Patient Data Exhibits Which can the nurse do to mitigate artifacts when performing auscultation? Select all that apply.

A. Wet the chest hair before auscultating. Chest hair can cause a "roaring" or crackling sound due to friction with the stethoscope. Wetting the hair with warm water or using a thin layer of lotion can help reduce this artifact, improving the accuracy of auscultation. B. Reach under a gown to listen and take care that no clothing rubs on the stethoscope. Clothing can create extra noise during auscultation, leading to misleading findings. Placing the stethoscope directly on the skin helps eliminate external interference and ensures clearer lung and heart sounds. C. Document the roaring and crackles. If the sounds are determined to be artifacts caused by external factors such as chest hair or clothing, they should not be documented as true auscultatory findings. Instead, the nurse should take steps to eliminate the artifacts before making an assessment. D. Keep the examination room warm, and warm the stethoscope. A cold environment or a cold stethoscope can cause the patient’s muscles to tense or shiver, leading to additional noise during auscultation. Keeping the room warm and warming the stethoscope before use helps prevent these unnecessary sounds.