A mother is upset because she was told by another provider that her child has a worrisome murmur. You listen near the clavicle and notice both a systolic and diastolic sound. You remember that diastolic murmurs are usually indicative of bad pathology. What would you do next?
A) Cardiology referral
B) Echocardiogram
C) Supine examination
D) Reassure the mother
C) Supine examination
The next step would be to examine the patient in the supine position. If this is a venous hum, this murmur will resolve almost completely in the supine position. This is a very common phenomenon in school-aged children, particularly over the clavicle, but can also occur outside this range. Reassurance cannot be given without further examination, especially with a diastolic murmur. Cardiology referral and echocardiography are unnecessary if examination in the supine position reveals no murmur.
You might also like to view...
A client has a metastatic bone tumor. What action by the nurse takes priority?
a. Administer pain medication as prescribed. b. Elevate the extremity and apply moist heat. c. Handle the affected extremity with caution. d. Place the client on protective precautions.
A patient saying he is spiritually balanced will demonstrate which of the following characteristics?
a. anxiety c. powerlessness b. hopelessness d. capacity for love
The client has a medical condition that often results in the development of metabolic acidosis. The nurse should observe this client for the development of which breathing pattern as a result of this condition?
A) Cluster B) Kussmaul's C) Cheyne-Stokes D) Biot's
A patient with hypertension is taking furosemide (Lasix) for congestive heart failure. The prescriber orders digoxin to help increase cardiac output. What other medication will the nurse expect to be ordered for this patient?
a. Bumetanide (Bumex) b. Chlorothiazide (Diuril) c. Hydrochlorothiazide (HydroDIURIL) d. Spironolactone (Aldactone)