A nurse is providing teaching to a client about recognizing manifestations of an impending cardiac arrest. Which of the following manifestations should the nurse include in the teaching?

A. Varicose veins: Varicose veins are dilated, twisted veins that commonly occur in the legs and are typically associated with venous insufficiency or venous valve dysfunction rather than valvular dysfunction of the heart.

B. Heart murmur: This is the correct answer. Valvular dysfunction can result in abnormal blood flow patterns across the heart valves, leading to turbulent blood flow and the production of audible heart murmurs upon auscultation.

C. Palpitations: Palpitations, or the sensation of rapid, pounding, or irregular heartbeats, can occur with valvular dysfunction, particularly if the dysfunction leads to alterations in heart rhythm or cardiac output.

D. Abdominal pain: Abdominal pain is not typically associated with valvular dysfunction. It may be a symptom of various gastrointestinal or abdominal conditions, but it is not a direct manifestation of valvular heart disease.

E. Chest pain: This is the correct answer. Chest pain can occur with valvular dysfunction, especially if the dysfunction leads to inadequate blood flow to the heart muscle (ischemia), which can cause angina or chest discomfort.

A. The client whose mother and uncle were diagnosed with this same condition: Hypertrophic cardiomyopathy (HCM) often has a genetic component, with a familial predisposition observed in many cases. Individuals with a family history of HCM, especially in first-degree relatives such as parents or siblings, are at higher risk of developing the condition due to genetic factors.

B. The client who is recovering from a recent illness that caused vomiting and diarrhea: Acute illnesses such as vomiting and diarrhea can lead to dehydration, electrolyte imbalances, and transient changes in cardiac function. While dehydration and electrolyte imbalances may exacerbate symptoms in individuals with existing cardiac conditions, they are not primary risk factors for developing hypertrophic cardiomyopathy (HCM).

C. The client who is out of work and has been experiencing increased stress: Chronic stress and psychosocial factors may contribute to the progression of cardiovascular disease in general, but they are not specific risk factors for developing hypertrophic cardiomyopathy (HCM).

D. The client who uses oxygen at night to treat obstructive sleep apnea: While obstructive sleep apnea is associated with cardiovascular complications, including hypertrophic cardiomyopathy (HCM), the use of oxygen therapy at night to treat sleep apnea does not directly increase the risk of developing HCM. However, untreated obstructive sleep apnea may lead to chronic hypoxia and other cardiac issues over time.