When taking a health history of a client with suspected aortic stenosis, which symptoms would the nurse anticipate? Select all that apply.

a. Bloody sputum: Bloody sputum is not typically associated with aortic stenosis. It may be indicative of other conditions such as pulmonary embolism, pneumonia, or bronchitis, but it is not a common symptom of aortic stenosis. Therefore, this symptom is not anticipated.

b. Peripheral edema: Peripheral edema is not a common symptom of isolated aortic stenosis. It is more commonly associated with conditions such as heart failure, where fluid retention leads to swelling in the extremities. Therefore, peripheral edema is not typically anticipated in aortic stenosis.

c. Dyspnea on exertion: Dyspnea on exertion is a classic symptom of aortic stenosis. It occurs due to the narrowing of the aortic valve, which leads to increased resistance to blood flow from the left ventricle to the aorta during physical activity. This can result in breathlessness and difficulty breathing during exertion.

d. Angina: Angina, or chest pain, is a common symptom of aortic stenosis, especially in cases where there is concurrent coronary artery disease (CAD). Aortic stenosis can increase myocardial oxygen demand, leading to ischemia and chest pain, particularly during exertion.

e. Syncope: Syncope, or fainting, is a serious symptom of aortic stenosis and indicates severe disease. It typically occurs due to decreased cardiac output during exertion, leading to inadequate cerebral perfusion. Syncope in aortic stenosis is often exertional and may occur with activities such as exercise or even just walking.

a. Review I&O (Intake and Output): While reviewing intake and output is an essential component of assessing fluid status in heart failure, it is not the immediate priority in this scenario. The client's presentation with dyspnea and crackles suggests acute respiratory distress, which requires immediate assessment and intervention to address potential hypoxemia.

b. Check pulse oximetry: In a client presenting with elevated blood pressure, dyspnea, and bilateral crackles throughout lung fields, the priority intervention is to assess oxygenation status. Checking pulse oximetry provides immediate information about the client's oxygen saturation levels, which is crucial for determining the severity of respiratory distress and guiding subsequent interventions. Hypoxemia is a common complication in heart failure exacerbations and can worsen symptoms such as dyspnea and respiratory distress.

c. Administer digoxin: Digoxin is a medication commonly used in the management of heart failure to improve cardiac output and reduce heart rate. However, it is not the priority intervention in this scenario. Assessing oxygenation status and addressing respiratory distress take precedence over administering medications.

d. Obtain 12-lead ECG: While obtaining a 12-lead ECG is important for assessing cardiac rhythm and identifying any potential cardiac abnormalities, it is not the immediate priority in this scenario. The client's presentation with acute respiratory distress warrants immediate assessment of oxygenation status to guide appropriate interventions.