The nurse is assessing a client’s activity intolerance by having the client walk on a treadmill for 5 minutes. Which of the following indicates an abnormal response?
A. Pulse rate increased by 20 bpm immediately after the activity.
B. Respiratory rate decreased by 5 breaths/minute.
C. Diastolic blood pressure increased by 7 mm Hg.
D. Pulse rate within 6 bpm of resting phase after 3 minutes of rest.
Correct Answer: B. Respiratory rate decreased by 5 breaths/minute.
The normal physiologic response to activity is an increased metabolic rate over the resting basal rate. The decrease in respiratory rate indicates that the client is not strong enough to complete the mechanical cycle of respiration needed for gas exchange. The respiratory system works in conjunction with the cardiovascular system. The pulmonary circuit receives almost all of the cardiac output. In response to the increased cardiac output, perfusion increases in the apex of each lung, increasing the available surface area for gas exchange (decreased alveolar dead space).
Option A: The post-activity pulse is expected to increase immediately after activity but by no more than 50 bpm if it is a strenuous activity. To accommodate the increased metabolic activity in skeletal muscle, the circulatory system must properly control the transport of oxygen and carbon dioxide, as well as help to buffer the pH level of active tissues. This action is accomplished by increasing cardiac output (increased heart rate and stroke volume) and modulating microvascular circulation.
Option C: The diastolic blood pressure is expected to rise but by no more than 15 mm Hg. There is a linear increase in systolic blood pressure to peak values of 200 to 249 mmHg in normotensive individuals, and the diastolic pressure value remains near rest level. Hypertensive individuals reach higher systolic blood pressures at a given rate of work, and they can also reach higher diastolic values.
Option D: The pulse returns to within 6 bpm of the resting pulse after 3 minutes of rest. To accommodate the increased metabolic activity in skeletal muscle, the circulatory system must properly control the transport of oxygen and carbon dioxide, as well as help to buffer the pH level of active tissues. To accommodate the increased metabolic activity in skeletal muscle, the circulatory system must properly control the transport of oxygen and carbon dioxide, as well as help to buffer the pH level of active tissues.
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