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 A

Explanation

A. An imaging test that uses sound waves to visualize the heart and its structures. It can help to identify abnormalities in the heart muscle, such as thickening, enlargement, or decreased contractility. Echocardiograms are a valuable tool for diagnosing cardiomyopathy and assessing the severity of the condition.
B. Cardiac enzyme studies are used to diagnose myocardial infarction (heart attack). While they can be helpful in evaluating cardiac function, they are not the most specific test for diagnosing cardiomyopathy.
C. Cardiac catheterization is an invasive procedure that is used to diagnose and treat certain heart conditions. While it can provide valuable information about the heart's function, it is not the most appropriate initial test for diagnosing cardiomyopathy.
D. This procedure is used to treat certain types of arrhythmias. It is not a diagnostic test and would not be appropriate for diagnosing cardiomyopathy.

A. Administer digoxin B. Continue to monitor the client. C. Defibrillate the client. D. Prepare for transcutaneous pacing

Correct Answer is D

Explanation

A. Digoxin is a medication used primarily to treat heart failure and certain types of arrhythmias, such as atrial fibrillation. It works by increasing the force of heart contractions and slowing the heart rate. However, digoxin is not typically used to treat bradycardia and may actually exacerbate the condition by further slowing the heart rate.
B. While monitoring is an essential part of patient care, it is not sufficient alone in this situation. The client’s heart rate is very low (45 beats per minute) and their blood pressure is low (82/60 mm Hg), which suggests they are symptomatic and potentially unstable.
C. Defibrillation is used to treat life-threatening arrhythmias such as ventricular fibrillation or pulseless ventricular tachycardia. It is not used for sinus bradycardia, which is a slow heart rate rather than a rapid, disorganized rhythm requiring electrical shock.

D. Transcutaneous pacing involves applying external pacing pads to the skin to stimulate the heart and increase the heart rate. This is a suitable intervention for symptomatic bradycardia, especially when accompanied by low blood pressure and dizziness.

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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?

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Naxlex Comprehensive Predictor Exams

A patient is admitted with suspected cardiomyopathy. What diagnostic test would be most helpful with the identification of this disorder?

Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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