The nurse is assessing a child with pulmonary valve stenosis. The nurse would expect to find which of the following?

A systolic murmur heard over the left sternal border
A thrill

Explanation

• Pulmonary stenosis is the narrowing of the pulmonary valve or the pulmonary artery just distal to the valve. The inability of the right ventricle to evacuate blood may lead to right ventricular hypertrophy.

• Most patients with pulmonary stenosis are asymptomatic. Severe stenosis can cause exertional angina, syncope, or sudden death.

• A typical systolic ejection murmur heard loudest at the upper left sternal border is indicative of pulmonic stenosis.

• A thrill may be present in the upper left sternal area or at the suprasternal notch.

• Exertional dyspnea is more often associated with severe aortic stenosis or Tetralogy of Fallot.

• Cyanosis does not usually occur with only pulmonic stenosis.

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