The nurse is caring for a client who has just had a pacemaker inserted. Which action should the nurse include in the initial plan of care?

Apply warm compresses to site of the client's pacemaker insertion

Teach the client to avoid being near any type of household microwave oven

Ambulate the client as soon as possible to evaluate function of pacemaker.

Instruct client to limit movement of arm on side where pacemaker inserted.

Answer and Explanation

The Correct Answer is D

A. Apply warm compresses to site of the client's pacemaker insertion: Heat application is contraindicated as it may increase swelling or risk infection.

B. Teach the client to avoid being near any type of household microwave oven: Modern pacemakers are shielded, so microwaves do not interfere with their function.

C. Ambulate the client as soon as possible to evaluate pacemaker function: While early ambulation is encouraged, pacemaker function is not evaluated through ambulation.

D. Instruct client to limit movement of the arm on side where pacemaker was inserted: Limiting arm movement prevents dislodging the pacemaker leads during the healing phase.

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Correct Answer is B

Explanation

A. Sinus rhythm with first-degree heart block: This rhythm is characterized by a regular sinus rhythm with a prolonged PR interval (greater than 0.20 seconds), indicating a first-degree heart block.

B. ST-segment elevation myocardial infarction (STEMI): STEMI is indicated by significant ST-segment elevation in specific leads, showing acute myocardial infarction.

C. Atrial fibrillation: Atrial fibrillation shows an irregularly irregular rhythm without distinct P waves.

D. Ventricular tachycardia: Ventricular tachycardia is a rapid heart rhythm originating from the ventricles, with wide QRS complexes and no preceding P waves.

A. First degree heart block B. Second degree heart block C. Bundle branch block D. Sinus arrhythmia

Correct Answer is A

Explanation

A. First-degree heart block: A prolonged PR interval greater than 0.20 seconds, as seen in this case, indicates first-degree heart block, which is a delay in conduction at the AV node.

B. Second-degree heart block. Second-degree heart block is characterized by some PR intervals being prolonged with occasional dropped beats (non-conducted P waves).

C. Bundle branch block. Bundle branch block causes a wide QRS complex (greater than 0.12 seconds), which is not seen here.

D. Sinus arrhythmia. Sinus arrhythmia involves changes in heart rate due to respiratory cycles, not prolonged PR intervals.

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The nurse is caring for a client who has just had a pacemaker inserted. Which action should the nurse include in the initial plan of care?

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