Practice Question
A nurse is assessing a 3-year-old child who has aortic stenosis. Which of the following findings should the nurse expect? (Select all that apply.)
Answer Choices:
Correct Answer:
Murmur
Rationale:
💠 B. Murmur
💠 Aortic stenosis leads to obstruction of blood flow from the left ventricle to the aorta, causing turbulent blood flow.
💠 This turbulence produces a systolic ejection murmur, which is a hallmark sign of aortic stenosis in children.
💠 The murmur is usually heard best at the right upper sternal border and can radiate to the neck or carotid arteries.
💠 The intensity of the murmur may increase with activity due to higher cardiac output demand.
💠 Presence of a murmur is a primary assessment finding and should prompt further cardiac evaluation.
💠 D. Weak pulses
💠 The narrowing of the aortic valve results in reduced stroke volume, so less blood reaches the systemic circulation with each heartbeat.
💠 As a result, peripheral pulses (e.g., radial, pedal) may feel weak, thready, or delayed on palpation.
💠 This reduced perfusion is a direct consequence of obstructed ventricular outflow.
💠 Weak pulses are more evident in the lower extremities, especially in severe stenosis.
💠 This finding supports the diagnosis and helps differentiate aortic stenosis from other heart defects.
💠 E. Hypotension
💠 Decreased cardiac output due to valve narrowing can lead to low blood pressure, especially during exertion or dehydration.
💠 The left ventricle must work harder to overcome the resistance, which may not be adequate in young children, resulting in systemic hypotension.
💠 The child may present with symptoms like dizziness, fatigue, pallor, or cold extremities.
💠 Persistent hypotension increases the risk for syncope and poor organ perfusion, requiring careful monitoring.
💠 Blood pressure readings are essential for evaluating the severity of the obstruction and response to treatment.
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This question is from RN ATI Pediatrics Simmons Bsn Exam I which contains 12 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: ATI Exam(s)
- Domain: RN ATI Pediatrics
- Answer Choices: 5