A nurse is caring for a client who recently had surgery for insertion of a permanent pacemaker. Which of the following prescriptions should the nurse clarify?

Physical therapy

Low-sodium diet

MRI of the chest

Serum cardiac enzyme levels

Answer and Explanation

The Correct Answer is C

A. Physical therapy is generally appropriate and beneficial post-surgery for mobility and rehabilitation.
B. A low-sodium diet is often recommended for heart health but is not specific to pacemaker insertion.
C. MRI of the chest should be clarified because the magnetic fields from MRI machines can interfere with the pacemaker’s function.
D. Serum cardiac enzyme levels are relevant for monitoring heart function and are appropriate.

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Correct Answer is D

Explanation

A. An arteriovenous fistula is used for dialysis, not for long-term antibiotic therapy.
B. An implanted infusion port is suitable for long-term therapy but is typically used for medications that require infusions over weeks or months rather than prolonged IV therapy.
C. A short peripheral catheter is not appropriate for extended therapy due to the risk of thrombophlebitis and infiltration.
D. A peripherally inserted central catheter (PICC) is appropriate for long-term intravenous antibiotic therapy as it provides reliable access and reduces the risk of complications associated with extended peripheral catheter use.

A. Potassium 7.0 mEq/L (3.5 to 5 mEq/L) B. WBC count 17,000/mm3 (Normal Finding: 5,000 to 10,000/mm3) C. Crackles throughout lungs D. Creatinine 3.0 mg/dL (0.5 to 1.3 mg/dL) E. Abdomen rigid with decreased bowel sounds F. Glucose 250 mg/dL G. No dialysis for 24 hr H. Hemoglobin 10 g/dL (12 to 18 g/dL) Nausea

Correct Answer is ["A","B","C","H"]

Explanation

A. Potassium 7.0 mEq/L (3.5 to 5 mEq/L): Elevated potassium levels (hyperkalemia) can cause life-threatening cardiac arrhythmias and are especially concerning in clients with chronic kidney disease who are at risk of renal complications. Immediate follow-up is crucial to prevent severe cardiac effects.

B. WBC count 17,000/mm³ (Normal Finding: 5,000 to 10,000/mm³): An elevated WBC count indicates an infection or inflammation, which is concerning given the client’s symptoms and temperature. This finding requires immediate follow-up to address potential infection.

C. Crackles throughout lungs: Crackles may indicate fluid overload or pulmonary edema, particularly in clients with chronic kidney disease. This could be a sign of worsening renal function or heart failure, which requires prompt attention.

H. No dialysis for 24 hr: Missing dialysis sessions in a client with stage IV chronic kidney disease can lead to dangerous fluid and electrolyte imbalances. This finding requires immediate action to prevent complications related to renal failure.

Explanation of Incorrect Options:

E. Creatinine 3.0 mg/dL (0.5 to 1.3 mg/dL): While elevated creatinine levels are concerning, the client’s history of chronic kidney disease means this level is expected to be higher. However, it is not as immediately critical as the other findings.

F. Abdomen rigid with decreased bowel sounds: This may suggest abdominal complications but is not as immediately critical as issues related to hyperkalemia or infection.

G. Glucose 250 mg/dL: Elevated glucose levels are concerning but less immediately critical compared to severe electrolyte imbalances and potential infections.

H. Hemoglobin 10 g/dL (12 to 18 g/dL): Anemia is a concern but is not as urgent as the immediate risks posed by elevated potassium, signs of infection, or missed dialysis.

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A nurse is caring for a client who recently had surgery for insertion of a permanent pacemaker. Which of the following prescriptions should the nurse clarify?

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