A nurse is assessing a 3-year-old child who has aortic stenosis.
Which of the following findings should the nurse expect?

Choice A rationale

Weak pulses are an expected finding in a child with aortic stenosis because the narrowed aortic valve obstructs blood flow from the left ventricle to the systemic circulation. This obstruction leads to a reduced stroke volume and consequently weaker peripheral pulses as less blood is ejected with each heartbeat.

Choice B rationale

Hypotension is not a typical early finding in aortic stenosis. Initially, the left ventricle compensates for the obstruction by increasing its contractility to maintain cardiac output and blood pressure. Hypotension usually occurs in severe, uncompensated aortic stenosis or with other complications. Normal systolic blood pressure for a 3-year-old ranges from 86 to 120 mmHg, and diastolic blood pressure ranges from 56 to 80 mmHg.

Choice C rationale

Bradycardia is not a common finding in aortic stenosis. The body typically responds to reduced cardiac output by increasing heart rate to maintain adequate circulation. Bradycardia might occur in severe cases with significant left ventricular dysfunction or as a result of other underlying conditions. A normal heart rate for a 3-year-old ranges from 70 to 110 beats per minute.

Choice D rationale

A murmur is a hallmark finding in aortic stenosis. The turbulent blood flow across the narrowed aortic valve creates an abnormal heart sound, typically a systolic ejection murmur heard best at the right upper sternal border, radiating to the neck. The characteristics of the murmur (intensity, timing, and location) can provide clues about the severity of the stenosis.

Choice E rationale

Clubbing of the nail beds is a sign of chronic hypoxemia, often associated with cyanotic congenital heart defects that cause long-term low blood oxygen levels. While severe aortic stenosis can eventually lead to heart failure and potentially some degree of hypoxemia, clubbing is not a typical or early finding in this condition.