What description fits a grade 5 heart murmur?

A grade 5 heart murmur is characterized as very loud and is often associated with a palpable thrill, which is a vibration felt on the skin over the area of the murmur. It is so intense that it can be detected not only through the placement of a stethoscope but also when the stethoscope is slightly off the chest, indicating it has sufficient intensity to be heard even at a distance. This level of audibility distinguishes it from lower-grade murmurs, which may not carry the same power or be associated with a palpable thrill. Understanding these nuances in the grading of heart murmurs is essential for accurate assessment and diagnosis in cardiovascular nursing.