A nurse is providing teaching about preventing mastitis to a client who is postpartum and breastfeeding her newborn. Which of the following Instructions should the nurse include?

- A: A heart rate greater than 60/min indicates that the transcutaneous pacing is effectively maintaining a heart rate within a normal range, which is crucial for adequate cardiac output and systemic perfusion.
- B: While 2+ pedal pulses indicate good peripheral perfusion, they do not directly reflect the effectiveness of transcutaneous pacing in treating complete heart block.
- C: Pacer spikes should appear before the QRS complex to show that the pacing stimulus is being delivered appropriately. Spikes after the QRS complex suggest that the pacing is not capturing the heart effectively.
- D: Distended jugular veins would be more indicative of heart failure or fluid overload and do not directly relate to the effectiveness of pacing therapy.

A. The child develops a dry, hacking cough: This suggests ineffective clearance of secretions and may indicate a need for further intervention.

B. The child has increased nasal secretions: Nasal secretions are not directly related to the effectiveness of high-frequency chest compressions in clearing pulmonary secretions.

C. The child has increased sputum production: Increased sputum production indicates that the

treatment is effectively mobilizing and clearing mucus from the airways, which is beneficial for a child with cystic fibrosis.

D. The child develops diminished breath sounds: Diminished breath sounds could indicate a complication such as atelectasis or pneumothorax and would not be an expected finding with effective high-frequency chest compressions.