The nurse is auscultating heart sounds for a pregnant client in the third trimester of pregnancy. The client wants to know why her doctor told her she had an extra heart sound at the last visit. Which response by the nurse is appropriate?
A) "You will need to have an echocardiogram to determine the reason for extra sound."
B) "You are likely experiencing heart failure due to the extra fluid that accumulates during this time in pregnancy."
C) "You have what is known as a ventricular gallop and it can be a normal finding during this trimester of pregnancy."
D) "You have what is known as atrial gallop and this is cause for concern."
Answer: C
Two other heart sounds may be present in some healthy individuals. The third heart sound (S3) may be heard in children, in young adults, or in pregnant Females during the third trimester. It is heard after S2 and is termed a ventricular gallop. When the AV valves open, blood flow into the ventricles may cause vibrations. These vibrations create the S3 sound during diastole. There is no need for an echocardiogram. While the S3 sound can be associated with heart failure, this is not the case during pregnancy. S4, also known as an atrial gallop, can also be present in health individuals.
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