A patient with recent prosthetic mitral valve replacement presents with a fever and petechiae. What should the nurse do first?

In this scenario, the patient is exhibiting signs that could indicate an infection, possibly related to the prosthetic mitral valve, such as fever and petechiae. In such cases, prompt action is critical. The most appropriate first step is to discontinue the IV and obtain an order to administer all medications orally. This choice is paramount as it helps prevent further complications related to IV access or infection and allows for timely intervention.

When a patient presents with signs of potential endocarditis or infection, the nurse must act quickly to manage the patient's condition. Discontinuing the IV minimizes the risk of further complications that can arise from intravenous therapy, particularly if the patient is potentially suffering from an infection that could be worsened by an existing IV line. After ensuring the IV is discontinued, the nurse should seek to provide appropriate medication management, which could include moving to oral antibiotics if the patient is stable enough to do so.

Other options, while relevant to patient care, are not prioritized appropriately for the immediate clinical situation. Monitoring for symptoms, teaching about prophylactic antibiotics, or instructing family members to administer antibiotics would come after ensuring the patient’s immediate medical needs are addressed.