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. Propranolol: This is a beta-blocker, which may be used to control heart rate, but it does not address the risk of thromboembolism in atrial fibrillation.

B. Procainamide: This is an antiarrhythmic used for rhythm control, but it does not address stroke prevention in atrial fibrillation.

C. Aspirin: Although aspirin is sometimes used for stroke prevention, it is generally less effective than anticoagulation therapy in clients with higher CHA2DS2-VASC scores.

D. Warfarin: A CHA2DS2-VASC score of 2 indicates a moderate risk for stroke, and warfarin (or another anticoagulant) is indicated to reduce the risk of thromboembolic events.

A. Client should increase potassium-rich foods in the diet B. Family members of the client should have a cardiac screening C. Client should notify the provider if palpitations develop D. Female clients should use measures to prevent pregnancy E. Client should use caution when taking over-the-counter (OTC) medications F. Client should avoid extremely hot or cold environments G. Client should be encouraged to quit smoking H. Client requires prophylactic antibiotics before dental procedures I. Client should avoid high amounts of caffeine and alcohol

Correct Answer is ["C","E","G","I"]

Explanation

A. Client should increase potassium-rich foods in the diet: Not applicable, as mitral valve prolapse (MVP) is not related to potassium levels.

B. Family members of the client should have a cardiac screening: This is unnecessary unless there is a strong family history of connective tissue disorders associated with MVP.

C. Client should notify the provider if palpitations develop: Palpitations can indicate arrhythmias, which are a possible complication of MVP.

D. Female clients should use measures to prevent pregnancy: Pregnancy is generally not contraindicated in MVP unless there is significant valve regurgitation.

E. Client should use caution when taking OTC medications: Stimulants in OTC drugs, like decongestants, can exacerbate palpitations.

F. Client should avoid extremely hot or cold environments: This is not typically required for MVP.

G. Client should be encouraged to quit smoking: Smoking can exacerbate cardiovascular risks associated with MVP.

H. Client requires prophylactic antibiotics before dental procedures: Not recommended unless there is a history of endocarditis or significant valve regurgitation.

I. Client should avoid high amounts of caffeine and alcohol: Both can exacerbate symptoms like palpitations and arrhythmias.

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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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