Author Question: The nurse is assessing a client who is 7 months pregnant. Which assessment finding will the nurse ... (Read 114 times)

EY67 · **on:** Jun 25, 2018

The nurse is assessing a client who is 7 months pregnant. Which assessment finding will the nurse document as a normal finding for this client?

1. Increased systolic and diastolic blood pressures when standing.
2. Point of maximal impulse palpated at fourth intercostal space and left of midclavicular line.
3. Bradycardia.
4. Diastolic murmur.

Question 2

The nurse is interviewing a client who has recently been diagnosed with atherosclerosis in the coronary arteries. Which question by the nurse is the priority when determining risk factors for this condition?

1. Can you please tell me about the vitamins or supplements that you take?
2. Have you ever been diagnosed with rheumatic fever?
3. Do you smoke or are you exposed to secondhand smoke?
4. Have you ever had a diagnostic test, such as an electrocardiogram, stress test, or echocardiogram, or a surgical procedure for a cardiovascular problem?

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

Answer to Question 1

Correct Answer: 2
During pregnancy, the heart is displaced to the left and upward and so it would be normal to palpate the point of maximal impulse left of the midclavicular line at the fourth intercostal space. At this stage of the client's pregnancy, the blood pressure should be normal when compared to pre-pregnancy values. The pregnancy usually results in an increase in the client's heart rate from pre-pregnancy values. It is not normal to find a diastolic murmur.

Answer to Question 2

Correct Answer: 3
The most important question regarding this client's history and recent diagnosis is about exposure to cigarettes smoke. The chemical contained in the cigarette smoke injures the inner wall of arterial vessels and contributes to the subsequent development of a coronary artery plaque. Information about vitamin and supplement use is important but is not specifically related to atherosclerosis and coronary artery disease. A history of rheumatic fever can increase the client's risk for valvular problems but does not necessarily increase the client's risk for developing atherosclerosis and coronary artery disease. The question regarding diagnostic testing may help the nurse determine if there was a previous suspicion that the client had developed a cardiovascular problem, but is not specifically related to coronary artery disease and atherosclerosis.