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

Elevated levels of LDL (low-density lipoprotein) cholesterol are associated with an increased risk of coronary artery disease (CAD). LDL cholesterol is often referred to as "bad" cholesterol because it can contribute to the formation of plaque in the arteries, leading to narrowing and blockage of the arteries supplying the heart. This increases the risk of developing CAD and related complications such as heart attack and stroke.

On the other hand, HDL (high-density lipoprotein) cholesterol is often referred to as "good" cholesterol. HDL cholesterol helps remove excess cholesterol from the bloodstream and transport it back to the liver for processing and excretion. Higher levels of HDL cholesterol are associated with a decreased risk of CAD because it helps to prevent the accumulation of cholesterol on artery walls.

Therefore, understanding that increased LDL and decreased HDL levels increase the risk of coronary artery disease demonstrates a good understanding of the significance of cholesterol levels and their impact on cardiovascular health.

A. Obtain consent for transesophageal echocardiogram (TEE) B. Obtain consent for a STAT defibrillation C. Obtain consent for cardioversion. D. Hold digoxin 48 hours prior to cardioversion.

Correct Answer is B

Explanation

Defibrillation is not the first-line treatment for atrial fibrillation. It is used to treat life-threatening cardiac arrhythmias such as ventricular fibrillation or pulseless ventricular tachycardia. Atrial fibrillation, on the other hand, is a rapid and irregular atrial rhythm, and defibrillation is not indicated for its treatment.

Obtain consent for transesophageal echocardiogram (TEE): This is an appropriate action for a client with atrial fibrillation. A TEE is often performed to assess the structure and function of the heart in cases of atrial fibrillation, especially when considering cardioversion or other interventions.

Obtain consent for cardioversion: Cardioversion is a common treatment option for atrial fibrillation, especially when the client is unstable or experiencing symptoms. It involves restoring a normal heart rhythm through the use of electrical shocks or medications. It is important to obtain informed consent before performing cardioversion, but this does not necessarily require questioning.

Hold digoxin 48 hours prior to cardioversion: Digoxin is commonly held before cardioversion because it can increase the risk of certain arrhythmias during the procedure. This is a standard precaution to minimize potential adverse effects. Therefore, the nurse does not need to question this action, as it aligns with established guidelines.

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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

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