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A 81 year old patient comes to the clinic following diagnosis of diseased aortic valve, aortic regurgitation. The nurse practitioner knows that the best place to hear this murmur is:

a. Second intercostal space, right of the sternum
b. Second intercostal space, left of the sternum
c. Third intercostal space, left of the sternum
c. Fifth intercostal space, left of the sternum

User Kounex
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Final answer:

The most appropriate location to hear an aortic regurgitation murmur is the fifth intercostal space, left of the sternum. This place correlates with the aortic valve's auscultation site in the heart. Proper stethoscope placement and auscultation technique are necessary to detect and diagnose heart murmurs, like aortic regurgitation.

Step-by-step explanation:

The best place to hear the murmur of aortic regurgitation is the fifth intercostal space, left of the sternum. This area is considered the auscultation site for the aortic valve, where such murmurs are most clearly heard. Aortic regurgitation is a condition where the aortic valve does not close properly, causing blood to flow back into the left ventricle from the aorta during ventricular diastole.

Auscultation should be performed with deep breath instructions to the patient, which may amplify the murmurs. Deep inhalation increases right-sided heart flow, enhancing right-sided heart murmurs, while expiration restricts left-sided heart flow, enhancing left-sided murmurs such as aortic regurgitation. Understanding the orientation of the heart within the thoracic cavity, including the position of the aortic valve, is crucial for accurate stethoscope placement.

The auscultation technique also involves understanding that heart murmurs are irregular sounds caused by turbulent blood flow. Aortic regurgitation murmurs can be hard to detect and are best heard with the stethoscope's bell placed at the accurate location on the patient's chest. Proper technique and stethoscope placement are essential for an accurate diagnosis.

User MikeTP
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