A patient's ECG monitor shows an accelerated junctional rhythm at a rate of 78 beats/minute. What is the nurse's priority intervention?

A. Administer ordered digoxin: Digoxin enhances vagal tone and slows conduction through the AV node, primarily used for atrial fibrillation or heart failure with reduced ejection fraction. An accelerated junctional rhythm at 78 beats/min is within normal heart rate range and often does not require pharmacologic suppression. B. Begin a continuous diltiazem infusion: Diltiazem is a calcium channel blocker that slows AV nodal conduction and is indicated for atrial tachyarrhythmias. An accelerated junctional rhythm at 78 beats/min is not tachycardic and is typically hemodynamically stable. Initiating a diltiazem infusion could lead to unnecessary bradycardia or hypotension. C. Prepare for cardioversion: Synchronized cardioversion is reserved for unstable tachyarrhythmias such as atrial fibrillation with rapid ventricular response or supraventricular tachycardia causing hemodynamic compromise. An accelerated junctional rhythm at 78 beats/min is generally benign and often transient. Electrical cardioversion is not indicated in a stable patient with this rhythm. D. Continue monitoring the patient: An accelerated junctional rhythm (rate 60–100 beats/min) often occurs due to increased automaticity of the AV junction, sometimes related to digoxin toxicity, ischemia, or post-cardiac surgery. If the patient is hemodynamically stable and asymptomatic, close monitoring and assessment for underlying causes are appropriate. Immediate intervention is not required unless instability develops.