A patient arrives in the triage area with complaints of episodic heart palpitations, dizziness, and a fear of impending doom. They report a previous diagnosis of both mitral valve prolapse and generalized anxiety disorder. During an episode in the ED, after an unremarkable workup, which intervention should the nurse prioritize to both assess and manage the patient's current symptoms?
Provide the patient with a dose of aspirin while waiting for further test results.
Schedule an echocardiogram to assess the function of the patient's mitral valve.
Perform the Valsalva maneuver to observe changes in the patient’s symptoms.
Administer a 12-lead ECG to look for potential arrhythmic events.
While both benzodiazepines and beta-blockers may eventually be used to manage symptoms associated with anxiety disorders or cardiac issues, the Valsalva maneuver will help differentiate whether the patient's symptoms are related to the mitral valve prolase or panic attacks. An increase in symptoms after the maneuver may suggest cardiac involvement, whereas a decrease may indicate panic attack. A 12-lead ECG should already be completed as part of the workup to rule out cardiac arrhythmias; administering aspirin would not be a priority without evidence of acute coronary syndrome; and scheduling an echocardiogram is important for long-term management but not an immediate intervention in the ED.
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