A nurse is providing teaching to a client who has a new permanent pacemaker. Which of the following statements by the client indicates an understanding of the teaching?

"I will hold my cellphone on the opposite side of the pacemaker."

"I can resume physical activity within 2 weeks."

"I need to cover my pacemaker with a dressing when I shower."

"I should avoid using a microwave oven."

Answer and Explanation

The Correct Answer is A

A. "I will hold my cellphone on the opposite side of the pacemaker.": Cellphones emit electromagnetic signals that can interfere with pacemaker function if held directly over the device. Keeping the phone on the opposite side minimizes the risk of interference and ensures proper pacemaker function.

B. "I can resume physical activity within 2 weeks.": Strenuous physical activity should be avoided for about 4-6 weeks to allow proper healing of the pacemaker site. Early resumption of activity can lead to lead dislodgement or complications.

C. "I need to cover my pacemaker with a dressing when I shower.": After the initial post-procedure period, there is no need to keep the pacemaker site covered while showering. The incision should be kept dry until it fully heals, but a permanent dressing is unnecessary.

D. "I should avoid using a microwave oven.": Modern pacemakers are shielded against microwave interference, making it safe to use a microwave. This is a common misconception, as older pacemakers were more susceptible to electrical interference.

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Correct Answer is A

Explanation

A. Obtain bottles of warm, sterile 0.9% sodium chloride solution: Evisceration requires immediate coverage of the exposed organs with sterile, saline-moistened dressings to prevent drying and infection. Using warm saline helps maintain tissue viability and minimizes damage.

B. Apply a firm pressure dressing across the client's abdomen: A firm pressure dressing is inappropriate, as it could cause further damage to the eviscerated organs and increase intra-abdominal pressure, leading to ischemia or perforation.

C. Attempt to reinsert the protruding viscera: Reinserting the eviscerated organs is contraindicated due to the high risk of contamination, trauma, and further complications. The nurse should instead protect the organs with moist dressings and prepare the client for emergency surgery.

D. Place the client in left lateral recumbent position: The client should be placed in a low Fowler’s position with knees slightly flexed to reduce tension on the abdominal wound and prevent further protrusion of organs. A left lateral recumbent position does not provide the same benefit.

A. Thalassemia B. Rheumatoid arthritis C. Thrombocytopenia D. COPD

Correct Answer is C

Explanation

A. Thalassemia: A genetic blood disorder affecting hemoglobin production. While patients with severe anemia may have an increased bleeding risk, thalassemia itself is not a contraindication to heparin. Caution is needed if the patient has splenomegaly or significant anemia.

B. Rheumatoid arthritis: An autoimmune condition that can increase bleeding risk due to chronic inflammation and medication use, such as NSAIDs or corticosteroids. However, heparin is not contraindicated unless there is an associated bleeding disorder or severe thrombocytopenia.

C. Thrombocytopenia: A condition characterized by a low platelet count, significantly increasing the risk of bleeding. Heparin use can worsen this condition, especially in cases of heparin-induced thrombocytopenia (HIT), which can lead to both bleeding and thrombosis.

D. COPD: A chronic lung disease that does not directly contraindicate heparin therapy. While COPD patients may be at risk for deep vein thrombosis due to immobility, heparin remains a standard prophylactic treatment unless there are other bleeding risks.

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A nurse is providing teaching to a client who has a new permanent pacemaker. Which of the following statements by the client indicates an understanding of the teaching?

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