A nurse is assessing a client who has valvular dysfunction. Which of the following manifestations should the nurse anticipate? (Select all that apply)
Heart murmur
Chest pain
Varicose veins
Palpitations
Abdominal pain
Correct Answer : A,B,D
Choice A reason:
Heart murmur is a common manifestation of valvular dysfunction. It occurs when there is turbulent blood flow across a damaged or abnormal heart valve. This can be due to stenosis (narrowing of the valve) or regurgitation (leakage of the valve). The murmur’s characteristics, such as timing, location, and intensity, can help in diagnosing the specific type of valvular disease. For example, a systolic murmur might indicate aortic stenosis or mitral regurgitation, while a diastolic murmur could suggest aortic regurgitation or mitral stenosis.
Choice B reason:
Chest pain is another symptom that can be associated with valvular dysfunction. This pain can result from increased workload on the heart due to inefficient blood flow through the valves. Conditions like aortic stenosis can lead to angina (chest pain) because the heart muscle may not receive enough oxygenated blood. This symptom is particularly concerning and warrants immediate medical attention to prevent complications such as myocardial infarction.
Choice C reason:
Varicose veins are not typically associated with valvular dysfunction in the heart. They are more related to issues with the veins in the legs, where the valves that prevent backflow of blood become weakened or damaged. This condition is generally referred to as chronic venous insufficiency and is not directly linked to the heart’s valvular problems.
Choice D reason:
Palpitations, or the sensation of irregular or rapid heartbeats, are common in clients with valvular dysfunction. These can occur due to arrhythmias, which are often seen in conditions like mitral valve prolapse or aortic regurgitation. The irregular heartbeats can be a result of the heart trying to compensate for the inefficient blood flow caused by the faulty valve.
Choice E reason:
Abdominal pain is not a typical manifestation of valvular dysfunction. While severe heart conditions can sometimes lead to generalized symptoms, abdominal pain is more commonly associated with gastrointestinal issues rather than heart valve problems. Therefore, it is not a primary symptom to anticipate in clients with valvular dysfunction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is a) Serum potassium levels.
Choice A reason:
Serum potassium levels are crucial to monitor in clients with hypervolemia, ketoacidosis, and metabolic acidosis. Potassium imbalances are common in these conditions due to shifts between intracellular and extracellular compartments. In diabetic ketoacidosis (DKA), for example, insulin deficiency and acidosis cause potassium to move out of cells, leading to hyperkalemia. However, once treatment with insulin begins, potassium shifts back into cells, which can cause hypokalemia. Both hyperkalemia and hypokalemia can have serious cardiac implications, making it essential to monitor and manage potassium levels closely.
Choice B reason:
Serum calcium levels are important for overall health, but they are not the primary concern in the context of hypervolemia, ketoacidosis, and metabolic acidosis. While calcium imbalances can occur, they are less common and less immediately life-threatening compared to potassium imbalances. Monitoring calcium is still necessary, but it does not require the same level of immediate intervention.
Choice C reason:
Serum sodium levels are also important to monitor, especially in conditions like hypervolemia where fluid balance is disrupted. However, sodium imbalances are typically managed through fluid management and do not pose the same immediate risk as potassium imbalances in the context of ketoacidosis and metabolic acidosis. Hyponatremia or hypernatremia can cause neurological symptoms, but these are generally less acute compared to the cardiac risks associated with potassium imbalances.
Choice D reason:
Blood urea nitrogen (BUN) levels provide information about kidney function and hydration status. Elevated BUN can indicate dehydration or renal impairment, which are relevant in the context of hypervolemia and ketoacidosis. However, BUN levels do not require the same level of immediate intervention as potassium levels. Monitoring BUN is important for overall management but is not the primary concern in acute settings.
Correct Answer is B
Explanation
Choice A reason:
“Blood flow is altered due to restricted stretching of the ventricles, impairing the heart’s ability to contract” is not accurate in the context of peripheral arterial disease (PAD). PAD primarily affects the arteries outside the heart, particularly those supplying the legs and feet. It is caused by atherosclerosis, which leads to the narrowing and hardening of the arteries, reducing blood flow to the extremities. The statement about restricted stretching of the ventricles and impaired heart contraction is more relevant to conditions like heart failure or cardiomyopathy.
Choice B reason:
“Blood flow is altered due to increased pressure in the arteries” is a more accurate description of PAD. In PAD, the buildup of fatty deposits (plaques) in the arterial walls leads to increased resistance and pressure within the arteries. This condition reduces the flow of oxygenated blood to the limbs, causing symptoms such as pain, cramping, and fatigue, especially during physical activity. Managing PAD involves lifestyle changes, medications, and sometimes surgical interventions to improve blood flow and reduce symptoms.
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