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About Mitral Valve Prolapse & Regurgitation. A heart murmur that is most pronounced when the stethoscope is positioned at the heart's apex and occurs in the late systolic phase may be caused by mitral valve prolapse. This is also known as floppy valve syndrome. The murmur is normally preceded by a series of clicks.
Auscultate for bowel sounds and bruits. Next, use the diaphragm of your stethoscope to auscultate bowel sounds. You should be able to hear bowel tones in all four quadrants of the abdomen, so perform the auscultation systematically. Many nurses start in the right lower quadrant, since bowel tones are usually active around the ileocecal valve, which is in that quadrant.