A patient with a sinus node dysfunction has a permanent pacemaker inserted. Before discharge, what should the nurse include when teaching the patient?

Avoid direct blows to the chest.

Start lifting the arm above the shoulder right away to prevent a "frozen shoulder".

Avoid cooking with microwave ovens.

Use mild analgesics to control the chest spasms caused by the pacing current.

Answer and Explanation

The Correct Answer is A

A.   The pacemaker and its leads are implanted in the chest area, and direct blows or trauma to this area can potentially dislodge the leads or damage the pacemaker. Patients should be advised to avoid activities that could result in trauma to the chest to protect the pacemaker and ensure its proper function.
B.   Patients are generally advised to avoid lifting the arm on the side of the pacemaker above shoulder level for a period (usually about 4-6 weeks) to prevent complications and ensure proper healing. Early lifting of the arm might dislodge the pacemaker leads or cause other issues. Exercises and range-of- motion activities are typically started under guidance once the initial healing period is over.

C.   Modern pacemakers are designed to be shielded against common household electrical appliances, including microwave ovens. Patients with pacemakers do not need to avoid using microwave ovens, as there is no significant risk of interference from these devices.
D.   Mild analgesics might be used for discomfort or pain in some cases, but the notion that chest spasms are caused by the pacing current is generally incorrect. Pacemakers are designed to be non-intrusive and should not cause spasm-like sensations if functioning correctly.

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Correct Answer is C

Explanation

A. Continuous antibiotic therapy is not typically recommended for preventing recurrence of endocarditis. Instead, endocarditis prophylaxis involves administering antibiotics only before certain invasive procedures that have a risk of introducing bacteria into the bloodstream.
B. Taking aspirin is not a recommended strategy for preventing endocarditis or vegetative lesions on heart valves. The formation of vegetative lesions in endocarditis is related to the presence of infection and not typically prevented by aspirin.
C. This is the correct recommendation for preventing recurrence of endocarditis. Prophylactic antibiotics are recommended before certain invasive procedures, such as dental work or surgery, to prevent bacteria from entering the bloodstream and causing endocarditis. This is especially important for patients with prosthetic heart valves, a history of endocarditis, or certain congenital heart defects.
D. Starting antibiotic therapy based on exposure to persons with infections is not a standard or effective strategy for preventing endocarditis. The focus of endocarditis prevention is on specific prophylaxis before high-risk procedures rather than general antibiotic use based on exposure to infected individuals.

A. The patient had a recent upper respiratory infection. B. The patient has a family history of coronary artery disease. C. The patient's 29-yr-old brother died from a sudden cardiac arrest. D. The patient reports using cocaine "a few times" as a teenager.

Correct Answer is C

Explanation

A. While a recent upper respiratory infection might be relevant to overall health and could potentially influence cardiac symptoms, it is not as directly pertinent to the management of hypertrophic cardiomyopathy. HCM is primarily a genetic condition affecting the heart muscle, and a recent infection does not significantly impact the primary concerns related to HCM.
B. A family history of coronary artery disease (CAD) can be relevant, but it is less directly related to hypertrophic cardiomyopathy than other factors. CAD involves the narrowing or blockage of coronary arteries and can lead to other cardiac issues, but HCM is more specifically associated with genetic factors and structural heart abnormalities rather than CAD.
C. This information is very important for planning care for the patient with hypertrophic cardiomyopathy. A family history of sudden cardiac death, particularly at a young age, raises significant concerns about the genetic nature of the condition and the potential for similar outcomes.
D. Cocaine use can have serious cardiovascular effects and might contribute to other heart issues, but its relevance in the context of hypertrophic cardiomyopathy is less direct. While substance abuse is a concern, it is not as critical in understanding or managing the risk associated with HCM compared to a family history of sudden cardiac arrest.

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A patient with a sinus node dysfunction has a permanent pacemaker inserted. Before discharge, what should the nurse include when teaching the patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What should the nurse teach the patient who has endocarditis about preventing recurrence of the infections?

Correct Answer is C

Explanation

The nurse is obtaining a health history from a 24-year-old patient with hypertrophic cardiomyopathy. Which information obtained by the nurse is most important in planning care?

Correct Answer is C

Explanation

A nurse is teaching a client who is postoperative following the insertion of a permanent pacemaker. Which of the following instructions should the nurse include? (Select all that apply.)

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The nurse obtains a health history from an older adult with a prosthetic mitral valve who has symptoms of infective endocarditis (IE). Which question by the nurse helps identify a risk factor for IE?

A nurse is caring for a client who has infective endocarditis. Which of the following manifestations is the priority for the nurse to monitor for?

A patient has been diagnosed with a 4cm abdominal aortic aneurysm. Which of the following conditions would indicate surgical intervention may be necessary?

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