A nurse is reinforcing teaching with an older adult client who has had a newly inserted permanent pacemaker. Which of the following manifestations should the nurse include in the teaching as a pacemaker malfunction that the client should report to the provider?

Fatigue

Increased urine output

Sneezing

Rapid pulse

Answer and Explanation

The Correct Answer is A

A. Fatigue: Fatigue may indicate that the pacemaker is not working effectively to maintain an appropriate heart rate and cardiac output, which can lead to symptoms such as weakness or tiredness.

B. Increased urine output: Increased urine output is not typically a sign of pacemaker malfunction. It could be related to other conditions but not directly linked to pacemaker issues.

C. Sneezing: Sneezing is not related to pacemaker function and would not indicate a malfunction.

D. Rapid pulse: A rapid pulse may occur in other cardiac conditions but is not commonly associated with pacemaker malfunction unless it is sustained and irregular.

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Correct Answer is A

Explanation

A. Potassium 2.3 mEq/L (3.5-5.0): This is a severely low potassium level (hypokalemia), which can cause dangerous arrhythmias, especially in a client with heart failure. Bumetanide is a loop diuretic, which can deplete potassium levels.

B. Magnesium 1.4 mEq/L (1.3-2.1): Although the magnesium level is on the lower end of normal, it is not a critical value, and the primary concern here is the potassium level.

C. Calcium 10 mg/dL (9.9-10.5): This is a normal calcium level, so there is no need to notify the provider based on this result.

D. Sodium 136 mEq/L (136-145): This is a normal sodium level, so it would not warrant notifying the provider. The critical concern is the hypokalemia.

A. Low sodium diet B. Physical therapy C. MRI of the chest D. Serum cardiac enzyme levels

Correct Answer is C

Explanation

A. Low sodium diet: A low sodium diet is generally beneficial for clients with heart disease or hypertension and poses no risk to a client with a pacemaker.

B. Physical therapy: Physical therapy can help improve mobility and strength and is safe for clients with pacemakers, though the affected arm should be limited initially.

C. MRI of the chest: MRI is contraindicated for clients with most types of pacemakers due to the risk of interference with the pacemaker’s function. Newer MRI-compatible pacemakers are available, but this should be clarified with the provider.

D. Serum cardiac enzyme levels: Checking serum cardiac enzymes is standard for clients with a history of heart disease or chest pain and poses no risk to pacemaker function.

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A nurse is reinforcing teaching with an older adult client who has had a newly inserted permanent pacemaker. Which of the following manifestations should the nurse include in the teaching as a pacemaker malfunction that the client should report to the provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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