A nurse is assessing a 3-year-old child who has aortic stenosis. Which of the following findings should the nurse expect? (Select all that apply.)

A. Weak pulses: Aortic stenosis involves the narrowing of the aortic valve, which obstructs blood flow from the left ventricle into the aorta (systemic circulation). Because less blood is being ejected, the peripheral pulses will be weak or thready. B. Murmur: As blood is forced through the narrowed, stiff valve, it creates turbulence. This turbulence produces a characteristic systolic ejection murmur. C. Hypotension: Due to the obstruction of blood flow, cardiac output decreases. This drop in the volume of blood entering the arteries leads to low blood pressure (hypotension) and a narrowed pulse pressure. D. Bradycardia: The heart actually has to work harder to pump blood against the resistance of the narrowed valve. Additionally, the body attempts to compensate for the decreased cardiac output by increasing the heart rate (tachycardia), not decreasing it. E. Clubbing of the nail beds: Clubbing is typically associated with chronic hypoxia found in cyanotic heart defects (right-to-left shunts) or chronic pulmonary disease. Aortic stenosis is an acyanotic defect; oxygen saturation typically remains normal unless severe heart failure develops.