The nurse is caring for a client who has just had a pacemaker inserted. Which action should the nurse include in the initial plan of care?

Apply warm compresses to site of the client's pacemaker insertion

Teach the client to avoid being near any type of household microwave oven

Ambulate the client as soon as possible to evaluate function of pacemaker.

Instruct client to limit movement of arm on side where pacemaker inserted.

Answer and Explanation

The Correct Answer is D

A. Apply warm compresses to site of the client's pacemaker insertion: Heat application is contraindicated as it may increase swelling or risk infection.

B. Teach the client to avoid being near any type of household microwave oven: Modern pacemakers are shielded, so microwaves do not interfere with their function.

C. Ambulate the client as soon as possible to evaluate pacemaker function: While early ambulation is encouraged, pacemaker function is not evaluated through ambulation.

D. Instruct client to limit movement of the arm on side where pacemaker was inserted: Limiting arm movement prevents dislodging the pacemaker leads during the healing phase.

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Correct Answer is B

Explanation

A. Complete (third-degree) heart block: This rhythm is characterized by a lack of relationship between P waves and QRS complexes, indicating a complete dissociation between atrial and ventricular activity.

B. A pacemaker rhythm on an ECG is characterized by the presence of pacing spikes followed by P waves or QRS complexes, depending on whether the pacemaker is pacing the atrium or the ventricle. If the pacemaker is pacing the ventricle, the pacing spike will be followed by a QRS complex. The QRS complexes in a paced rhythm are often wider than normal.

C. Sinus bradycardia: Sinus bradycardia is a slow but regular rhythm originating from the sinus node, with normal P waves and QRS complexes.

D. First-degree heart block: First-degree heart block is characterized by a prolonged PR interval (greater than 0.20 seconds) but with all P waves followed by QRS complexes, differing from third-degree heart block.

A. Pacemaker B. Cardiac catheterization C. Pulmonary artery pressure monitoring D. Cardioversion

Correct Answer is D

Explanation

A. Pacemaker: Pacemakers are used for bradyarrhythmias or heart block, not typically for atrial flutter.

B. Cardiac catheterization: This is used for diagnostic or interventional procedures, not for rhythm correction.

C. Pulmonary artery pressure monitoring: This is a monitoring tool for critically ill clients with heart failure or pulmonary hypertension, not a treatment for atrial flutter.

D. Cardioversion: Cardioversion is often used for atrial flutter when drug therapy fails. It delivers synchronized electrical energy to restore normal sinus rhythm.

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The nurse is caring for a client who has just had a pacemaker inserted. Which action should the nurse include in the initial plan of care?

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Naxlex Comprehensive Predictor Exams

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