While auscultating heart sounds on a 7-year-old child for a ...

[charchew]

While auscultating heart sounds on a 7-year-old child for a routine physical examination, the nurse hears an S3, a soft murmur at the left midsternal border, and a venous hum when the child is standing.
 
  What would be a correct interpretation of these findings?
  a.
  S3 is indicative of heart disease in children.
  b.
  These findings can all be normal in a child.
  c.
  These findings are indicative of congenital problems.
  d.
  The venous hum most likely indicates an aneurysm.

Question 2

While counting the apical pulse on a 16-year-old patient, the nurse notices an irregular rhythm. His rate speeds up on inspiration and slows on expiration. What would be the nurse's response?
 
  a. Talk with the patient about his intake of caffeine.
  b. Perform an electrocardiogram after the examination.
  c. No further response is needed because sinus arrhythmia can occur normally.
  d. Refer the patient to a cardiologist for further testing.

[xthemafja]

Answer to Question 1

ANS: B
A physiologic S3 is common in children. A venous hum, caused by turbulence of blood flow in the jugular venous system, is common in healthy children and has no pathologic significance. Heart murmurs that are innocent (or functional) in origin are very common through childhood.

Answer to Question 2

ANS: C
The rhythm should be regular, although sinus arrhythmia occurs normally in young adults and children. With sinus arrhythmia, the rhythm varies with the person's breathing, increasing at the peak of inspiration and slowing with expiration.

[charchew]

TYSM

[gcook]

Excellent