The nurse is caring for a client who is being discharged after insertion of a permanent pacemaker. The client, an avid tennis player, is scheduled to play in a tournament in one week. What teaching should the nurse provide to the client related to this activity?

You may resume all normal activity in one week; if you are used to playing tennis, you may proceed with this activity.

Cancel your tennis tournament and wait until fall; then try hockey; skating is much easier on pacemakers.

You should avoid tennis; basketball or football would be a good substitute.

You will need to cancel this activity; you must restrict arm movement above your head for two weeks.

Answer and Explanation

The Correct Answer is D

Choice A reason: Resuming vigorous activity like tennis one week post-pacemaker insertion risks lead dislodgement, as the device requires time to stabilize. Arm movements in tennis, especially overhead swings, can disrupt the pacemaker leads, making this advice unsafe and inappropriate.

Choice B reason: Suggesting hockey or skating as alternatives is incorrect, as these activities also involve significant physical exertion and risk of trauma to the pacemaker site. Additionally, delaying until fall is arbitrary, and these sports do not reduce the risk of lead dislodgement compared to tennis.

Choice C reason: Substituting tennis with basketball or football is inappropriate, as these contact sports pose a higher risk of trauma to the pacemaker site, potentially causing device malfunction or lead dislodgement. These activities are not safer alternatives and could exacerbate complications.

Choice D reason: Restricting arm movement above the head for two weeks post-pacemaker insertion prevents lead dislodgement, as the leads need time to anchor in the heart tissue. Tennis involves vigorous arm motions, so canceling the tournament is necessary to ensure device stability and client safety.

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Free Nursing Study Resources

Correct Answer is ["1.44"]

Explanation

Step 1: Calculate the total units to be given per hour: 18 × 90 = 1620 units/hour Result = 1620 units/hour

Step 2: Determine the concentration of Heparin in 1 mL: 25000 ÷ 250 = 100 units/mL Result = 100 units/mL

Step 3: Calculate the required volume in mL/hr using total units per hour: (1620 ÷ 100) = 16.2 mL/hr Result = 16.2 mL/hr

Final answer 16.2 mL/hr

Question 47

Calculate the initial bolus of Heparin. Heparin is ordered as 80 units/kg. The client weighs 90 kg. How many mL would you administer using a vial of Heparin labeled Heparin 5000 units/mL?

The correct answer is 1.44 mL

Explanation:

Step 1: Calculate the total number of units required for the bolus: 80 × 90 = 7200 units Result = 7200 units

Step 2: Use the vial concentration to find out how many mL deliver 7200 units: (7200 ÷ 5000) = 1.44 mL Result = 1.44 mL

Final answer 1.44 mL

A. Give half of the prescribed dose B. Give the full dose as ordered C. Delay the dose until the pulse is below 60 D. Omit the dose and record the pulse rate as the reason

Correct Answer is B

Explanation

Choice A reason: Giving half the dose of metoprolol is inappropriate without a medical order, as it may reduce therapeutic efficacy. The client’s vital signs (BP 132/78, HR 86) are stable, indicating no need to alter the prescribed dose, which is intended to manage hypertension and heart failure.

Choice B reason: Metoprolol, a beta-blocker, reduces heart rate and blood pressure in hypertension and heart failure. The client’s vital signs (BP 132/78, HR 86) are within acceptable ranges, indicating the full 25 mg dose is safe and appropriate to maintain therapeutic control of their condition.

Choice C reason: Delaying the dose until the pulse is below 60 is unnecessary, as the client’s heart rate of 86 is not bradycardic. Metoprolol is indicated for heart rates above 60 in heart failure and hypertension, and withholding it could worsen blood pressure control.

Choice D reason: Omitting the dose due to a pulse of 86 is inappropriate, as this heart rate is not dangerously low. Metoprolol is prescribed to manage hypertension and heart failure, and withholding it without clinical justification could lead to uncontrolled symptoms or disease progression.

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The nurse is caring for a client who is being discharged after insertion of a permanent pacemaker. The client, an avid tennis player, is scheduled to play in a tournament in one week. What teaching should the nurse provide to the client related to this activity?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Calculate the initial rate for a Heparin infusion. The infusion is ordered as 18 units/kg/hr. The client weighs 90 kg. The concentration of the Heparin bag is 25,000 units/250 mL. You are administering the Heparin drip via an electronic infusion device. Calculate the infusion rate in mL/hr.

Correct Answer is ["1.44"]

Explanation

A nurse is preparing to administer metoprolol 25 mg PO to a client with a history of hypertension and heart failure. The client’s vital signs are: BP 132/78 mm Hg, HR 86 beats per minute, and respiratory rate 18 breaths per minute. Which action should the nurse take?

Correct Answer is B

Explanation

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