The nurse is providing discharge education to a client who recently have insertion of a pacemaker/ICD. Which statement by the client should require further follow up by the nurse?

"I should never place items that generate magnetic fields over the pacemaker/ICD"

"I should not play contact sports or lift heavy objects for two months"

“I should inform dentists and health care providers about the pacemaker/ICD"

“I should never allow metal detectors at the airport or the use of household appliances"

Answer and Explanation

The Correct Answer is D

While it is generally recommended to avoid close or prolonged exposure to strong magnetic fields, such as those generated by MRI machines, placing items that generate magnetic fields over the pacemaker/ICD, such as cell phones or certain medical devices, does not typically pose a risk. Therefore, it would be important for the nurse to clarify the client's understanding and provide accurate information about the precautions related to magnetic fields.

The other statements made by the client are generally correct and align with the typical recommendations for individuals with pacemakers/ICDs:

Avoiding contact sports or lifting heavy objects for a specified period of time after pacemaker/ICD insertion is usually advised to allow for proper healing and to reduce the risk of lead dislodgment or damage to the device.

Informing dentists and healthcare providers about the presence of a pacemaker/ICD is important so that they can take appropriate precautions during procedures or treatments that may involve electromagnetic interference or interfere with the device's functioning.

While it is generally advised to avoid close proximity to strong magnetic fields, such as those in airports or certain household appliances, it does not necessarily mean completely avoiding them. The nurse can clarify the specific recommendations regarding metal detectors at airports and the safe use of household appliances.

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Correct Answer is A

Explanation

The best response by the nurse would be to explain that no food or drink is allowed for 4 hours before the stress test.

The reason for this restriction is that consuming food or drink can affect the accuracy of the cardiac stress test results. Eating or drinking can increase heart rate and blood pressure, potentially altering the test's interpretation. It is important for the client to have an empty stomach to ensure accurate test results.

Let's review the other options and explain why they are not the best responses:

Asking the client's visitor to bring some coffee from the cafeteria for the client: This option goes against the restriction of no food or drink before the stress test. It is important to adhere to the guidelines provided to ensure accurate test results.

Making up a small breakfast tray from what is available on the unit: Similarly, providing breakfast to the client goes against the restriction of no food before the stress test. The client should have an empty stomach for the test.

Offering hot tea or coffee only: While hot tea or coffee might be tempting for the client, it still violates the requirement of no food or drink before the stress test. The client should only be allowed to consume water during the fasting period.

A. Pacer spikes are adequate in number. B. Pacer spikes occur directly before the P waves. C. Pacer spikes occur directly before the QRS waves. D. Pacer spikes occur on the T waves. E. The heart rate is within programmed parameters.

Correct Answer is ["D","E"]

Explanation

The traces that should require immediate follow-up by the nurse are:

● Pacer spikes occur directly before the T waves.

Pacer spikes occurring on the T waves indicate an issue with the pacemaker's timing or sensing. This could lead to inappropriate pacing or pacing during the refractory period, which can be detrimental to the client's heart function.

● The heart rate is outside of programmed parameters.

If the heart rate is outside of the programmed parameters set for the client's pacemaker, it may indicate a malfunction or failure of the device or a change in the client's cardiac status. It is important for the nurse to assess the client's condition and notify the healthcare provider for further evaluation and intervention.

Let's review the other options and explain why they do not require immediate follow-up:

Pacer spikes are adequate in number: This indicates that the pacemaker is delivering the appropriate number of electrical impulses as programmed. As long as the other parameters are normal, this finding does not require immediate follow-up.

Pacer spikes occur directly before the P waves: This is the desired and expected pattern for a pacemaker in normal sinus rhythm. It indicates proper timing and coordination between the pacemaker and the client's intrinsic electrical activity.

Pacer spikes occur directly before the QRS waves: This is also the desired and expected pattern for a pacemaker in clients with ventricular pacing. It indicates proper timing and coordination between the pacemaker and the client's intrinsic electrical activity.

The heart rate is within programmed parameters: If the heart rate falls within the programmed parameters set for the client's pacemaker, it indicates that the device is functioning appropriately in maintaining the desired heart rate.

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The nurse is providing discharge education to a client who recently have insertion of a pacemaker/ICD. Which statement by the client should require further follow up by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client scheduled for a cardiac stress test at 1100. When the nurse enters the client's room at 0800, the client requests toast or at least some coffee. What is the best response?

Correct Answer is A

Explanation

The nurse is caring for a client with a pacemaker/ICD on a continuous cardiac monitor. Which trace should require immediate follow up by the nurse? Select all that apply

Correct Answer is ["D","E"]

Explanation

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