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 B
Explanation
Choice A reason: Increased Thirst, Increased Urine Output, and Weight Loss
Increased thirst, increased urine output, and weight loss are symptoms commonly associated with diabetes mellitus, particularly uncontrolled diabetes. These symptoms occur due to the body’s attempt to eliminate excess glucose through urine, leading to dehydration and subsequent weight loss. However, these symptoms are not typically associated with elevated TSH levels, which indicate hypothyroidism.
Choice B reason: Fatigue, Constipation, Weight Gain
Fatigue, constipation, and weight gain are classic symptoms of hypothyroidism2. When the thyroid gland is underactive, it produces insufficient thyroid hormones, leading to a slowdown in the body’s metabolism. This results in fatigue, weight gain, and constipation, among other symptoms. Elevated TSH levels are a compensatory response by the pituitary gland to stimulate the thyroid to produce more hormones, confirming hypothyroidism.
Choice C reason: Anxiety, Unintended Weight Loss, Palpitations
Anxiety, unintended weight loss, and palpitations are symptoms typically associated with hyperthyroidism, not hypothyroidism. Hyperthyroidism occurs when the thyroid gland produces excessive thyroid hormones, leading to an accelerated metabolism. This results in symptoms such as weight loss, increased heart rate (palpitations), and anxiety. Elevated TSH levels would not be expected in hyperthyroidism; instead, TSH levels would be low due to negative feedback from high thyroid hormone levels.
Choice D reason: Shakiness, Sweating, Nausea
Shakiness, sweating, and nausea can be symptoms of various conditions, including hypoglycemia (low blood sugar), anxiety, or panic attacks. These symptoms are not specific to thyroid dysfunction and are not typically associated with elevated TSH levels. Hypothyroidism, indicated by high TSH levels, usually presents with symptoms related to a slowed metabolism, such as fatigue and weight gain, rather than shakiness and sweating.
Correct Answer is B
Explanation
Choice A Reason:
Conivaptan hydrochloride is a vasopressin receptor antagonist used to treat hyponatremia in patients with SIADH. It works by blocking the action of vasopressin, thereby promoting water excretion without significant loss of sodium. This helps to correct the water imbalance caused by SIADH. Conivaptan is typically administered intravenously and is effective in increasing serum sodium levels.
Choice B Reason:
Vasopressin, also known as antidiuretic hormone (ADH), is contraindicated in patients with SIADH because it exacerbates the condition. SIADH is characterized by excessive release of ADH, leading to water retention and hyponatremia. Administering vasopressin would further increase water reabsorption in the kidneys, worsening the hyponatremia.
Choice C Reason:
Sodium chloride tablets are used to manage hyponatremia in SIADH by increasing sodium intake. This helps to counteract the dilutional hyponatremia caused by excessive water retention. Sodium chloride tablets are often prescribed alongside fluid restriction to help raise serum sodium levels.
Choice D Reason:
Tolvaptan is another vasopressin receptor antagonist used to treat hyponatremia in SIADH. It works similarly to conivaptan by blocking the action of vasopressin, promoting water excretion, and increasing serum sodium levels. Tolvaptan is typically administered orally and is effective in managing SIADH.
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