He aha ngā waikawa amino (ara rānei i roto i te uaua): Ngā whakamahinga, te inenga, ngā pānga taha me ētahi atu

Ko ngā waikawa amino e whakawhiwhia ana mā te IV he pūtake hanga nui o te pūmua ka tukuna tika ki roto i tō toto i te wā e kore ai tō tinana e whiwhi kai nui mā te kai, mā ngā tāpiringa waha rānei. Kei roto i ēnei otinga huakore he ranunga taurite o ngā waikawa amino e hiahiatia ana e tō tinana hei whakatika i ngā kiko, hei pupuri i te papatipu uaua, me te tautoko i ngā mahi okana nui.

Whakaarohia ngā waikawa amino IV hei ara oranga kai tika. I te wā e kore ai tō pūnaha kūnatu e mahi tika ana, e mate rānei koe ki te kai, ka karo ēnei otinga i tō puku katoa, ka tukuna ngā matūkai nui ki te wāhi e tino hiahiatia ana e tō tinana.

He aha ngā waikawa amino (ara rānei i roto i te uaua)?

Ko ngā waikawa amino rānei i roto i te uaua he otinga huakore kei roto he ranunga o ngā waikawa amino nui me ngā waikawa amino kore-nui e whakauruhia tika ana ki roto i tō toto mā te uaua. E whakarato ana ēnei otinga i tō tinana ki ngā pūtake hanga pūmua e hiahiatia ana i te wā e kore ai e taea, e kore rānei e nui te kai noa.

E whakamahi ana tō tinana i ēnei waikawa amino hei hanga me te whakatika i ngā pūmua, he mea nui mō ngā mea katoa mai i te whakaora i ngā patunga ki te pupuri i tō pūnaha ārai mate. E whakarite ana te ara IV i te 100% te ngongo mai i te mea ka karo ngā matūkai i tō pūnaha kūnatu katoa.

Kei roto i ēnei otinga te 8-10 ngā waikawa amino nui e kore e taea e tō tinana te hanga i a ia anō, me ētahi waikawa amino kore-nui ka whai pānga nui i te wā e mate ana koe, e pōhēhē ana rānei. He rerekē te hanganga tika i runga i ō hiahia hauora motuhake me te waitohu e whakamahia ana.

He aha ngā waikawa amino (ara rānei i roto i te uaua) e whakamahia ana mō?

Ko ngā waikawa amino IV te mea e whakamahia ana i te tuatahi i te wā e hiahia ana tō tinana i te kai pūmua engari e kore e taea te tiki mā te kai noa. Ka puta tēnei i te nuinga o te wā i ngā tūāhuatanga hōhipera i te wā e tino mate ana ngā tūroro, e ora ana rānei i te pokanga nui.

Anei ngā āhuatanga matua ka tūtohu pea tō tākuta i ngā waikawa amino IV, e mahi ana i ia hiahia kai motuhake:

• Te kore kai nui - Ki te kore koe i kaha ki te kai tika mō ngā wiki, ā, kua pau ngā pūmua o tō tinana
• Te whakaora i muri i te pokanga nui - E hiahia ana tō tinana i te pūmua anō hei whakaora i ngā patunga pokanga me te hanga anō i ngā kiko kua pakaru
• Te mate nui - Ko ngā āhuatanga pēnei i te sepsis, i ngā wera nui rānei, ka nui rawa te hiahia o tō pūmua
• Ngā mate o te pūnaha whēkau - Ki te kore e taea e ngā āhuatanga pēnei i te mate a Crohn, i te pancreatitis nui rānei te tango kai
• Te kore e kaha ki te kai mō te wā roa - Ki te mea kei runga koe i te tūāpapa hau, kei te tino pāhoahoa rānei koe e kore ai e taea te kai
• Ngā āhuatanga hypermetabolic - Ngā āhuatanga e tahu ai tō tinana i ngā matūkai i te tere ake i te tikanga

He rite tonu te kaupapa o ēnei āhuatanga: e tino hiahia ana tō tinana i ngā poraka hanga pūmua, engari kāore e taea e tō pūnaha whēkau te whakarato i a rātou i runga i te pono. Ka whakakiia e ngā waikawa amino IV tēnei wāhi nui i te wā e whakaora ana tō tinana.

Me pēhea te mahi a ngā waikawa amino (ara i roto i te uaua)?

Ka mahi ngā waikawa amino IV mā te tuku i ngā poraka hanga pūmua ki roto tonu i ō toto, kei reira tonu e wātea ana mō ngā mahi nui o tō tinana. E kiia ana tēnei he wawaotanga kai kaha-āhua e whakarato ana i te tautoko whāinga i te wā e kore ai te kai waha e whai hua.

Kia uru ki ō toto, ka haere ēnei waikawa amino ki tō ate, ō uaua, me ētahi atu okana kei reira e huihuia ana ki ngā pūmua motuhake e hiahia ana tō tinana. Ka mahi tō ate pēnei i te wheketere pūmua, mā te whakamahi i ēnei waikawa amino hei hanga i ngā mea katoa mai i ngā paturopi e whawhai ana i te mate ki ngā enzyme e āwhina ana i te whakaora i ngā patunga.

He tino whai hua te tukanga nei nā te mea ka karo katoa i tō pūnaha kūnatu. Ahakoa te kai pūmua e hiahia ana tō puku me ō whekau ki te wawahi i te tuatahi, ko ngā waikawa amino IV kei roto i tō rātou āhua māmā rawa atu, ā, kua rite mō te whakamahi tonu.

Ka whakanui tō tinana i ēnei waikawa amino i runga i ōna hiahia tino nui. Ki te whawhai ana koe i tētahi mate, ka whakamahia rātou ki te hanga pūmua ārai mate. Ki te ora ana koe i te pokanga, ka āwhina rātou ki te hanga anō i ngā kiko kua pakaru. Ko tēnei huarahi whāinga ka whai hua ngā waikawa amino IV i ngā wā o te pēhanga hauora.

Me pēhea taku tango i ngā waikawa Amino (Ara Intravenous)?

Ka whakahaerehia ngā waikawa amino IV e ngā tākuta whakangungu i roto i te hōhipera, te whare haumanu, te wāhi tiaki kāinga motuhake rānei. Kāore e taea e koe, ā, kaua e ngana ki te hoatu i ēnei otinga ki a koe anō.

Ko te tukanga whakauru he 4-12 hāora te roa i runga i ō hiahia motuhake me te kukū o te otinga. Ka whakauru tō nēhi i tētahi katetā IV iti ki roto i tētahi uaua i tō ringa, i tō ringa rānei, ka hono atu ki tētahi pēke kei roto te otinga waikawa amino.

Anei te mea ka taea e koe te tūmanako i te wā o te tukanga whakauru:

• Te whakarite tuatahi - Ka tirohia e tō nēhi tō wāhi IV me te whakarite kia noho te otinga i te pāmahana rūma
• Tīmatanga pōturi - Ka tīmata te whakauru i te reiti pōturi kia mōhio ai koe kei te pai tō tinana
• Aroturuki - Ka tirohia ō tohu nui me te wāhi IV i ngā wā katoa o te tukanga
• Whakaritenga reiti - Ka taea te whakatika i te reiti rere i runga i te āhua o tō urupare
• Aroturuki taiwhanga - Ka taea te mahi whakamātautau toto hei tirotiro i te urupare o tō tinana

Kāore koe e hiahia ki te karo i te kai, i te inu rānei ki te kore te tākuta e kī atu ki a koe. Inā, ki te taea e koe te kai i ngā rahinga iti, ka āwhina tēnei i tō tinana ki te whakamahi i ngā waikawa amino IV i te whai hua ake.

E hia te roa e tango ai ahau i ngā waikawa amino (ara i roto i te uaua)?

Ko te roa o te rongoā waikawa amino IV e whakawhirinaki katoa ana ki tō āhuatanga e hāngai ana, me te tere o te whakaora o tō tinana i tōna kaha ki te tiki kai mā te kai noa. Ko te nuinga o ngā tūroro e whiwhi ana i ēnei otinga mō te wā mai i te rā torutoru ki te wiki maha.

Mō ngā āhuatanga wā-poto pēnei i te whakaora mai i te pokanga, tērā pea ka hiahia koe ki ngā waikawa amino IV mō te 3-7 rā kia taea anō e koe te kai i ngā kai mārō. Heoi anō, ko ngā tūroro e pā ana ki ngā āhuatanga mau tonu, tūkinotia rānei, ko te hunga rānei kei roto i te manaaki kaha, tērā pea ka hiahiatia ngā wiki, ngā marama rānei o te tautoko.

Ka arotakehia e tō rōpū hauora i ngā wā katoa mēnā e hiahia ana koe ki ngā waikawa amino IV mā te tirotiro i tō kaha ki te kai, i ō tohu toto kai, me tō anga whakamua whānui. Ko te whāinga ko te hoki tonu ki te kai noa i te wā ka noho haumaru, ka whai hua.

Ko ētahi tūroro e whiwhi ana i ngā waikawa amino IV i runga i te hōtaka huringa, pēnei i ngā whakaurunga i te pō e taea ai e rātou te neke i te awatea. He pai te mahi a tēnei huarahi mō te hunga e hiahia ana ki te tautoko kai wā-roa engari e hiahia ana ki te pupuri i ētahi mana motuhake.

He aha ngā pānga taha o ngā waikawa amino (ara i roto i te uaua)?

Ko te nuinga o te tangata e pai ana ki ngā waikawa amino IV, engari pēnei i ētahi atu rongoā, ka taea e rātou te pānga taha. Ko te rongo pai ko te kore noa o ngā raruraru nui ina tika ana te hoatu o ngā otinga e ngā tohunga whakangungu.

Me haere tātou i ngā pānga taha ka pā ki a koe, ka tīmata mai i te mea noa, ka neke ki ngā mea onge:

Ngā Pānga Taha Noa

Ka puta ēnei pānga taha i roto i te 10-20% o ngā tūroro, ā, he ngawari, he whakahaere hoki:

• Te whakapairuaki, te mamae puku ranei - Ahakoa ka karo nga waikawa amino i tō puku, ka pā tonu pea ki tō punaha kūnatu
• Te ānini - He ngawari noa iho, e pā ana ki ngā huringa o te matū o tō toto
• Te ngenge - E kaha ana tō tinana ki te whakamahi i ēnei matūkai, ā, he wā poto nei pea te ngenge
• Te riri o te wāhi IV - He whero ngawari, he ngawari rānei te pā ki te wāhi e uru ai te ngira ki tō uaua
• Te kirika ngawari - He pāmahana iti i te wā e urutau ana tō tinana ki te whakaurunga

Ko te tikanga ka pai ake ēnei tohumate i te wā e urutau ana tō tinana ki te rongoā, ā, he uaua noa iho te kino ki te aukati i te whakaurunga.

Ngā Pānga Kāore i te Nui

Ka puta ēnei i te 2-5% o ngā tūroro, ā, me mātakitaki tata, me whakatika rānei te rongoā:

• Te pupuri wai - Te pūhihi i ō waewae, rekereke, ringa rānei i te nui o te wai
• Ngā huringa huka toto - Ka pā ngā waikawa amino ki ō taumata kūhuka, ina koa he mate huka tōu
• Ngā tauritenga hiko kore - Ngā huringa o te konutai, te pāhare pāporo, ētahi atu kohuke rānei i tō toto
• Ngā huringa mahi ate - Ngā huringa wā poto i ngā whākōkī ate i te wā e tukatuka ana tō ate i ngā waikawa amino
• Ngā tauhohenga pāwera - Te pūwha, te mānukanuka, te māngai rānei i ngā tāngata tairongo

E mātakitaki ana tō rōpū hauora i ēnei pānga mā ngā whakamātautau toto me ngā whakamātau tinana, e āhei ana rātou ki te whakatika i tō rongoā ki te hiahiatia.

Ngā Pānga Kāore i te Nui, engari he Kaha

Ka puta ēnei raruraru i raro i te 1% o ngā tūroro, engari me āwhina tonu te rongoā:

• Ngā tauhohenga mate pāwera nui - Uaua ki te manawa, te pupuhi nui, te pūhi whānui rānei
• Ngā pūhui toto - Inā koa ki te uru IV mō te wā roa, ahakoa he nui ake tēnei e pā ana ki te kātere IV i ngā waikawa amino ake
• Ngā raruraru ate nui - Ngā huringa nui i te mahi ate, inā koa ki te whakamahi mō te wā roa
• Metabolic acidosis - He huringa mōrearea i roto i te matū o tō toto e pā ana ki te manawa me te mahi ngākau
• Ngā raruraru electrolyte nui - Ngā tauritenga mōrearea ka pā ki te manawataki ngākau, ki te mahi roro rānei

Ahakoa he onge ēnei pānga taha nui, e whakaatu ana he aha i tika ai kia hoatu ngā waikawa amino IV i roto i ngā wāhi rongoā me te aroturuki tika me ngā taputapu ohorere e wātea ana.

Ko wai kāore e tika ana kia tango Waikawa Amino (Ara Intravenous)?

Ahakoa he haumaru ngā waikawa amino IV mō te nuinga o te tāngata, nā ētahi āhuatanga rongoā ka kore e tika, ka hiahiatia rānei ētahi whakatūpato motuhake. Ka āta arotake tō tākuta i tō hītori rongoā i mua i te tūtohu i tēnei rongoā.

Ko ēnei ngā āhuatanga matua ka kore pea e tika ngā waikawa amino IV mōu:

Ngā Whakahē Kāore e taea

Nā ēnei āhuatanga ka mōrearea pea ngā waikawa amino IV, ā, ka whakakorehia te whakamahi:

• Te ngoikoretanga ate nui - E kore e taea e tō ate te tukatuka tika i ngā waikawa amino, e arahi ana ki te pūpū kino
• Te mate tākihi nui me te kore o te tātai - E kore e taea e ō tākihi te whakakore i ngā hua para mai i te pūngao pūmua
• Ngā hē whānau o te pūngao waikawa amino - Ngā āhuatanga ira e aukati ana i tō tinana ki te tukatuka i ētahi waikawa amino
• Te ngoikoretanga ngākau nui, kāore i te pūmau - Ka taea e te nui o te wai te whakapōrearea i tō āhua ngākau
• Te mōhiotia o te mate pāwera nui ki ngā otinga waikawa amino - Ngā tauhohenga pāwera nui i mua ki ēnei hua

Mēnā he āhuatanga tō, ka tūhura tō tākuta i ētahi atu huarahi hei tautoko i ō hiahia kai.

Ngā Whakaaetanga Whanaunga

E kore ēnei āhuatanga e aukati rawa i te whakamahi waikawa amino IV, engari me mātakitaki tupato, me te whakarerekē i te horopeta:

• Te mate ate ngawari ki te āhua - Me iti ake pea ngā horopeta me te mātakitaki pinepine
• Te mate tākihi ngawari - Ka taea e tō tākuta te whakatika i te hanganga waikawa amino me te mātakitaki i tō mahi tākihi
• Te mate huka - He mea nui te mātakitaki i te huka toto i te wā o te rongoā
• Te mate ngākau - Me puhoi ake pea ngā reiti whakauru me te mātakitaki tupato i te taurite wai
• Te hītori o te hopu - Ka taea e ētahi waikawa amino te whakaoho i te hopu i roto i ngā tāngata e tūpono ana

Ko te whai i tētahi o ēnei āhuatanga kāore i te kī e kore e taea e koe te whiwhi waikawa amino IV, engari e kī ana ka whai ngā tō rōpū hauora i ngā whakatūpato anō hei whakarite i tō haumaru.

Ngā Waikawa Amino (Ara Whakauru) Ngā Ingoa Mōhio

He maha ngā kamupene rongoā e hanga ana i ngā otinga waikawa amino IV, he rerekē ngā hanganga me ngā kukū o ia mea. Mā tō hōhipera, tō whare haumanu rānei e whiriwhiri te hua e tika ana i runga i ō hiahia motuhake.

Koinei ngā ingoa waitohu e whakamahia nuitia ana ka tūtaki pea koe:

• Aminosyn - Ko tētahi o ngā waitohu e whakamahia whānuitia ana, e wātea ana i roto i ngā momo kukū rerekē
• Travasol - Ko tētahi atu waitohu noa he rekoata pai mō te haumaru me te whai hua
• FreAmine - He maha ngā wā e whakamahia ana mō ngā tūroro e whai ana i ngā hiahia pūkoro motuhake
• Novamine - He hanganga hou i hangaia mō ngā tūroro e tino mate ana
• Clinisol - He maha ngā wā e whakamahia ana i ngā hōhipera Pākehā, ā, kei te wātea haere i ētahi atu whenua

Ko te whiriwhiri i te waitohu e pā ana ki ngā manakohanga o tō hōhipera, tō āhuatanga hauora motuhake, me te mea e wātea ana mā rātou rongoā. E tutuki ana ēnei hua katoa i ngā paerewa haumaru mātāmua, ā, e kiia ana he whai hua ōrite mō te nuinga o ngā tūroro.

Ngā Waikawa Amino (Ara I roto i te Uaua) Ngā Kōwhiringa kē

Ahakoa he tino whai hua ngā waikawa amino IV, ehara koinei anake te huarahi hei whakarato i te tautoko kai ina kore e taea te kai noa. Ka whakaaro pea tō rōpū hauora ki ētahi kōwhiringa kē i runga i tō āhuatanga motuhake.

Koinei ngā kōwhiringa kē matua ka kōrero pea tō tākuta ki a koe:

Ngā Kōwhiringa Kai Enteral

Mēnā kei te mahi tō pūnaha kūnatu engari kāore e taea e koe te kai noa, ka whakaarohia pea ēnei kōwhiringa i te tuatahi:

• Ngongo whāngai ihu-puku - He ngongo angiangi mā tō ihu e tuku ana i te kai wai ki tō puku
• Ngongo gastrostomy (G-tube) - He ngongo i whakatakotoria mā te pokanga i tō pakitara puku mō te whāngai wā-roa
• Ngongo jejunostomy - E tuku ana i te kai ki tō whekau iti i te wā e kore e taea te whāngai i te puku
• Ngā taapiri kai waha - He inu pūmua nui, he paura rānei mēnā ka taea e koe te horo engari e hiahia ana koe ki te kai atu

Ko ēnei kōwhiringa te nuinga e pai ana i te wā e taea ana nā te mea he iti ake te whakaeke, ā, ka āwhina i te pupuri i te mahi nakunaku noa.

Ētahi atu Kōwhiringa Kai IV

I ētahi wā ka pai ake te huarahi whakakotahi, ētahi atu rānei otinga IV:

• Te Kai Parenteral Katoa (TPN) - Te kai katoa tae atu ki ngā waikawa amino, ngā ngako, ngā warowaihā, ngā huaora, me ngā kohuke
• Te Kai Parenteral Porowhita (PPN) - He iti ake te pūngao kai e hoatu ana mā ngā uaua iti ake
• Intralipid (emulsion ngako IV) - E whakarato ana i ngā kārahi me ngā waikawa ngako nui me ngā waikawa amino
• Otinga Dextrose - Ngā warowaihā māmā mō ngā hiahia pūngao tonu

Ka āwhina tō rōpū hauora i a koe ki te mārama ko tēhea kōwhiringa te mea tika mō tō āhuatanga me ō whāinga whakaora.

He Pai Ake Ngā Waikawa Amino (Ara I roto i te Uaua) i te Kai Enteral?

Kāore tēnei i te mea kotahi e pai ake ana i tētahi atu, engari ko te huarahi e tika ana mō tō āhuatanga hauora. He wāhi tō ngā waikawa amino IV me te kai enteral (whāngai ngongo) i roto i te manaaki hauora.

Ko te waikawa amino IV te tikanga ka kōwhiria ina kore e pai te mahi o tō pūnaha kūnatu, ina hiahia rānei koe ki te whakahaere kai tino tika. He mea tino nui mō ngā tūroro e tino mate ana, kāore e pai te ngongo o ō rātou whekau i ngā matūkai.

Ko te kai mā te enteral te tikanga e pai ana ina pai te mahi o tō pūnaha kūnatu, nā te mea he mea māori ake, he iti ake te utu, ā, ka āwhina i te pupuri i te mahi noa o te whekau. He iti ake hoki ngā tūponotanga o ngā raruraru nui pērā i te mate urutā, i te pūpū toto rānei.

Anei te wā e pai ana te mahi o ia huarahi:

He pai ake te waikawa amino IV i te nuinga o te wā ina:

• He tino raru tō pūnaha kūnatu, kāore rānei e mahi ana
• Kei te hiahia koe ki te whakahaere kai tino tika
• Kei te tino mate koe, ā, kāore ō whekau e ngongo ana i ngā matūkai
• He nui te whakapairuaki, te ruaki rānei e aukati ana i te whāngai ngongo
• Kei te hiahia koe ki te tautoko kai wā-poto i muri i te pokanga nui

He pai ake te kai mā te enteral i te nuinga o te wā ina:

• E mahi ana tō pūnaha kūnatu, ahakoa kāore i te tino pai
• Kei te hiahia koe ki te tautoko kai wā-roa
• He pūmau koe, ā, kāore koe e hiahia ana ki te aroturuki kaha
• He mea nui te utu
• Kei te hiahia koe ki te pupuri i te mahi kūnatu noa

Ka whakaaro tō rōpū hauora ki ēnei mea katoa me ō hiahia kia whakatau i te huarahi pai mō tō āhuatanga.

Ngā Pātai Auau mō te Wāikawa Amino (Ara Intravenous)

He haumaru te rongoā waikawa amino IV mō ngā tāngata whai mate huka?

Āe, ka taea te whakamahi haumaru i te waikawa amino IV i roto i ngā tāngata whai mate huka, engari me āta aroturuki, me te whakatika rongoā pea. Ka taea e te waikawa amino te pā ki ō taumata huka toto, i ētahi wā ka piki, ka heke rānei i te kore e kitea.

Ka tirohia e tō rōpū hauora tō huka toto i te wā e rongoa ana koe, ā, tērā pea ka whakatikatika i ō rongoā mō te mate huka. Ka aroturukihia hoki e rātou ngā tohu o ngā raruraru o te mate huka, ā, ka whakarite kia noho haumaru tō huka toto i te wā e rongoa ana koe.

Me pēhea taku mahi mēnā ka momotuhia taku rongoā waikawa amino IV?

Mēnā ka momotuhia tō rārangi IV, kaua e ngana ki te hono anō i a koe anō. Engari, waea atu ki tō nēhi tonu, ka pēhi marie ki te wāhi IV ki te kakahu mā, kia kore ai e toto.

Kia mā te rārangi IV kua momotuhia, kaua e tukua kia pā ki te papa, ki ētahi atu mea rānei. Ka arotakehia e tō nēhi te āhuatanga, ā, ka hono anō i te rārangi i runga i te haumaru, ka whakauru rānei i tētahi kōwhao IV hou mēnā e tika ana. Ko te ngaro i te wā poto o te rongoā kāore i te mōrearea, engari he mea nui kia whiwhi āwhina hauora tonu.

Me pēhea taku mahi mēnā ka ngaro i ahau tētahi horopeta waikawa amino IV kua whakaritea?

Mēnā ka ngaro i a koe tētahi rongoā kua whakaritea, whakapā atu ki tō rōpū hauora tonu ki te kōrero mō te whakarite anō. Kaua e ngana ki te "whakatika" mā te whiwhi i te horopeta rua, mā te whakaroa rānei i te wā o te rongoā e whai ake nei me te kore e tirotirohia e te tākuta.

Ko te ngaro i tētahi horopeta kāore i te mōrearea, ina koa kei te kai koe i ētahi kai, kei te whiwhi rānei i ētahi atu tautoko kai. Heoi anō, me mōhio tō rōpū hauora mō ngā horopeta kua ngaro kia whakatikatika i tō mahere rongoā, ā, kia whakarite kia whiwhi koe i te kai tika.

Āhea ka taea e au te whakamutu i te tango waikawa amino IV?

Ka taea e koe te whakamutu i te rongoā waikawa amino IV i te wā e taea ana e koe te whakatutuki i ō hiahia kai mā te kai noa, mā ētahi atu tikanga iti ake te whakaeke. Ko tēnei whakatau me mahi tonu e tō rōpū hauora, kaua e mahi takitahi.

Ka whai whakaaro tō tākuta ki ētahi āhuatanga, tae atu ki tō kaha ki te kai, ngā tohu toto kai, te ahunga whakamua o tō whakaora, me te pai ake o tō āhua i raro. Ko te whakawhiti he mea haere haere tonu, ka whakaitihia ngā waikawa amino IV i te pikinga o tō kai waha.

Ka taea e au te whakakori tinana, te pukumahi rānei i te wā e whiwhi ana i ngā waikawa amino IV?

He pai te mahi māmā, ā, he pai anō hoki i te wā e whiwhi ana i ngā waikawa amino IV, engari me tirotiro tonu koe ki tō rōpū hauora i te tuatahi. He iti te here o te rārangi IV i tō nekehanga, engari ka taea e koe te hīkoi i tō rūma, i te papa hōhipera rānei.

Kaua e whakakori tinana kaha, ngā mahi rānei ka tūpono ka tūkinotia tō kātere IV. Me karo te kauhoe, ngā hākinakina whakapā, te hiki taumaha rānei kia oti rawa tō rongoā IV. Ka taea e tō kaimātai tinana, tō nēhi rānei te kōrero i ngā mahi e tika ana e mahi ana me tō whakatakotoranga IV me tō āhua hauora.