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 A

Explanation

A. 3% hypertonic saline: In SIADH, the body holds onto too much water, leading to dilutional hyponatremia. Hypertonic saline helps to slowly raise the sodium level and correct the dilution.

B. Normal saline solution: Normal saline (0.9%) would not be effective for SIADH as it is isotonic and would not correct the sodium imbalance.

C. Dextrose 5% in water: This would not be appropriate, as it contains free water and could exacerbate hyponatremia in a client with SIADH.

D. Lactated Ringers: This is an isotonic solution and would not effectively address the dilutional hyponatremia caused by SIADH.

A. Intracranial pressure (ICP) is now 15. B. The patient voids 250 mL over 2 hours. C. The patient's pupils are dilated and sluggish. D. Seizure behavior is absent.

Correct Answer is A

Explanation

A. Intracranial pressure (ICP) is now 15: Mannitol is an osmotic diuretic used to reduce intracranial pressure (ICP). The intended effect of the medication is to lower ICP. A decrease in ICP to 15 mmHg is within the normal range and indicates the medication has worked effectively.

B. The patient voids 250 mL over 2 hours is incorrect. While mannitol promotes diuresis, the amount of urine output alone does not directly indicate a reduction in ICP. The goal is to lower ICP, which is best assessed by measuring the ICP itself.

C. The patient's pupils are dilated and sluggish is incorrect. Dilated and sluggish pupils can be a sign of increased ICP, not a response to effective treatment.

D. Seizure behavior is absent is incorrect. While mannitol can help reduce ICP and potentially prevent seizures, the absence of seizure behavior is not a direct indicator of the medication's effect on ICP.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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