The patient is asymptomatic but is diagnosed with second-degree heart block Mobitz 1. The patient is on digoxin at home. Which of the following interventions will the nurse anticipate?

Administration of prescribed Atropine

A prescription for transcutaneous pacing.

An extra dose of digoxin will be prescribed

The next dose of digoxin will be held

Answer and Explanation

The Correct Answer is D

A. Administration of prescribed Atropine. Atropine is typically used for bradycardia related to second-degree heart block Mobitz 2 or complete block, but Mobitz 1 usually resolves on its own and does not require atropine unless symptoms develop.

B. A prescription for transcutaneous pacing. Transcutaneous pacing is typically used for more severe types of heart block, such as Mobitz 2 or third-degree block, not Mobitz 1.

C. An extra dose of digoxin will be prescribed. Giving additional digoxin would be contraindicated due to its effects on AV conduction.

D. The next dose of digoxin will be held: Second-degree heart block Mobitz 1 (also known as Wenckebach) can be worsened by digoxin, which has a vagomimetic effect that can slow conduction through the AV node. Therefore, the next dose of digoxin should be held to avoid further exacerbating the block.

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Correct Answer is D

Explanation

A. A patient with second-degree atrioventricular (AV) block, type 1, rate 60, who is dizzy when ambulating. While dizziness may be a concern, second-degree AV block type 1 (Wenckebach) typically resolves without immediate intervention.

B. A patient who is in a sinus rhythm, rate 98 and regular, recovering from an elective cardioversion 2 hours ago. This patient is stable, and recovery from cardioversion typically involves monitoring, but the patient does not require immediate intervention.

C. A patient with atrial fibrillation, rate 88 and irregular, who has a dose of warfarin (Coumadin) due. The patient is stable, and the dose of warfarin can be administered after assessing the patient’s overall condition, making it a lower priority.

D. A patient whose implantable cardioverter-defibrillator (ICD) fired twice today and has a dose of amiodarone (Cordarone) due: The patient whose ICD fired twice is at high risk for life-threatening arrhythmias, and this situation requires immediate evaluation and intervention. The nurse should assess the patient first, and the dose of amiodarone may be administered to manage any underlying arrhythmias.

A. To increase hydration B. To control symptoms C. To promote nutrition D. To limit environmental hazards

Correct Answer is B

Explanation

A. To increase hydration: This is not a priority in terminal care. In fact, increasing hydration can be uncomfortable for dying patients who are often unable to process fluids effectively.

B. To control symptoms: The primary focus in end-of-life care is to manage symptoms, such as pain, difficulty breathing, and anxiety, to ensure the patient is as comfortable as possible.

C. To promote nutrition: At the end of life, promoting nutrition is usually not the priority, as the client may no longer desire food and may be unable to tolerate it.

D. To limit environmental hazards: While important, it is not the priority in terminal care. The focus should be on comfort and symptom control.

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The patient is asymptomatic but is diagnosed with second-degree heart block Mobitz 1. The patient is on digoxin at home. Which of the following interventions will the nurse anticipate?

Nursing Test Bank

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