The nurse is performing a cardiac assessment on a healthy older ...

[javeds]

The nurse is performing a cardiac assessment on a healthy older adult client. Which findings may be expected when compared to when the client was middle-aged? Select all that apply.
 
  1. Systolic murmur.
  2. Increased cardiac output.
  3. Increased systolic blood pressure.
  4. Increased stroke volume.
  5. Slight decrease in heart rate.

Question 2

The nurse is assessing a client and notes a loud, blowing sound over the right carotid artery. Based on this data, which diagnosis does the nurse anticipate?
 
  1. Mitral stenosis.
  2. Aortic regurgitation.
  3. Atrial septal defect.
  4. Stricture of the carotid.

[chem1s3]

Answer to Question 1

Correct Answer: 1, 3, 4, 5
Systolic murmurs become more common as people age, especially because of aortic stenosis. The older client's systolic blood pressure may increase. Stroke volume may increase slightly when the older client is at rest and during exercise. The healthy older adult may have an insignificant decrease in heart rate. In the healthy older adult, cardiac output remains relatively stable.

Answer to Question 2

Correct Answer: 4
A bruit, which is a loud swishing or blowing sound, is most often associated with a narrowing or stricture of the carotid artery. The most common cause for this is atherosclerosis. Mitral stenosis is a narrowing of the left mitral valve. In a client with mitral stenosis, there is often a murmur heard at the apical area with the client in left lateral position. Aortic regurgitation is the backflow of blood from the aorta into the left ventricle. With aortic regurgitation, a murmur may be heard when the client is leaning forward, at the second intercostal space. With an atrial septal defect, there is an opening between the right and left atrium. Regurgitation occurs through this defect resulting in a harsh, loud, high-pitched murmur heard at the left sternal border at the second intercostal space.