A nurse is reviewing the laboratory values for a client who takes spironolactone and notes that the client's serum potassium level is 6.8 mEq/L. The nurse notifies the provider and anticipates that the provider will provide which of the following instructions?

Choice A reason: A barrel chest is typically not associated with mitral valve stenosis. It is more commonly seen in chronic obstructive pulmonary disease (COPD) due to hyperinflation of the lungs. Mitral valve stenosis affects the heart and not the lung structure.

Choice B reason: Clubbing of the fingers is a sign that can be associated with chronic hypoxia and certain types of congenital heart disease. While it can be seen in some heart conditions, it is not a specific finding for mitral valve stenosis.

Choice C reason: A heart murmur, specifically a diastolic murmur, is a classic finding in mitral valve stenosis. As the stenotic mitral valve obstructs blood flow from the left atrium to the left ventricle, a pressure gradient is created, which produces a murmur that can be heard upon auscultation.

Choice D reason: Bradycardia, or a slower than normal heart rate, is not a direct finding associated with mitral valve stenosis. Mitral valve stenosis may lead to arrhythmias such as atrial fibrillation due to atrial enlargement, but bradycardia is not typically induced by this condition.

Choice A reason : Keeping the client in a high-Fowler's position for 6 hours post-cardiac catheterization is not recommended. After a femoral approach, it's important to keep the leg straight and the patient flat or with the head slightly elevated to prevent bleeding from the catheter insertion site. High-Fowler's position could increase the risk of bleeding and is not conducive to maintaining pressure at the arterial access site.

Choice B reason : Allowing the patient to ambulate around the room immediately after the procedure is contraindicated. The patient is typically required to remain on bed rest with the affected leg straight to prevent bleeding and ensure proper healing of the arterial puncture site. Ambulation is usually restricted for several hours post-procedure.

Choice C reason : Checking pedal pulses every 15 minutes is a critical action following cardiac catheterization via the femoral artery. It ensures that there is adequate blood flow to the extremity and helps to identify any complications such as occlusion or bleeding early. Adequate perfusion is indicated by strong and equal pedal pulses.

Choice D reason : Performing passive range-of-motion exercises for the affected extremity immediately after cardiac catheterization is not recommended. The affected leg should remain straight without bending at the hip to prevent bleeding from the catheter site. Passive range-of-motion could disrupt the vascular integrity at the puncture site and increase the risk of bleeding.