The nurse working on the cardiac unit notes that the client has an S2 murmur, which the nurse understands is caused by:
1. Pulmonic or aortic valve backflow or regurgitation
2. Mitral valve backflow or regurgitation
3. Tricuspid valve backflow or regurgitation
4. Poor coronary arterial circulation
ANS: 1
Closure of aortic and pulmonic valves represents S2, or the second heart sound. Some clients with valvular disease have backflow or regurgitation of blood through the incompetent valve, causing a murmur that you can hear on auscultation. During ventricular diastole the atrioventricular (mi-tral and tricuspid) valves open and blood flows from the higher-pressure atria into the relaxed ventricles. This represents S1, or the first heart sound. A murmur is caused by blood turbulence, not coronary artery disease
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