Question

Hello! I am really having a hard time with this case study. Your help will be really appreciated. Than you. 

Case Study, Chapter 21, Assessing Heart and Neck Vessels

A Black 50-year-old female client is admitted to the health care facility with mitral valve prolapse. The client states that a week ago she became dizzy and began to perspire while at work. She was working at the computer in her office on a major project that was due that day. The client attributed the episode to the stress and anxiety she was experiencing from finishing the project, so she put a cold wet towel around her neck and continued working. The next day, she woke up with a headache and felt a little tightness in her chest. She took an aspirin, and the symptoms subsided. The client became alarmed today when the tightness in her chest felt more like a pain. The client’s presenting symptoms include fatigue, headaches, and sharp chest pains.

VS: BP 160/90 mm Hg, HR 110 beats/min, RR 24 breaths/min, Temp. 98.0° F (36.7°C), Pulse Ox 96%, the skin is warm; the nurse notes the client is perspiring. Her weight is 30 lb over what it should be. She gives a history of having a murmur since she was little but that it never caused her any problems. She takes cholesterol and blood pressure-lowering medications daily.

a. What are the conditions that contribute to turbulent blood flow or heart murmurs?

b. What are the three techniques used to assess the precordium and heart sounds?

c. Based on these symptoms and history, what is the correct landmark for auscultation of heart sounds in this client?

d. What kind of heart sounds may be heard in this client?

e. When teaching this client about coronary heart disease (CHD), which risk factors are important for the nurse to emphasize?