A nurse is providing discharge teaching to a client who has GERD.
Which of the following information should the nurse include?

Choice A rationale

This location, the second intercostal space at the right sternal border, corresponds to the aortic valve area. Auscultation here allows the nurse to assess the sounds produced by the aortic valve, which are distinct from the mitral valve sounds. These sounds are generated as blood is ejected from the left ventricle into the aorta during systole.

Choice B rationale

The second intercostal space at the left sternal border is the correct anatomical location for auscultating the pulmonic valve. The pulmonic valve separates the right ventricle from the pulmonary artery, and listening here allows the nurse to assess the sounds of blood flow into the pulmonary circulation.

Choice C rationale

The fifth intercostal space at the left midclavicular line is the point of maximal impulse (PMI), also known as the apical pulse, which is the anatomical location for the mitral valve. This is the optimal site for auscultating the S1 and S2 heart sounds, as well as any murmurs or abnormal sounds associated with the mitral valve's function.

Choice D rationale

This location, the fourth intercostal space at the left sternal border, is the anatomical location for the tricuspid valve. Auscultation in this area allows the nurse to assess the sounds generated by the tricuspid valve, which regulates blood flow between the right atrium and the right ventricle. *.

Choice A rationale

A tracheostomy tray is used to perform an emergency tracheostomy. This procedure is not a standard requirement for a client with a thoracotomy and chest tube placement, as the primary respiratory intervention is typically managed via the chest tube and other supportive measures.

Choice B rationale

Montgomery straps are used to secure dressings that require frequent changes, preventing skin irritation from repeated tape removal. They are useful for abdominal wounds or other high-drainage sites but are not a specific or essential piece of equipment for a chest tube.

Choice C rationale

Wire cutters are used to cut stainless steel wires that may be used to secure the sternum after cardiac surgery. A thoracotomy is an incision into the chest wall to access the thoracic cavity; it does not involve sternal wiring.

Choice D rationale

A padded clamp is an essential piece of equipment at the bedside for a client with a chest tube. In the event of a chest tube dislodgement or if the drainage system needs to be changed, the clamp is used to temporarily occlude the tube to prevent a pneumothorax. .