James, the ICU nurse, is assessing a client with mitral valve insufficiency. Which of the following findings should the nurse expect?

Choice A Reason:
First-degree heart block is a condition where the electrical signals in the heart are delayed but still reach the ventricles. It is generally considered benign and does not typically lead to heart failure. It is often asymptomatic and discovered incidentally on an ECG.

Choice B Reason:
Atrial fibrillation (AFib) is a common arrhythmia associated with heart failure. AFib causes the atria to beat irregularly and often rapidly, which can lead to poor blood flow and increased risk of stroke. In heart failure patients, AFib can exacerbate symptoms and worsen the prognosis due to the loss of atrial contraction and irregular ventricular response.

Choice C Reason:
Ventricular tachycardia (VT) is a serious arrhythmia that is often associated with heart failure. VT originates in the ventricles and can lead to hemodynamic instability and sudden cardiac death if not treated promptly. It is a common complication in patients with heart failure and cardiomyopathy.

Choice D Reason:
Sinus bradycardia is a slower than normal heart rate, typically less than 60 beats per minute. While it can occur in healthy individuals, especially athletes, it is not specifically associated with heart failure. In some cases, severe bradycardia can lead to symptoms of heart failure, but it is not a primary arrhythmia linked to the condition.

Choice A Reason:
Reduced blood pressure is not a specific complication of infective endocarditis. While hypotension can occur in severe cases due to septic shock, it is not a hallmark of the disease. Infective endocarditis primarily affects the heart valves and can lead to embolic events, heart failure, and other complications.

Choice B Reason:
Osler's nodes are a classic sign of infective endocarditis. These are painful, red or purple, raised lesions found on the hands and feet. They are caused by immune complex deposition and are indicative of the systemic nature of the infection. Their presence can help in the clinical diagnosis of infective endocarditis.

Choice C Reason:
Clear lung sounds are not a complication of infective endocarditis. In fact, clear lung sounds would generally indicate that there is no pulmonary involvement or congestion. Complications of infective endocarditis are more likely to involve the heart, kidneys, and other organs through embolic events.

Choice D Reason:
Increased appetite is not associated with infective endocarditis. Patients with this condition often experience symptoms such as fever, fatigue, and weight loss due to the chronic infection. Increased appetite would be an unusual finding and not related to the disease process.