Final answer:
A client at 28 weeks gestation with previously diagnosed mitral valve stenosis exhibiting breathlessness on exertion, giddiness, pallor, or ankle edema is indicating potential cardiac difficulties. These symptoms are signs that the heart is struggling to cope with the increased demands of pregnancy.
Step-by-step explanation:
The question pertains to the manifestations that may indicate a client at 28 weeks gestation with previously diagnosed mitral valve stenosis is experiencing cardiac difficulties. During pregnancy, the heart is under increased stress due to the additional blood volume it needs to pump. For a pregnant woman with mitral valve stenosis, signs of cardiac difficulties can include breathlessness on exertion, feeling faint or dizzy (giddiness), and a pale complexion (pallor). In more severe cases, the client may exhibit ankle edema (swelling at the ankles). These symptoms reflect the heart's reduced ability to manage the increased circulatory demands of pregnancy and warrant prompt medical attention.
When assessing a pregnant client with known cardiac conditions like mitral valve stenosis, it is essential to monitor for these symptoms closely. If these symptoms are present, it may be indicative of cardiac decompensation, and the need for intervention by the healthcare team is critical.