During a routine well child exam on a 5yearold child, the primary care pediatric
nurse practitioner auscultates a grade II/VI, harsh, late systolic ejection murmur at the upper left sternal border that transmits to both lung fields. The child has normal growth and development. What will the nurse practitioner suspect?

Question

During a routine well child exam on a 5­year­old child, the primary care pediatric
nurse practitioner auscultates a grade II/VI, harsh, late systolic ejection murmur at the upper left sternal border that transmits to both lung fields. The child has normal growth and development. What will the nurse practitioner suspect?

Quizplus · Accepted Answer

The murmur described is consistent with pulmonic stenosis, which is a condition in which the pulmonic valve is narrowed, causing decreased blood flow out of the right ventricle and into the pulmonary artery. This results in a harsh, late systolic ejection murmur that is heard best at the upper left sternal border and may transmit to both lung fields. It is important to note that the child's normal growth and development do not rule out the possibility of a cardiac anomaly. Further evaluation, such as an echocardiogram, may be necessary to confirm the diagnosis.

During a Routine Well Child Exam on a 5­year­old Child

During a Routine Well Child Exam on a 5yearold Child