The nurse auscultates a heart murmur that is continuous and ...

[mckennatimberlake]

The nurse auscultates a heart murmur that is continuous and rumbling and increases in sound toward the end. Which conditions should the nurse suspect this patient might be experiencing?
 
  Select all that apply.
 
  1. mitral stenosis
  2. tricuspid stenosis
  3. mitral regurgitation
  4. aortic regurgitation
  5. tricuspid regurgitation

Question 2

A male patient of African-American descent is prescribed hydralazine and isosorbide (BiDil) as treatment for heart failure. What should the nurse instruct the patient about this medication?
 
  Select all that apply.
 
  1. Change positions slowly.
  2. Dizziness and fainting are expected adverse effects of this medication.
  3. You may have a headache when starting this medication, but it will subside.
  4. Notify the healthcare provider if you have chest pain while taking this medication.
  5. Do not take medications to treat erectile dysfunction while taking this medication.

[atrochim]

Answer to Question 1

Correct Answer: 1, 2
The murmurs associated with mitral and tricuspid stenosis are continuous and rumbling and increase in sound towards the end. The murmurs associated with mitral and tricuspid regurgitation are continuous and occur throughout systole. The murmur associated with aortic regurgitation is decrescendo and continuous.

Answer to Question 2

Correct Answer: 1, 3, 4, 5
This drug can cause a drop in blood pressure, particularly when changing positions from lying to sitting or sitting to standing. The patient should change positions slowly and use caution to prevent falls. Headache is a common adverse effect of this drug, particularly when first starting therapy. Headaches tend to subside with continued treatment. The doctor should be notified if chest pain develops while taking this medication. Drugs such as sildenafil (Viagra, Revatio), vardenafil (Levitra), or tadalafil (Cialis) are not to be taken while taking this medication because the combination may cause an extreme drop in blood pressure, leading to fainting, chest pain, or a heart attack. Dizziness and fainting should be reported to the healthcare provider as they may indicate a significant drop in blood pressure.