A nurse is teaching a client who is postoperative following the insertion of a permanent pacemaker. Which of the following instructions should the nurse include? (Select all that apply)

Do not have a microwave oven in the home.

Request to be scanned with a handheld metal detector when in the airport.

Count your pulse for 1 min each morning.

Do not wear tight clothing over the insertion area.

Resume activities that can cause jolting, such as horseback riding, after 4 weeks.

Answer and Explanation

Correct Answer : C,D

A. Modern pacemakers are designed to withstand interference from microwave ovens, so it is not necessary to avoid having them in the home.
B. Airport security staff should be informed about the pacemaker, but handheld metal detectors should be avoided because prolonged exposure can interfere with pacemaker function. Instead, the client should request a manual search.
C. Monitoring the pulse daily helps to ensure the pacemaker is functioning properly and to detect any irregularities early.
D. Wearing tight clothing over the insertion area can cause discomfort and may interfere with the function of the pacemaker.
E. Activities that involve jolting or the risk of impact to the pacemaker should be avoided until cleared by a healthcare provider, and this period may extend beyond 4 weeks.

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Correct Answer is A

Explanation

A. Administer oxygen therapy. This is the priority intervention to ensure adequate oxygenation and address hypoxemia due to the pulmonary embolism.

B. Start an IV infusion of lactated Ringer's is not the immediate priority; oxygen therapy addresses acute symptoms of a pulmonary embolism first.

C. Initiate cardiac monitoring is important, but it is secondary to addressing the client's oxygenation needs.

D. Give morphine IV may be part of the treatment plan, but oxygen therapy is the most immediate intervention for a pulmonary embolism.

A. The client is experiencing premature atrial contractions. B. The client has bilateral wheezes. C. The client has a decreased oxygen saturation level. D. The client has lower leg edema.

Correct Answer is A

Explanation

A. The client is experiencing premature atrial contractions is correct. Premature atrial contractions can interfere with pulse pressure analysis and affect the accuracy of cardiac output measurements.

B. The client has bilateral wheezes is incorrect. Wheezes affect lung function, not directly the accuracy of pulse pressure analysis for cardiac output.

C. The client has a decreased oxygen saturation level is incorrect. While it is a concern, it does not compromise pulse pressure readings directly.

D. The client has lower leg edema is incorrect. Edema affects peripheral circulation but does not directly compromise pulse pressure measurements for cardiac output.

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A nurse is teaching a client who is postoperative following the insertion of a permanent pacemaker. Which of the following instructions should the nurse include? (Select all that apply)

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