Malignant is a growth-based classification of tumors.
Cells in malignant tumors proliferate uncontrollably and spread nearby or to distant places. Tumors that are cancerous are malignant (i.e. they invade other sites). They spread via the lymphatic system or bloodstream to distant locations. Metastasis describes this spreading. Although it can happen everywhere in the body, metastasis most frequently affects the liver, lungs, brain, and bone.
Malignant tumors can spread quickly and need to be treated to stop this from happening. Early detection and surgery are the most likely forms of treatment, while chemotherapy or radiotherapy may also be used. If the cancer has spread, systemic treatments like chemotherapy or immunotherapy are probably necessary.
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after explaining the causes of hypothyroidism to the parents of a newly diagnosed infant, the nurse should recognize that further education is needed when the parents ask which question?
The correct answer is option C, which says, hypothyroidism can we treated by exposing are baby to a special light, right?
Hypothyroidism is the condition of the body when the thyroid gland does not produces enough amount of important hormones which are crucial for the metabolism of the body.
When the parents say that hypothyroidism can be treated my exposing our child to a special light is completely wrong this is why the nurse recognize that further education and information to be given to the parents so that they can have more knowledge about hypothyroidism.
Hypothyroidism has nothing to do with the special kind of light it is and Radioactive rays which are used sometimes so that hypothyroidism can be treated. When it is present in a very bad condition in the body.
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Complete question - After explaining the causes of hypothyroidism to the parents of a newly diagnosed infant, the nurse should recognize that further education is needed when the parents ask which question?
a) "So, hypothyroidism can be only temporary, right?"
b) "Are you saying that hypothyroidism is caused by a problem in the way the thyroid gland develops?"
c) "So, hypothyroidism can be treated by exposing our baby to a special light, right?"
d) "Do you mean that hypothyroidism may be caused by a problem in the way the body makes thyroxine?"
the nurse cares for a client with an abnormal cortisol level. the nurse recalls which information about cortisol?
the nurse cares for a client with an abnormal cortisol level. the nurse recalls that Cortisol stimulates gluconeogenesis.
Cortisol maintains the blood glucose concentration by stimulating the liver for gluconeogenesis. Gluconeogenesis involves the formation of glucose from amino acids and fatty acids. Cortisol mobilizes free fatty acids and inhibits protein synthesis. The blood levels of cortisol increase in stressful conditions.
In fact, the hormone cortisol has many roles for the body, especially in controlling metabolism. The production of this hormone is regulated by three organs at once, namely the pituitary gland, the hypothalamus in the brain, and the hormonal gland. When cortisol levels are low, these organs work together to meet the levels.
Cortisol hormone function
Following are the tasks performed by the hormone cortisol in the human body:
• Affects memory formation.
• Fights inflammation in the body.
• Controls the balance of salt and water in the body.
• Regulate blood sugar levels.
• Adjust blood pressure to body conditions.
• Helping the development of the fetus in pregnant women.
The role of the hormone cortisol is so important, it is mandatory to maintain levels of this hormone so that it is not deficient or excessive. Things like stress and physical activity like exercise can affect the levels of the hormone cortisol in the body. During exercise, for example, cortisol performs its function as a blood sugar regulator so that sugar can be processed into an energy source. That way, the body is able to adapt to the increased energy needs and you can exercise smoothly.
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a patient is diagnosed with giant cell arteritis (gca) and is placed on corticosteroids. a concern for this patient is that he will stop taking the medication as soon as he starts to feel better. why must the nurse emphasize the need for continued adherence to the prescribed medication?
Numerous regimens are used to treat giant cell arteritis by obtaining strong evidence from clinical trials. The nurse advises the patient to follow the required regimen.
What is the most effective treatment for giant cell arteritis?
The primary treatment for giant cell arteritis is high doses of corticosteroid medication such as prednisone. Because immediate treatment is required to prevent vision loss, your doctor will most likely begin treatment before confirming the diagnosis with a biopsy.
The need to suppress vascular inflammation and reduce the risk of blindness underpins the use of high doses of corticosteroids in the treatment of giant cell arteritis.
Therefore, GCA may cause bilateral damage to the vertebral arteries, such as bilateral occlusion, resulting in a severe stroke with a high mortality rate if the patient doesn't adhere to prescribed medication.
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a nurse refers a client with severe anxiety to a psychiatrist for medication evaluation. the physician is most likely to order which psychotropic drug regimen on a short-term basis?
Orthostatic hypotension can cause a feeling of light-headedness or dizziness if one stands up too quickly. Why can standing quickly cause this to occur?.
The reason why Orthostatic hypotension occurs quickly in a standing position is the percolation of blood around the legs die to change in gravity.
What is Orthostatic hypotension?We must recall that the term "hypotension" is synonymous with the decrease in the blood pressure. So it can just be said to mean, a situation in which a person has a low blood pressure.
On the other hand, Orthostatic hypotension is a unique case of low blood pressure that is rampant when you are standing or sitting. It is caused by the fact that the change in the gravity could cause blood to accumulate around the legs.
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what additional nursing theory from our readings could also align with an improved quality of practice initiative?
Florence Nightingale's nursing theory is an dditional nursing theory from our readings that could also align with an improved quality of practice initiative.
Nursing Concepts and Theory Models According to Florence Nightingale
In her conceptual model, Florence Nightingale positions the environment as the main focus of nursing care so that nurses do not have to understand the entire disease process. This concept model is an attempt to separate the nursing profession from medicine. In general, the nursing care provided is more oriented to the provision of air, light, cleanliness, environmental comfort, tranquility and adequate nutrition (vitamins and minerals are given in sufficient quantities), starting with data collection compared to mere treatment measures. The effort of this theory is for nurses to be able to carry out independent practice without being dependent on other professions.
The Three Major Environments In Florence Nightingale's Theory
1. Physical Environment
According to Florence Nightingale, the basic natural environment is related to ventilation and air. A clean physical environment will greatly affect the patient wherever the patient is, whether in the room it must be free from dust, odors, and smoke. Likewise, the bed must be clean, the room warm, the air clean and not humid.
2. Environmental Psychology
According to Florence Nightingale, negative environmental conditions can cause physical stress and adversely affect the patient's emotions. Therefore, the patient is required to maintain physical stimulation. Getting enough food and sunlight, as well as doing manual activities that can stimulate all the factors to be able to maintain his emotions. Communication that exists with the patient is seen in an overall environmental context, communication should not be carried out in a hurry or discontinuous.
3. Social Environment
According to Florence Nightingale, observations from the social environment, especially specific relationships, specific data are collected and then associated with disease states, this is very important for disease prevention. Thus, every nurse must exercise their observational skills in connecting specific cases more than just the data shown by patients in general.
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which statement is not true? vitamins provide energy. deficiency of a fat-soluble vitamin is less likely than of a typical water-soluble vitamin. vitamins are necessary in many biochemical reactions in the body. vitamin deficiencies are rare in the united states.
Vitamin deficiencies are rare in the united states is false statement.
Vitamins are organic molecules required as micronutrients. They are of two types, fat soluble and water soluble. Vitamin B and C are water soluble while vitamin A, D, E and K are fat soluble.
They are present in vegetables, fruits, dairy and meat products. Although vitamins do not convert into ATP directly, but they perform significant functions responsible for energy generation. For example, vitamin B12 assists in red blood cell formation, vitamin D increases muscle function thus metabolism of glucose to produce energy.
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a client is scheduled for an upper gastrointestinal barium study. which teaching will the nurse provide for the client to prepare for this diagnostic test?
The nurse should advice client to only have fluids.
Prior to this test, your doctor may advise without eating, drinking, or chewing gum the night before or in the morning. Food obstructs the view of your GI system on X-rays, thus your stomach must be empty. A little sip of water may be taken together with your regular medications if your doctor approves.
Drinking clear liquids up to 5 hours before the procedure's start time (water, Seven-Up, ginger ale, or apple juice) is right for procedures that are scheduled to begin after noon. Still, you shouldn't eat anything substantial after midnight the previous evening.
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the nurse is caring for a client having chorionic villus sampling using the transcervical approach. when preparing the client for the procedure, in which position is the client placed?
The client is placed supine and a needle is inserted through the skin into the uterus and guided to the placenta using ultrasound imaging. The needle has a syringe attached and is used to take a small sample of cells from the chorionic villi. After the sample is taken, the needle is removed.
Chorionic villus sampling (CVS) is a prenatal test that takes a chorionic villus sample from the placenta for examination. Samples can be taken from the cervix (transcervical) or the abdominal wall (transabdominal).
How Chorionic Villus Sampling Works:-
During pregnancy, the placenta provides the growing baby with oxygen and nutrients and removes waste products from the baby's blood.Chorionic villi are very thin by-products of placental tissue that share the baby's genetic makeup.This test is performed from the 10th week of pregnancy.Chorionic villus sampling can tell if a baby has a chromosomal disorder like Down syndrome or other genetic disorders like cystic fibrosis. However, it is important to understand the risks and be prepared for the consequences.
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which life-threatening condition would the nurse monitor for potential development when providing care
Tension pneumothorax is a life-threatening condition would the nurse monitor for potential development when providing care.
A tension pneumothorax is a severe circumstance that results whilst air is trapped within the pleural area below effective pressure, displacing mediastinal structures, and compromising cardiopulmonary features. The early popularity of this condition is lifestyle-saving both outdoors in the health facility and inside the current ICU.
A pneumothorax may be because of a blunt or penetrating chest injury, positive scientific strategies, or damage from an underlying lung disorder. Or it can arise for no apparent cause. symptoms normally include sudden chest pain and shortness of breath.
Prevention consists of elevating the pinnacle of the bed 30-forty five levels, imparting everyday oral hygiene with chlorhexidine answer, training strict hand hygiene, and acting daily sedation vacations.
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the client with chronic kidney disease is exhibiting signs of anemia. which is the best nursing rationale for this symptom?
The client with chronic kidney disease is exhibiting signs of anemia and the best nursing rationale for this symptom is diminished erythropoietin production.
Anemia happens once your blood does not have enough red blood cells. this will happen if: Your body does not build enough red blood cells. hurt causes you to lose red blood cells additional quickly than they'll get replaced. Your body destroys red blood cells.
When your kidneys are broken, they turn out less glycoprotein (EPO), a endocrine that signals your bone marrow—the spongy tissue within most of your bones—to build red blood cells. With less erythropoietin production, your body makes fewer red blood cells, and fewer element is delivered to your organs and tissues.
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a client with coccidioidomycosis has developed a severe headache with neck stiffness, has a fever, and states feeling very ill. which complication does the nurse prioritize investigating, because it is the most common cause of death from coccidioidomycosis?
Meningitis complication that nurses prioritize investigating because it is the most common cause of death from coccidioidomycosis
The most frequent cause of death from coccidioidomycosis infection is meningitis. Headache, fever, and neck stiffness are symptoms of meningitis, an inflammation of the meninges surrounding the central nervous system. Coccidioidomycosis infection can cause joint (arthritis) and dermatologic (erythema nodosum) consequences, however these do not result in mortality. Coccidioidomycosis and acquired immune deficiency syndrome are unrelated.
An inflammation (swelling) of the linings that protect the brain and spinal cord is known as meningitis. The swelling is typically brought on by a bacterial or viral infection of the fluid around the brain and spinal cord. However, other types of infections, tumors, certain medications, and traumas can also result in meningitis.
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the nurse is caring for a school-aged child with duchenne muscular dystrophy. which would be the most appropriate nursing diagnosis?
The most appropriate nursing diagnosis is Activity intolerance.
A genetic condition known as Duchenne muscular dystrophy (DMD) is characterized by advancing muscle weakness and degeneration as a result of changes to a protein called dystrophin, which aids in maintaining healthy muscle cells. One of the four diseases referred to as dystrophinopathies is DMD.
The child would not be able to keep up with peers because of weakness, progressive loss of muscle fibers, and loss of muscle strength as the muscles are losing their strength day by day and proteins are lost hence the child will be activity intolerant meaning inadequate physical or mental energy to finish necessary or preferred daily chores. hence, it will be appropriate diagnosis.
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Physical
means that you have more than enough
to complete
tasks. Someone physically fit has a
risk of
problems including
and
disease.
Physical means that you have more than enough to complete tasks. Someone physically fit has a risk of problems including disease but is comparatively less.
Physical fitness is described by experts as "one's capacity to carry out everyday activities with maximum efficiency, strength, and endurance while managing the illness, exhaustion, and stress and reducing sedentary behavior." This goes beyond just being able to sprint fast or lift a lot of weight.
Fitness is defined as the quality or state of being fit and healthy.
Someone who is physically fit with a good state of physical well being and mental well being have the risk of diseases but those are comparatively less because the person has good immune system.
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a 17-year-old high school football player is seen in your clinic with neck pain after practice. he reports the pain started after he tackled a teammate and was associated with tingling in both arms. what is next best step in management?
a nurse is monitoring the vital signs of a patient who has been administered epinephrine. which of the readings should nurse report immediately to the primary health care provider?
The readings that the nurse should report immediately to the primary health care provider is a Systolic blood pressure below 100 mmHg.
What is vital signs?Vital signs is defined as the cardinal signs that can be measured in the body which evaluates the physiological conditions of the major organs of the body.
The four vital signs that are usually monitored include the following:
Body temperature : The normal temperature is 36.2 -37.2 °CPulse rate: The normal pulse rate for an adult is 60 to 100 beats per minute.Respiration rate (rate of breathing): The normal respiratory rate for an adult is 12 to 16 breaths per minute.Blood pressure: The normal blood pressure of an adult is a systolic pressure of 120 and a diastolic pressure of 80.Epinephrine is a medication that has the ability of increasing the activities of the heart thereby should lead to an increase in blood pressure.
If after administration of epinephrine and the client's systolic pressure is below 100mmHg, the attention of the physician should be called as the the administered drug is not effective.
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Blocking all translation in hormone secreting cells would most immediately impact secretion of? insulin cortisol norepinephrine estradiol epinephrine
Blocking all translation in hormone secreting cells would most immediately impact secretion of insulin .
The majority of hormones are released into the body's general circulation to act on the proper distant target tissues. There are significant exceptions, though, including self-contained portal circulations, in which blood is diverted to a particular location. Capillary beds are where a portal circulation starts. Capillaries join together to form a group of veins as they move out from the capillary bed, and the veins eventually separate to create another capillary bed. The tissues that are fed by the second capillary bed are the only ones to get blood drawn from the first capillary bed.
The human body contains two portal circulations that transfer hormones. Blood is gathered by one system, the hypothalamic-hypophyseal portal circulation, from capillaries that originate in the hypothalamus.
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a nurse is assessing a child with a tick-borne disease. what finding would indicate to the nurse that the child has developed ehrlichiosis and not rocky mountain spotted fever?
Absence of rash would indicate to the nurse that the child has developed ehrlichiosis and not rocky mountain spotted fever
What is tick-borne disease ?Through the bite of an infected tick, tick-borne illnesses are spread. These include Tularemia, Powassan Rocky Mountain Spotted Fever, Babe-siosis, Anaplasmosis, and Ehrlichiosis. Bacteria, viruses, or parasites may be present in ticks.
The bacterium Borrelia burgdorferi and, in rare cases, Borrelia mayonii are the culprits behind Ly-me disease. Through the bite of infected blacklegged ticks, it is transferred to people. Fever, headaches, exhaustion, and the distinctive skin ra-sh known as erythema migrans are typical symptoms.The majority of Lyme disease cases can be healed with a 2- to 4-week course of oral antibiotics, but patients can occasionally experience pain, exhaustion, or problems thinking for more than 6 months after finishing therapy. "Post-Treatment Ly-me Disease Syn-drome" is the name of this ailment (PTLDS).Learn more about Tick-borne disease here:
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on examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely saturated a perineal pad within 15 minutes. what is the nurse's highest priority?
A nurse who is evaluating a lady who gave birth five hours earlier discovers that after 15 minutes, the mother completely drenched a perineal pad. The nurse begins by massaging the patient's fundus.
What is endometrial fundus?Similar to the rest of the uterus, the fundus comprises three layers. The perimetrium surrounds the organ from the outside. The second layer, which is muscular, is the myometrium. the mucous membrane and inner channel of the uterus is the endometrium.
These tubes aid in the movement of eggs into the uterus from your ovaries. The cervix is the bottom portion of the uterus that joins to the vagina. The corpus or fundus refers to the upper, larger region of the uterus.
The fundus, a broad area at the top of the uterus, will house a fertilised embryo as it develops into a baby and will be the superior-most part of the uterus.
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caregivers of a 9-year-old client in the terminal phase of a fatal illness ask the nurse for guidance in discussing death with the client. which response is appropriate?
The response which is appropriate is that at this developmental stage, most children have an adult concept of death and should be encouraged to discuss it.
What is Death?This is referred to as the irreversible functioning of the organism and is characterized by the stoppage of the activities which are done by the body system on a daily basis such as respiration, excretion etc.
At this developmental stage and age, most children have an adult concept of death and usually have fears for it when under severe conditions such as in the terminal phase of a fatal illness.
This therefore means that the child should be encouraged to discuss about it with anyone so as to know what the child wants and feel relaxed about the process during the process of medical care.
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What best describes when the majority of case report form (crf) data are verified against source record information?
Periodic site visits describe when the majority of case report form (CRF) data are verified against source record information.
Describe the case report form (CRF).In clinical research, a case report form (CRF) is a specific document. It should be driven by the study protocol, have substantial content, and have materials to gather the study's unique data.
What information is contained in a case report?Data gathered during the patient's involvement in the clinical trial is recorded in case report forms.
How may a case report form be made more effective?To meet the demands of everyone who handles data, including investigators, data managers, biostatisticians, clinical research monitors and coordinators, database developers and programmers, and data entry employees, etc., case report form designs should be standardized. An efficient CRF design would always be simple to use.
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the nurse is caring for a client suspected of having stones that have collected in the common bile duct. what test should the nurse prepare the client for that will locate these stones?
Based on the fact that the nurse is caring for a client suspected of having stones that have collected in the common bile duct, the test that should be conducted is Ultrasonography
What is Ultrasonography?This refers to the procedure that is taken by a medical professional or practitioner in order to work on suspected gallbladder or biliary tract disease.
Hence, it can be seen that based on the given question, there is a suspicion that there are stones that have been collected in the common bile duct and the test that the nurse should prepare the client for that will locate these stones is Ultrasonography
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in virginia, a period of accidental and health insurance coverage which may be applied to reduce the length of a pre existing condition exclusion under a new plan is called
A period of accidental and health insurance coverage which may be applied to reduce the length of a pre existing condition exclusion under a new plan is called Creditable coverage
What is Creditable coverage ?When you first become eligible for Medicare, the Notice of Creditable Coverage serves as documentation of your insurance. Every year, a Notice of Creditable Coverage is mailed to people who have creditable coverage through their workplace or union. You are being notified that your existing coverage is acceptable.
Prescription drug coverage offered by a group health plan is deemed creditable if its actuarial value is equivalent to or greater than that of typical Medicare Part D prescription drug coverage. "Non-creditable" prescription drug coverage is that which does not adhere to this requirement.Learn more about Creditable coverage here:
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micro tears in the skin have been discussed in class as increasing the chance of passing or receiving an infection (if one is present in a partner). what has not been mentioned as potentially increasing one's risk to micro tears:
In the classroom, it has been highlighted how micro tears in the skin increase the risk of infection (if one is present in a partner) silicone-based lubrication.
By lowering surface-to-surface friction, silicone lubricant allows items that have rusted or grown stiffer over time to move more freely. Lubricating particles like graphite, PTFE, or molybdenum disulphide are present in dry lubricants.
Silicone lubricant is a fantastic product for maintaining and prolonging the life of your tools and equipment, lubricating rubber surfaces, and preventing parts from sticking and binding. It also prevents dust, filth, oil, and grime from adhering.
The Silicone Lube has relatively little anti-corrosive qualities because it is intended to be a lubricant. Temperatures beyond 350°F are not advised for use.
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which cardiac dysrhythmia would result in the lowest cardiac output or no cardiac output, and what treatment would be effective?
Ventricular fibrillation would result in the lowest cardiac output or no cardiac output, and treatment with electrical countershock would be effective.
Cardiac refers to heart and dysrhythmia is representative of abnormal heart beat. Ventricular fibrillation is the type of cardiac dysrhythmia. It occurs due to disorganised or improper electrical activity. This further results in ventricles to move in unsynchronized and irregular manner.
Practically this condition is associated with cardiac arrest due to low cardiac output or no cardiac output. The consequence of ventricular fibrillation are cardiac arrest leading to unconsciousness and loss of pulse. The condition can be lethal and required immediate medical attention.
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menstrual bleeding for long periods of time or intermittent bleeding throughout a cycle is called .
Menorrhagia is the medical term for extremely heavy menstrual bleeding and/or bleeding that lasts longer than seven days.
What triggers bleeding?Injuries include bone fractures, traumatic brain injury, or cuts and puncture wounds. Physical abuse or acts of violence, like a knife or bullet wound. viruses like viral hemorrhagic fever that target blood vessels.
Why am I now bleeding?Excessive menstrual bleeding or bleeding in between periods are examples of abnormal uterine bleeding. The cause is typically unknown. Polyps, fibroids, endometriosis, medications, infections, and some kinds of contraception are among the known causes of irregular uterine bleeding.
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what is an amount of medication required to produce a specific effect, the size of which varies for each drug, is a:
How much of a drug is needed to produce a certain effect, which varies for each drug, is the dose.
Drug dose is a certain amount or dose of a drug that gives a certain effect on a disease. The dose of the drug must be appropriate because if the dose is too low, the therapeutic effect will not be achieved. Conversely, if it is excessive, it can cause toxic effects or poisoning and even death.
Understanding drug dose
The dose of a drug is the amount of a drug that can be used or given to a patient either for internal or external use. Types of dose includes 2 doses, namely:
• Maximum Dose (maximum)
Valid for one-time and daily use. Submission of drugs with doses exceeding the maximum dose can be done by putting an exclamation mark and the doctor's initials, writing the prescription, underlined under the name of the drug or the number of drugs should be written in full letters.
• Usual Dosage
It is a non-binding guide but is used as a general guideline (usual / commonly used dose).
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true or false? most aids patients who contracted the disease because of drug injection are heroin users.
Most AIDS patients who contracted the disease because of drug injection are heroin users.[TRUE]
The Link Between Drug Use and HIV
Injecting drug use and alcohol are major factors in the spread of HIV infection. Outside Africa, injection drug use is responsible for one-third of new HIV infections. Interchangeable drug use devices can carry HIV and viral hepatitis, and drug and alcohol use has also been linked to unsafe sex.
Drug and alcohol use can also be dangerous for people taking antiretroviral therapy (ART). Adherence to medication appears to be more difficult for drug users, and street drugs can interact seriously with antiretroviral (ARV) drugs.
Injections and Infections
HIV infection spreads easily when people share syringes for drug use. Sharing tools also transmits hepatitis B virus, hepatitis C virus, and other serious diseases.
The infected blood is found in the syringe (insula) and then injected with the drug when the following user uses the syringe. This is the easiest way to transmit HIV because the infected blood is put directly into another person's bloodstream. To reduce the risk of transmitting HIV and hepatitis, do not share any syringes, and wash your hands frequently. Clean the tools and skin at the injection site. Follow actions to reduce the harm reduction of drug use.
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when adding the prescribed end-expiratory pressure therapy to a patient's mechanical ventilator settings, the nurse would associate the therapy with the development of which complication?
When adding the prescribed end-expiratory pressure therapy to a patient's mechanical ventilator settings, the nurse would associate the therapy with the development of complications of respiratory aid Pulmonary barotrauma.
An infection is the major danger of mechanical ventilation because the artificial airway (the breathing tube) might allow bacteria to enter the lung. The risk of infection is highest during the first two weeks of mechanical breathing and rises with duration. Positive-pressure breathing is known to cause pulmonary barotrauma. Consequences might include pneumothorax, pneumomediastinum, pneumoperitoneum, and subcutaneous emphysema.
A reduction in venous return, right ventricular output, and pulmonary blood flow are caused by positive pressure ventilation's increased intrathoracic pressure during inspiration. Ventilator-associated pneumonia is the most prevalent illness among patients on mechanical ventilation who also receive positive pressure ventilation. Due to the high intrathoracic pressure (ITP), positive pressure ventilation made it difficult for the right ventricle to fill with blood, which in turn decreased cardiac output.
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a nurse is teaching a client about diaphragmatic breathing. what client action indicates that further teaching is needed?
If the client exhales forcefully with a short expiration indicates then it indicates that further teaching is needed to illustrate diaphragmatic breathing.
What is the diaphragmatic breathing method?The diaphragmatic breathing method is a respiratory strategy based on the use of the diaphragm muscles, which include deep breathing and paused cycles and it is associated with the relaxation of the lung tissues.
Therefore, with this data, we can see that the diaphragmatic breathing method involves the use of the diaphragm muscles during the breathing process and it may enhance breathing by relaxation.
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