Author Question: An adult client is admitted to the hospital with complaints of increasing fatigue. The client's ... (Read 122 times)

penza · **on:** Jun 25, 2018

An adult client is admitted to the hospital with complaints of increasing fatigue. The client's history is remarkable for rheumatic fever as a child.

The nurse hears a diastolic murmur at the apex when the client is in the left lateral position. The murmur is described as a rumble without radiation. Which diagnosis does the nurse anticipate based on this data?
1. Tricuspid regurgitation.
2. Mitral regurgitation.
3. Mitral stenosis.
4. Pulmonic stenosis.

Question 2

The nurse is percussing the client's anterior chest and notes a dull sound over an area where lung tissue is normally found. Which conclusion by the nurse is the most appropriate based on this data?

1. This is a normal finding.
2. The client's heart may be enlarged.
3. The client has developed a murmur.
4. The client has a pulse deficit.

brittrenee · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Correct Answer: 3
The murmur associated with mitral stenosis is best heard with the bell of the stethoscope at the apex while the client is placed in the left lateral position. It is a low-frequency diastolic murmur, which does not radiate. It is often caused by rheumatic fever or a cardiac infection. The murmur associated with tricuspid regurgitation is often described as systolic, blowing, high-pitched, and may radiate. Mitral regurgitation is a high-pitched, blowing, harsh, systolic murmur with radiation to the left axilla. The murmur associated with pulmonic stenosis is often described as a harsh, systolic murmur heard best over the pulmonic area with radiation to the neck.

Answer to Question 2

Correct Answer: 2
This is not a normal finding. An enlarged heart emits a dull sound on percussion over a larger area than a heart of normal size. When the nurse percusses over lung tissue, the sound should be described as resonant. Murmurs can be determined during auscultation of the heart. A pulse deficit is present when the apical pulse is greater than the carotid pulse.