching, and a family meeting in the same hall. The Spanish that works on that floor is not a translation of English reassurance. It is specific to what each patient is carrying at 2 AM and 4 AM when the interpreter service is slower, the family is not present, and the patient is alone with whatever the day left behind.


Scenario one: the patient who will not push the call light

Patricia is a retired school cafeteria worker from Salinas. She has five grandchildren and has never spent a night in a hospital before this one. She was awake at midnight with hip and thigh pain. She was awake at 2 AM with the same pain, stronger. She looked at the call light cord. She did not press it. At 4 AM she is still awake.

When Rebeca asks her directly about pain — ¿tiene dolor? — Patricia says yes. Rebeca asks what number, zero to ten. Patricia says six. Then pauses. Tal vez siete.

Maybe seven.

Rebeca does not move toward the medication cart yet. She sits down first.

— Patricia, ¿cuánto tiempo lleva con ese dolor?

How long have you been in that pain?

Patricia: Un rato. Desde medianoche más o menos.

A while. Since about midnight.

— Son las cuatro de la mañana. Son cuatro horas.

It is four in the morning. That is four hours.

Patricia: No quería molestar. Ustedes están muy ocupadas. Hay personas más graves que yo.

I did not want to bother anyone. You are all very busy. There are people worse off than me.


The “no quería molestar” dynamic

This is one of the most consistent patterns in Spanish-speaking inpatient care. The patient who will not call. The patient who judges her own pain against an imagined scale of severity and finds it insufficient to justify the intrusion. The patient who has been taught — explicitly or through the signals of a lifetime — that asking for help is a weakness or an imposition.

The response that does not work: no se preocupe, no es ninguna molestia. This tells Patricia that her worry about bothering the nurse is wrong, but it does not tell her why, and it does not change the underlying calculation she is making. The next time she is in pain at 3 AM, she will run the same calculation and arrive at the same answer.

Rebeca gives Patricia a different frame.

— Lo que me acaba de decir me preocupa — y quiero explicarle por qué. No porque me moleste que llame — sino porque eso significa que llevó cuatro horas con un dolor que no tenía que esperar cuatro horas. El dolor que viene de una cirugía se trata mucho más fácil cuando es un cuatro que cuando ya llegó a un siete. Cuatro horas despierta con dolor no es lo que tiene que pasar aquí. Eso no es cómo funciona esto.

What you just told me concerns me — and I want to tell you why. Not because it bothers me for you to call — but because it means you have been in pain for four hours that did not have to wait four hours. The pain that comes from surgery is much easier to treat when it is a four than when it has already reached a seven. Four hours awake in pain is not what has to happen here. That is not how this works.

Patricia is quiet for a moment. ¿No les molesta si llamo de noche?

Does it not bother you if I call at night?

— No. Llamarme es para lo que estoy aquí. Si usted tiene dolor — de noche, a las tres de la mañana, a las cinco, cuando sea — ese botón es para eso. Eso es mi trabajo. Usted no me interrumpe — me está dejando hacer mi trabajo.

No. Calling me is what I am here for. If you have pain — at night, at three in the morning, at five, whenever — that button is for that. That is my job. You are not interrupting me — you are letting me do my job.


The pain assessment

Now Rebeca does the assessment, because it matters to Patricia to see that her call is producing a response — not just acknowledgment.

— Cuénteme sobre el dolor. ¿Dónde le duele más — en la cadera, en el muslo, en la rodilla?

Tell me about the pain. Where does it hurt most — in the hip, the thigh, the knee?

Patricia: En la cadera y baja por el muslo. Como un dolor que jala.

In the hip and down the thigh. Like a pulling pain.

— ¿Y cómo está cuando no se mueve? ¿El dolor sigue o baja un poco?

And how is it when you are not moving? Does the pain continue or drop a little?

Patricia: Cuando no me muevo está mejor. Como un cinco.

When I do not move it is better. Like a five.

— ¿A qué número quiere llegar para poder dormir?

What number do you want to reach to be able to sleep?

Patricia pauses. She has not thought about pain relief as something she gets to request a target for. ¿Se puede llegar a dos?

Can you get to a two?

— Vamos a intentarlo. Tiene una orden de medicamento para el dolor en estos momentos. Voy a revisarla y vuelvo en diez minutos.

Let us try. You have a pain medication order right now. I am going to review it and come back in ten minutes.


The phrase that changes the next call

Before Rebeca leaves the room — after giving the medication and confirming Patricia understands what to expect — she leaves Patricia with one specific instruction for the rest of the shift.

— Una cosa más. Si a las seis de la mañana todavía tiene dolor, o si cuando se mueva para ir al baño el dolor vuelve al siete, ¿me puede hacer una prueba? ¿Puede hacer la prueba de llamarme?

One more thing. If at six in the morning you still have pain, or if when you move to go to the bathroom the pain goes back to a seven, can you do me a test? Can you try calling me?

She does not say use the call light if you have pain. She asks for a specific, bounded action — one call, framed as a trial — because Patricia needs to experience the call as something that works before she will believe the call is welcome. The test lowers the threshold. It is not an obligation; it is a small promise that either party can honor.

Patricia: Está bien. Hago la prueba.

All right. I will do the test.

At 5:48 AM, Patricia uses the call light. Her pain is a six. Rebeca comes within four minutes. By 6:30 AM, Patricia’s pain is a two. She sleeps for an hour before morning rounds.


Scenario two: the fall the call light was supposed to prevent

José Contreras, 74, was brought in two days ago from his cardiologist’s office after presenting with a ten-pound weight gain in four days, bilateral ankle edema, and orthopnea that had started two nights prior. He is a retired plumber from Pomona. His Spanish is Mexican regional, confident, with no hesitation. He has been managing his own health for thirty years. When the nurses explained the telemetry leads, he nodded. When they explained the fluid restriction, he said está bien. He listened and did not ask questions, which in his case means he understood, not that he was confused.

At 2:14 AM, the night nurse Claudia is at the nurses’ station when José’s telemetry leads show artifact. She goes to his room to check. She opens the door. José is standing at the right side of the bed, his right hand on the IV pole, his left hand on the bedrail. He is wearing socks. He is standing very still.

— Don José, ¿está bien?

He looks at her. Sí, sí. Ya fui al baño y ya regresé. No se preocupe, estoy bien.

Yes, yes. I already went to the bathroom and came back. Do not worry, I am fine.

He is not fine. His grip on the IV pole is the grip of a man who is not confident in his legs.


The assessment before the conversation

Claudia does not start with the fall-risk lecture. She starts with the assessment.

— ¿Puede soltarse del tubo por un momento y dejar que le agarre el brazo?

Can you let go of the pole for a moment and let me hold your arm?

José lets go. His weight shifts slightly. Claudia has him. She guides him back to the edge of the bed, takes his blood pressure sitting. 98/62. Standing two minutes ago, it was lower.

— Don José, ¿cuándo fue al baño iba bien o estaba un poco mareado?

When you went to the bathroom, were you steady or were you a bit dizzy?

José: Un poco mareado cuando me levanté. Pero se pasó rápido.

A little dizzy when I stood up. But it passed quickly.

— ¿Y en el baño se sostuvo de algo?

And in the bathroom did you hold onto something?

José: Del lavabo.

The sink.

He got there and back on his own, dizzy both ways, holding whatever was available. He did not fall. It was not because the risk was not there.


The explanation that does not insult him

José is a man who has been physically capable his entire adult life. He built things. He fixed things. He is not going to accept an explanation that treats him as someone who needs help standing up because he is old or weak. The explanation that works is the one that names the actual mechanism — which is the diuretic, not him.

— Don José, quiero explicarle algo sobre el medicamento que tiene corriendo en la vena, porque tiene que ver con lo que le pasó esta noche cuando se levantó.

Don José, I want to explain something about the medication running in the IV, because it has to do with what happened to you tonight when you stood up.

José listens.

— El medicamento que le estamos dando es un diurético — es el que le hace sacar todo el líquido extra que el corazón no estaba pudiendo manejar. Ese medicamento hace algo muy específico cuando uno se levanta rápido: la presión cae un momento antes de que el cuerpo la ajuste. En una persona sin medicamento, ese ajuste es casi instantáneo. Con diurético corriendo, el ajuste tarda más — dos, tres, cuatro segundos. En esos segundos, las piernas pueden sentirse flojas y la cabeza puede dar vueltas aunque usted sea una persona completamente fuerte. No es debilidad. Es el medicamento haciendo exactamente lo que tiene que hacer, y su cuerpo tardando un poco más en responder.

The medication we are giving you is a diuretic — it is the one making you remove all the extra fluid that your heart was not able to manage. That medication does something very specific when you stand up quickly: the blood pressure drops for a moment before the body adjusts it. In a person without the medication, that adjustment is almost instant. With a diuretic running, the adjustment takes longer — two, three, four seconds. During those seconds, the legs can feel weak and the head can feel dizzy even if you are a completely strong person. It is not weakness. It is the medication doing exactly what it needs to do, and your body taking a bit longer to respond.

José is quiet for a moment. ¿Y por eso me mareaé?

And that is why I got dizzy?

— Por eso. No porque algo esté mal — sino porque el medicamento está sacando el líquido y eso cambia la presión cuando uno se levanta. Mientras ese medicamento esté corriendo a esta dosis, eso va a pasar cada vez que se levante rápido. No siempre — pero sí las veces que se levante rápido de la cama o de la silla.

For that reason. Not because something is wrong — but because the medication is removing the fluid and that changes the pressure when you stand. While that medication is running at this dose, that is going to happen each time you stand up quickly. Not always — but yes the times you stand up quickly from the bed or the chair.


The phrase that makes calling feel like strength

Claudia does not say llámeme si necesita ir al baño and leave. She gives him the reason the call is the strong man’s move.

— Lo que quiero que haga cuando necesite levantarse esta noche: llámeme, espera a que llegue, y nos levantamos juntos — dos o tres pasos despacio, hasta que la presión se ajuste. Eso tarda menos de un minuto. No porque usted no pueda solo — sino porque usted sabe cómo funciona el medicamento ahora, y la persona que sabe cómo funciona el medicamento no se levanta sola con eso corriendo. Eso no es pedir ayuda por no poder. Es saber lo que tiene puesto.

What I want you to do when you need to get up tonight: call me, wait for me to arrive, and we stand up together — two or three slow steps, until the blood pressure adjusts. That takes less than a minute. Not because you cannot do it alone — but because you now know how the medication works, and the person who knows how the medication works does not stand up alone with that running. That is not asking for help because you cannot. That is knowing what you have on board.

José looks at the call light cord for a moment. Then at Claudia. ¿Y usted llega rápido?

And you arrive quickly?

— En menos de tres minutos.

In less than three minutes.

José nods. Está bien. La llamo.

All right. I will call you.

He calls twice more before morning. Both times Claudia is there in under three minutes. José tells the day nurse at shift change: La enfermera de la noche me explicó lo del medicamento. Por eso llamé.

The night nurse explained the thing about the medication. That is why I called.


What Claudia did not say

Claudia did not say usted no debe levantarse solo porque es un riesgo de caídas. She did not put a fall-risk bracelet on his wrist without explaining what it was for. She did not frame the call light as a rule he was required to follow. She gave José the physiological mechanism that explained his own experience — the dizziness he had already had twice that night — and she framed the call as the behavior that matches understanding the mechanism, not as a concession to dependence. The man who knows why he gets dizzy when he stands up is not a man who needs someone to take care of him. He is a man who knows what his medication does. Those are different identities. The second one calls the light.


Scenario three: the diagnosis the doctor delivered and left behind

María Elena Torres, 52, was admitted two days ago after presenting to the ED with two weeks of abdominal discomfort and a 6-pound unintentional weight loss. She told the ED physician she had been feeling full after eating small amounts. The CT scan of the abdomen showed a 3.8 centimeter hypodense lesion in the liver with features concerning for malignancy. She had a follow-up MRI today. The hospitalist reviewed the results at 6:45 PM and placed a call to the language line. The phone interpreter connected. The hospitalist explained that the imaging showed a mass, that the team wanted to discuss next steps, and that she would be staying at least one more night. The interpreter call ended at 7:03 PM. The hospitalist left. The day nurse was finishing her charting. The shift changed at 7 PM.

The night nurse, Miguel, comes in at 8:05 PM for his first check. María Elena is lying in bed with the lights off. She has not eaten the dinner tray. She is staring at the ceiling.

Miguel turns on the lamp. He says her name. She turns her head and looks at him. She says: Me dijeron que tal vez es cáncer. Pero no entendí bien. El médico habló muy rápido y la intérprete también. No sé qué me dijo exactamente.

They told me it might be cancer. But I did not understand well. The doctor spoke very fast and the interpreter too. I do not know exactly what he said.


What the nurse can say and what must wait for the physician

Miguel is a floor nurse, not the hospitalist. He does not have the imaging in front of him. He does not know the exact language the hospitalist used or intended. He does not know whether the hospitalist said “cancer” or “concerning for malignancy” or “a mass that needs further evaluation” — and through a phone interpreter at the end of a busy attending’s day, the distinction between those things may have collapsed for María Elena regardless. What Miguel knows is this: she received significant medical information, she did not understand it, the physician is gone, and she has been lying in the dark for an hour.

The nurse’s role in this moment is not to explain the diagnosis. The nurse’s role is presence, acknowledgment of what she said, clarity about what comes next, and the concrete actions Miguel can take before he leaves the room.

Miguel does not sit on the corner of the bed. He pulls a chair. He asks: ¿Está bien si me siento un momento?

Is it okay if I sit down for a moment?

María Elena: Sí.


The question that opens the gap

Miguel does not launch into an explanation. He asks the question that surfaces what she actually understood.

— ¿Qué entendió de lo que le dijo el médico esta tarde?

What did you understand from what the doctor told you this afternoon?

María Elena: Que la imagen que me tomaron hoy — la del hígado — muestra algo. Que tal vez es cáncer. Que me quedo aquí mañana también. Eso es lo que entendí. Pero no sé qué quiere decir “tal vez.” No sé si ya saben que es cáncer o si todavía no saben.

That the image they took today — the one of the liver — shows something. That it might be cancer. That I am staying here tomorrow too. That is what I understood. But I do not know what “might” means. I do not know if they already know it is cancer or if they still do not know.

That last sentence is the core of what she needs answered. The difference between “we found cancer and we are telling you” and “we found something concerning and we need more information” is not a small difference. It is everything.


What Miguel says

Miguel does not have the imaging report in front of him. He does not know which of those two things the hospitalist meant. He is not going to guess. He says what he can honestly say.

— La pregunta que me hace — si ya saben que es cáncer o si todavía no — es exactamente la pregunta correcta. Y es una pregunta que el médico tiene que contestarle directamente a usted, con tiempo y sin prisa, con toda la información delante. Lo que me está diciendo — que no entendió bien, que tiene preguntas que no sabe cómo hacer, que el médico habló rápido — me dice que usted necesita otra conversación con el médico. Eso es algo que yo puedo pedir esta noche.

The question you are asking me — whether they already know it is cancer or not yet — is exactly the right question. And it is a question the doctor needs to answer you directly, with time and without rush, with all the information in front of him. What you are telling me — that you did not understand well, that you have questions you do not know how to ask, that the doctor spoke fast — tells me that you need another conversation with the doctor. That is something I can request tonight.

María Elena: ¿Puede venir esta noche?

Can he come tonight?

— Voy a hacer la solicitud ahora mismo. No le puedo prometer que viene en la próxima hora — depende del médico de guardia. Lo que sí le puedo decir es que esto se va a quedar en sus notas esta noche: que usted necesita tiempo con el médico para hacer preguntas. Si el médico de noche no puede venir, el equipo que llega mañana va a saber que esto es lo primero.

I am going to make the request right now. I cannot promise you he comes in the next hour — that depends on the on-call physician. What I can tell you is that this is going to stay in your notes tonight: that you need time with the doctor to ask questions. If the night physician cannot come, the team that arrives tomorrow will know this is the first thing.


Before Miguel leaves the room

Miguel makes two more moves before he steps out. The first is the practical question.

— ¿Hay alguien a quien quiera llamar esta noche? ¿Un familiar, alguien que le gustaría que estuviera aquí cuando hable con el médico?

Is there someone you would like to call tonight? A family member, someone you would like to have here when you speak with the doctor?

María Elena: Mi hija. Está en Riverside. No sé si puede venir esta noche.

My daughter. She is in Riverside. I do not know if she can come tonight.

— Si quiere llamarla ahora, puede. Y cuando hable con el médico — ya sea esta noche o mañana — puede pedirle que la llame por teléfono para que escuche la conversación. El médico puede hacer eso.

If you want to call her now, you can. And when you speak with the doctor — whether tonight or tomorrow — you can ask him to call her by phone so she can hear the conversation. The doctor can do that.

The second move is the presence statement. Not reassurance. Presence.

— Voy a estar aquí toda la noche. Si necesita algo — si quiere hablar, si tiene preguntas, si no puede dormir — el botón es para eso. No me está quitando de otra parte. Esto es lo que hay aquí esta noche.

I am going to be here all night. If you need anything — if you want to talk, if you have questions, if you cannot sleep — the button is for that. You are not taking me from somewhere else. This is what is here tonight.

María Elena nods. She does not say anything for a moment. Then: Gracias. Me había quedado sola con eso.

Thank you. I had been left alone with that.

Miguel calls the on-call hospitalist before he finishes his first round. The hospitalist comes at 10:30 PM. He brings the imaging. He explains, with time, with the interpreter on the phone, with María Elena’s daughter on speaker from Riverside. It takes twenty-five minutes. At 11:15 PM María Elena’s call light goes on. Miguel goes in. She says: Ahora entendí. Ya sé qué me dijo.

Now I understood. I know now what he told me.


Eight practical phrases for med-surg nurses in Spanish

These phrases address the specific communication needs of the medical-surgical floor: call light hesitancy, pain assessment at night, diuretic-related fall risk, and post-disclosure presence. Each phrase is paired with what it replaces and why the replacement matters.

1. Reframing the call light (replaces “don’t worry, it’s no bother”)
Llamarme es para lo que estoy aquí. Si usted tiene dolor — de noche, a las tres de la mañana, cuando sea — ese botón es para eso. Usted no me interrumpe — me deja hacer mi trabajo.
Calling me is what I am here for. If you have pain — at night, at three in the morning, whenever — that button is for that. You are not interrupting me — you are letting me do my job.

2. Naming what untreated pain costs (replaces “you should have called sooner”)
El dolor después de cirugía se trata más fácil cuando es un cuatro que cuando ya llegó a un siete. Cuatro horas despierta con dolor no es lo que tiene que pasar aquí.
Post-surgical pain is easier to treat when it is a four than when it has already reached a seven. Four hours awake in pain is not what has to happen here.

3. Pain assessment at night: location and character before the number
¿Dónde le duele más? ¿Cómo describiría el dolor — punzante, que aprieta, que arde, sordo? Del cero al diez, ¿cómo está ahora? ¿A qué número quisiera llegar para poder descansar?
Where does it hurt most? How would you describe the pain — stabbing, squeezing, burning, dull? Zero to ten, how is it now? What number would you like to reach to be able to rest?

4. The small promise that makes the next call more likely
Si a las tres de la mañana tiene dolor, ¿puede hacer la prueba de llamarme?
If at three in the morning you have pain, can you try calling me?

5. Explaining orthostatic hypotension from diuretics (replaces generic “fall risk”)
El diurético hace que la presión baje un momento cuando se levanta. Eso puede hacer que las piernas se sientan flojas aunque sea usted una persona completamente fuerte. No es debilidad — es el medicamento haciendo su trabajo.
The diuretic makes the blood pressure drop for a moment when you stand. That can make your legs feel weak even if you are a completely strong person. It is not weakness — it is the medication doing its job.

6. Making the call light feel like strength, not dependence
Llamarme para levantarse no es pedir ayuda por no poder. Es saber lo que tiene puesto.
Calling me to get up is not asking for help because you cannot. It is knowing what you have on board.

7. Asking what the patient understood from the physician (opens the real gap)
¿Qué entendió de lo que le dijo el médico?
What did you understand from what the doctor told you?

8. Naming the nurse’s action after post-disclosure presence (replaces vague reassurance)
Lo que me está diciendo me dice que necesita más tiempo con el médico, con la información enfrente y con tiempo para hacer preguntas. Eso es algo que voy a pedir esta noche — y va a quedar en sus notas.
What you are telling me tells me you need more time with the doctor, with the information in front of you and time to ask questions. That is something I am going to request tonight — and it will be in your notes.


The shared structure of all three scenarios

Patricia, José, and María Elena are in three different situations on the same floor on the same night. Patricia needs permission to ask for help. José needs an explanation calibrated to his identity as someone physically capable. María Elena needs someone to name what she is carrying and to do something concrete about it before leaving the room.

In each situation, the Spanish that works is the Spanish that names the real thing rather than a softened version of it. Rebeca does not tell Patricia her call is welcome — she tells her that four hours in pain is not what should happen here. Claudia does not tell José he needs help — she tells him the diuretic changes the pressure and a person who knows that does not stand alone with it running. Miguel does not tell María Elena that it will be okay — he tells her the question she asked is exactly the right question, and that he is going to put her need into her notes tonight.

The medical-surgical floor is where Spanish-speaking patients land after the ED, after surgery, after the CT that found something. The floor nurse is often the last English-speaking clinician a patient sees before the lights go out. What that nurse says in the last two minutes of the room check — the specific thing, not the generic thing — determines whether the patient sleeps or lies in the dark for four hours with pain that did not need to wait.


What these conversations look like from the outside

A floor nurse who has worked Spanish-speaking units develops a feel for these moments over time. The way a patient answers ¿cómo está? when she is not fine but does not want to say so. The way a man holds the IV pole when his legs are not trustworthy. The way a room feels when someone received news and has been alone with it. None of that transfer happens automatically in Spanish if the nurse has never had these conversations in Spanish before.

The phrases in this post are not translated floor nursing. They are clinical Spanish built for the specific moments med-surg produces — the 4 AM pain that waited too long, the diuretic-mediated fall that almost happened, the disclosure that went through a phone interpreter and left a patient alone in the dark. The nurse who has said llamarme es para lo que estoy aquí before the shift will say it at 4 AM with enough ease that Patricia hears it as true. The nurse who has practiced el medicamento hace que la presión baje un momento will say it to José with enough specificity that he nods instead of just agreeing to comply. The nurse who has asked ¿qué entendió de lo que le dijo el médico? before will know what to do with the answer at 8 PM when María Elena has been lying in the dark for an hour.

This post is part of a clinical Spanish library for working nurses. Related posts: Pain scale in Spanish for nurses — how to ask where it hurts without asking the wrong thing · The interpreter is on hold for eleven minutes — bridge phrases for the floor nurse · Discharge instructions in Spanish — the last five minutes of the visit that determine the readmission. Download the 50 Spanish phrases every nurse should know for a quick reference card to carry on shift. Practice med-surg Spanish scenarios at ClinicaLingo.


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