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?

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.

Choice A reason: Fried chicken and mashed potatoes are high in fat and carbohydrates, which may provide energy but lack balanced nutrition. Milk offers protein, but the meal’s high caloric density may not suit the client’s hyperactive state, requiring lighter, nutrient-dense options.

Choice B reason: A peanut butter sandwich, chips, and cola are high in fat and sugar, providing quick energy but lacking balanced nutrients. Cola’s caffeine may exacerbate mania, increasing agitation, making this meal less suitable for a manic client’s nutritional needs.

Choice C reason: A turkey sandwich, cheese slices, and milk provide balanced protein, carbohydrates, and calcium, supporting energy needs during mania’s hyperactive state. Milk avoids caffeine, which could worsen agitation, making this meal ideal for nutritional balance and calming effects.

Choice D reason: Spaghetti, garlic bread, and salad are nutritious but carbohydrate-heavy, potentially causing energy spikes and crashes in manic clients. Tea may contain caffeine, increasing agitation, making this meal less optimal than a balanced, low-stimulant option.