A nurse cares for a patient who has a heart rate averaging 54 beats/min with no adverse symptoms. Which activity modification would the nurse suggest to avoid further slowing of the heart rate?

Choice A reason: Suctioning every 2 hours is not appropriate for a patient with increased intracranial pressure (ICP). Suctioning can increase ICP due to the stress and stimulation it causes. It should only be performed when absolutely necessary and with proper precautions to minimize ICP spikes.

Choice B reason: Providing rest periods between nursing procedures is the correct measure. This helps minimize stimulation and stress, which can increase ICP. Rest periods allow the patient to stabilize and reduce the risk of further increasing the pressure within the skull.

Choice C reason: Encouraging active range of motion exercises is not suitable for a patient with increased ICP. Physical activity can exacerbate the condition by increasing intracranial pressure. The focus should be on minimizing activity and stress to prevent further elevation of ICP.

Choice D reason: Assigning the patient to a semiprivate room near the nurse's station is not the best approach. Patients with increased ICP require a quiet and calm environment to help manage their condition. A semiprivate room near the nurse's station may expose the patient to more noise and activity, which could increase ICP.

Choice A reason: Complete bedrest for the duration of the treatment with subcutaneous enoxaparin is not the best approach for managing infective endocarditis. While bed rest may be recommended initially to reduce cardiac workload, long-term bed rest is not necessary and could lead to complications such as muscle atrophy or thromboembolism. Subcutaneous enoxaparin is used for prophylaxis against deep vein thrombosis, but it does not address the underlying infection.

Choice B reason: Long-term anticoagulant therapy with IV heparin followed by oral warfarin is not the standard treatment for infective endocarditis. Although anticoagulant therapy may be necessary in some cases, such as for patients with prosthetic valves or specific cardiac conditions, it is not the primary treatment for the infection itself. The focus should be on eradicating the infection with appropriate antibiotics.

Choice C reason: Administration of IV penicillin, followed by oral penicillin for 10 weeks, is not the typical treatment regimen for infective endocarditis. While penicillin may be part of the antibiotic therapy, the duration and route of administration need to be tailored to the specific causative organism and the patient's clinical condition. Usually, a combination of antibiotics and a specific treatment plan is developed based on culture and sensitivity results.

Choice D reason: Hospitalization for initial IV antibiotics, followed by continued IV antibiotics at home, is the best treatment approach for a client newly diagnosed with infective endocarditis. This allows for intensive management and monitoring during the critical initial phase of treatment, ensuring that the infection is adequately controlled. Transitioning to continued IV antibiotics at home provides the necessary long-term therapy while allowing the patient to recover in a familiar environment. This approach ensures compliance with the treatment regimen and reduces the risk of complications.