A 39-year-old client has been admitted to the hospital with complaints of increasing fatigue. The 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. This description is most consistent with: 1. tricuspid regurgitation.
2. mitral regurgitation.
3. mitral stenosis.
4. pulmonic stenosis.
3
Rationale 1: The murmur associated with tricuspid regurgitation is often described as systolic, blowing, high-pitched, and may radiate.
Rationale 2: Mitral regurgitation is a high-pitched, blowing, harsh, systolic murmur with radiation to the left axilla.
Rationale 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.
Rationale 4: 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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