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.
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.
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