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.
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.
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