A nurse is teaching a newly licensed nurse about heart and lung assessments in children. Which of the following statements made by the newly licensed nurse demonstrates an understanding of the teaching?
Explanation & Rationale
A. Assessment techniques must be adapted for infants and children because their chest wall is thinner, heart rate is faster, and lung sounds may vary with age. For example, breath sounds may be louder, and heart sounds may be more difficult to distinguish. This statement demonstrates an understanding that pediatric assessments require age-specific techniques. B. Some innocent heart sounds, including brief clicks or murmurs, can be normal in the first weeks of life as the cardiovascular system transitions from fetal circulation. Not all clicks indicate pathology. C. Many newborns have transient or innocent murmurs during the first days as ductus arteriosus and fetal shunts close. Murmurs are not automatically abnormal and must be assessed for timing, quality, and associated findings. D. Crackles and stridor are abnormal lung sounds in infants and typically indicate respiratory pathology such as infection, obstruction, or congenital anomalies. Normal breath sounds in infants should be clear and equal bilaterally.