The nurse is assessing a client and notes a loud, blowing sound over the right carotid artery. The nurse would suspect the client has developed which of the following disorders?
1. Mitral stenosis
2. Aortic regurgitation
3. Atrial septal defect
4. Stricture of the carotid
4
Rationale 1: 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.
Rationale 2: 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.
Rationale 3: 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.
Rationale 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.
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