A client with paroxysmal supraventricular tachycardia asks the nurse why the health care provider (HCP) is going to perform carotid sinus massage. The nurse educates the client about the treatment. Which statement by the client indicates that the teaching has been effective?

A. Maintain the infusion because the client had a cardiac arrest: While epinephrine is essential during cardiac arrest, continuing a high-dose infusion post-resuscitation without reassessment may lead to complications like tachycardia, hypertension, and increased myocardial oxygen demand.

B. Continue to monitor the client's rhythm closely: Ongoing monitoring is important, but it is a passive intervention. The heart rate of 120 bpm may reflect excessive adrenergic stimulation from epinephrine, and further action is needed to prevent deterioration.

C. Suggest that the client's medication be changed to norepinephrine: Norepinephrine is another vasopressor that has less of a beta-1 adrenergic effect compared to epinephrine. It is primarily used for hypotension and septic shock, not as a direct substitute for epinephrine post-cardiac arrest. Changing to another vasopressor without indication is not the best initial step.

D. Ask the physician if the dose can be decreased: A heart rate of 120 bpm may indicate that the epinephrine dose is too high, causing sympathetic overstimulation. Prolonged or excessive tachycardia increases myocardial oxygen demand, which can be detrimental, especially in a post-arrest heart. Decreasing the dose can help prevent arrhythmias or myocardial ischemia, making this the most appropriate and proactive action.

A. Teach the client how to change the pacemaker dressing: Client education is important but not a priority in the immediate post-procedure phase. Dressing changes should initially be performed using sterile technique by clinical staff to prevent infection at the insertion site.

B. Immobilize the affected arm using a sling: After pacemaker insertion, the affected arm (usually on the side of the implantation) should be immobilized or limited in movement to prevent lead dislodgment. Elevating the arm above the shoulder or excessive motion can compromise pacemaker lead placement during the early healing period.

C. Arrange for ancillary personnel to feed the client: Assistance with feeding is only necessary if the client has physical or cognitive limitations. This is not a routine or priority intervention following pacemaker insertion unless clinically indicated by other assessments.

D. Monitor urine output every two hours: Frequent monitoring of urine output is not directly related to pacemaker insertion unless there are other concerns such as fluid imbalance or renal dysfunction. It's not a standard intervention in the immediate care plan for this procedure.