A client has had a pacemaker inserted and is ready for discharge. The nurse is providing education about pacemaker safety. Which of the following are items that the nurse will be sure to address?

A. Sit at least 12 feet from analog television sets: Pacemaker interference from televisions is not a concern with modern devices. Routine household electronics, including TVs, do not produce significant electromagnetic fields, so this precaution is unnecessary for discharge teaching.

B. Avoid large sports fields: Open outdoor areas pose no electromagnetic risk to pacemakers. There is no evidence that sports fields interfere with device function, so this option does not represent appropriate safety guidance.

C. Do not stand near a microwave oven: Modern microwave ovens are shielded and safe for clients with pacemakers. Avoidance is outdated and unnecessary, and providing this instruction may increase anxiety without clinical value.

D. Monitor your pulse daily: Daily pulse monitoring is essential to detect pacemaker malfunction, such as failure to capture or pace. Tracking pulse changes helps the client identify abnormalities early and promotes timely reporting for follow-up care.

A. Ventricular fibrillation and pulseless ventricular tachycardia: Both of these rhythms are considered shockable because they result in no effective cardiac output and can rapidly lead to death. Defibrillation delivers an unsynchronized electrical shock to depolarize the myocardium and restore a perfusing rhythm.

B. Ventricular fibrillation and pulseless electrical activity: Pulseless electrical activity is not a shockable rhythm. It involves organized electrical activity without mechanical cardiac output, so defibrillation is ineffective. Treatment focuses on CPR and addressing the underlying cause rather than delivering a shock.

C. Ventricular fibrillation and asystole: Asystole represents a flatline with no electrical or mechanical activity and is not shockable. Defibrillation will not restart cardiac activity; instead, CPR and pharmacologic interventions are prioritized. Only ventricular fibrillation in this pair is shockable.

D. Pulseless ventricular tachycardia and atrial fibrillation: Pulseless ventricular tachycardia is shockable, but atrial fibrillation is not typically treated with emergent defibrillation unless the patient is unstable and requires synchronized cardioversion. Atrial fibrillation is generally managed with rate or rhythm control, not immediate defibrillation.