A nurse is caring for a client who has constricted pupils, delayed reflexes, and decreased blood pressure. The nurse should identify that these findings are potential manifestations of which of the following?

A. Speaking directly into one of the client's ears may be ineffective if the client has bilateral hearing impairment or if the hearing impairment is not related to the ear anatomy.

B. Rephrasing sentences the client does not understand can help clarify communication and ensure the client receives necessary information.

C. Dropping voice volume at the end of sentences can make it difficult for the client to hear the entire message, especially if the client relies on lip-reading or amplification devices.

D. Exaggerating lip movements may not be helpful for all clients with hearing impairment and may not accurately convey the intended message. Instead, clear and natural lip movements should be used along with other communication strategies such as rephrasing sentences and facing the client directly.

A. To best hear the closing of the aortic heart valve, the nurse should place the diaphragm of the stethoscope at the second intercostal space, right sternal border. This is also known as the aortic area.
B. This is the tricuspid region, and defects with the tricuspid valve will be best heard in this area.
C. This is the mitral region and murmurs due to defects in the mitral valve will be appreciated here