When teaching a patient about the long-term consequences of rheumatic fever, the nurse should discuss the possibility of

A. Digoxin is a medication used primarily to treat heart failure and certain types of arrhythmias, such as atrial fibrillation. It works by increasing the force of heart contractions and slowing the heart rate. However, digoxin is not typically used to treat bradycardia and may actually exacerbate the condition by further slowing the heart rate.
B. While monitoring is an essential part of patient care, it is not sufficient alone in this situation. The client’s heart rate is very low (45 beats per minute) and their blood pressure is low (82/60 mm Hg), which suggests they are symptomatic and potentially unstable.
C. Defibrillation is used to treat life-threatening arrhythmias such as ventricular fibrillation or pulseless ventricular tachycardia. It is not used for sinus bradycardia, which is a slow heart rate rather than a rapid, disorganized rhythm requiring electrical shock.

D. Transcutaneous pacing involves applying external pacing pads to the skin to stimulate the heart and increase the heart rate. This is a suitable intervention for symptomatic bradycardia, especially when accompanied by low blood pressure and dizziness.

A. Fever is a common manifestation of infective endocarditis and often indicates an ongoing infection or systemic inflammatory response. While it is important to monitor fever as it can signal worsening infection or treatment response, it is not necessarily the highest priority when compared to other potentially life-threatening complications.

B. Dyspnea, or difficulty breathing, is a critical manifestation to monitor in a patient with infective endocarditis. This symptom may indicate the presence of heart failure or pulmonary embolism, which can result from the infection.
C. Anorexia, or loss of appetite, is a common but less urgent symptom associated with various infections, including infective endocarditis. While it can affect the patient's nutritional status and overall well-being, it is not usually the most immediate or life-threatening concern compared to more acute manifestations like dyspnea.
D. Malaise, or a general feeling of discomfort or unease, is a common symptom of many infections, including infective endocarditis. While it reflects the patient's overall state of health and can be distressing, it is generally less critical than symptoms indicating acute or severe complications, such as dyspnea.