BHCLR- Adult nursing exam 2 Updated 2024/2025 Actual Questions and answers with complete solutions

- stertor - *crackles*- caused by fluid in the alveoli. They are discontinuous sounds usually heard on inspiration, but they may be heard throughout the respiratory cycle. They may be high-pitched, popping sounds or low-pitched, bubbling sounds, and they have been described as being similar to the sound made by rubbing strands of hair together with the fingertips. *strider* -a piercing, high-pitched sound that is heard without a stethoscope, primarily during inspiration in infants who are experiencing respiratory distress or in someone with an obstructed airway. *stertor*- refers to labored breathing that produces a snoring sound. It is common with mouth breathing due to nasal congestion. The "death rattle" is a type of stertorous breathing. - Developmental level - Gender - Exercise - *Developmental level* - Newborns have a rapid pulse rate. The rate stabilizes in childhood and gradually slows through old age. The resting heart rate increases with age; however, variability decreases. - Thus, you should not rely solely on changes in the pulse rate of older adults to detect their response to external stressors. *Gender* - Adult women have a slightly higher pulse rate than do adult men. *Exercise* - Muscle activity normally increases the pulse rate. After exercise, a well-conditioned heart returns to a normal rate more quickly. People who are well conditioned have lower heart rates, both before and during exercise, than those who are less conditioned. - Disease - Blood loss - *disease* - Diseases, such as heart disease, hyperthyroidism, respiratory diseases, and infections, are generally associated with increased pulse rates. Hypothyroidism is associated with decreased pulse rates.*blood loss* - Small blood loss is generally well tolerated and produces only a temporary increase in pulse rate. Theoretically, a large blood loss stimulates the sympathetic nervous system, bringing about an increase in pulse rate to compensate for the decreased blood volume - Disease - Medication - *disease* - The rate of breathing may be increased or decreased by various diseases. For example, brainstem injuries and increased intracranial pressure may interfere with the respiratory center, inhibiting respirations or altering respiratory rhythm *medication* - Central nervous system depressants, such as morphine or general anesthetics, cause slower, deeper respirations. Caffeine and atropine can cause shallow, fast breathing. - dispnea - orrthopnea - breath sounds - *dispnea- * increased effort with breathing or labored breathing. It is uncomfortable for the client and frequently produces fatigue and fear. *orrthopnea- * difficulty or inability to breathe when in a horizontal position. You will observe this in some clients with respiratory or cardiac conditions. *breath sounds-* You will use a stethoscope to listen for breath sounds. Normal respirations are quiet. - diurnal variations - genes - *Diurnal Variations* - Generally, BP varies according to the person's daily schedules and routines. BP is lower while the person is sleeping and upon wakening, rising during the day and dropping again toward bedtime. *Genes*- . Researchers used the recognized 29 genetic variants known to influence systolic and diastolic blood pressure to develop a genetic risk score. Twenty-nine percent of people with the top 10% of genetic risks had hypertension compared with 16% in the lowest risk groups - exercise- pain - stress - smoking - fever - *exercise* -Muscular activity causes a temporary increase in respiratory rate and depth to increase oxygen availability to the tissues and to rid the body of excess carbon dioxide. *pain* - Acute pain causes an increase in respiratory rate but a decrease in depth. *stress* - Psychological stress, such as anxiety or fear, may markedly influence respiration as a result of sympathetic stimulation. The most common change is an increase in rate. *smoking* - *fever* - - exercise - body positions - *Exercise.*- Physical fitness has been shown to reduce BP in many individuals. However, muscular exertion temporarily increases BP as a result of increased heart rate and cardiac output. You should, therefore, wait about 30 minutes before you assess the BP of someone who has been physically active. *Body Position*-. BP is higher when a person is standing than when she is sitting or lying down. Readings are higher if taken with the client's arm above heart level or if the arm is unsupported at the client's side. Seated readings are higher if the client's feet are dangling rather than resting on the floor or if the legs are crossed at the knees. - Food intake - Stress - Fever - * Food intake* -Ingestion of a meal causes a slight increase in pulse rate for several hours. *stress* - triggers the fight-or-flight sympathetic nervous system response, which increases both pulse rate and strength of the heart contractions (stroke volume).*fever*- The pulse rate tends to increase about 10 beats/min for each degree Fahrenheit of temperature elevation. The reasons are that (1) the metabolic rate increases and (2) in response to the fever, peripheral vasodilation occurs, causing a decrease in blood pressure. The body then causes the heart to beat faster to compensate for the decreased blood pressure. - gender - family history - lifestyle - *Gender.* - The average BP for men is slightly higher than that for women of comparable age. After menopause, a woman's BP tends to increase, possibly due to a decrease in estrogen. *Family History* -. A family history of hypertension markedly increases the likelihood of an individual's developing hypertension. *Lifestyle.* - Increased sodium consumption, smoking, and consumption of three or more alcoholic drinks per day have been shown to elevate BP. Caffeine may raise BP for a short while after ingestion, but it has no long-term effect on the BP. - positon changes