Question

"When ascultating the heart, which of the following characteristics best describes the first heart sound in a client with tachycardia? A. splitting B. accentuated C. midstyolic click D. an opening snap"

Answer 1

When ascultating the heart, the first heart sound in a client with tachycardia is best described as B. accentuated.

In a normal heart, the first heart sound, known as S1, is caused by the closure of the mitral and tricuspid valves. It is typically a low-pitched sound that is heard as a "lub" during auscultation. However, in a client with tachycardia (a fast heart rate), the heart is beating faster than usual. As a result, the first heart sound may be louder and more pronounced, giving it an accentuated quality.

To better understand this, imagine a drumbeat. When the drum is struck at a slow pace, the sound it produces is relatively soft. However, if the drum is struck rapidly, the sound becomes louder and more noticeable. Similarly, in tachycardia, the faster heart rate can cause the first heart sound to be accentuated.

Therefore, when auscultating the heart of a client with tachycardia, the first heart sound is likely to be accentuated.

Answer 2

Auscultation of the heart requires excellent hearing and the ability to distinguish subtle differences in pitch and timing. Hearing-impaired health care practitioners can use amplified stethoscopes. High-pitched sounds are best heard with the diaphragm of the stethoscope. Low-pitched sounds are best heard with the bell. Very little pressure should be exerted when using the bell. Excessive pressure converts the underlying skin into a diaphragm and eliminates very low-pitched sounds.

The entire precordium is examined systematically, typically beginning over the apical impulse with the patient in the left lateral decubitus position. The patient rolls supine, and auscultation continues at the lower left sternal border, proceeds cephalad with auscultation of each interspace, then caudad from the right upper sternal border. The clinician also listens over the left axilla and above the clavicles. The patient sits upright for auscultation of the back, then leans forward to aid auscultation of aortic and pulmonic diastolic murmurs or pericardial friction rub.

Major auscultatory findings include

*Heart sounds

*Murmurs

*Rubs

Hope it helps.