The nurse is caring for a client with a permanent biventricular pacemaker. What should the nurse include in the discharge teaching?

Avoid use of the microwave for three months

Use cellular phone sparingly

Resume outdoor activities in two days

No heavy lifting for two months

Answer and Explanation

The Correct Answer is D

A) Avoid use of the microwave for three months:
Microwaves do not interfere with pacemaker function. Modern pacemakers are designed to be resistant to electromagnetic interference from household devices like microwaves. Therefore, there is no need to avoid microwave use. The nurse should focus on other areas of safety that are more pertinent to the functioning of the pacemaker.

B) Use cellular phone sparingly:
Cellular phones generally do not interfere with the operation of most modern pacemakers. The nurse may advise the client to avoid holding a mobile phone directly over the pacemaker (i.e., on the chest) for prolonged periods, but there is no need to avoid using the phone entirely. Current guidelines suggest using the phone on the opposite ear from the side of the pacemaker if concerned, but the phone itself does not pose a significant risk.

C) Resume outdoor activities in two days:
Although outdoor activities may be safe after some time, the client should avoid strenuous physical activity or exercise for a period after receiving a pacemaker. The recommended rest period after pacemaker placement typically ranges from several days to a few weeks, depending on the individual and the procedure. However, resuming outdoor activities like walking or mild exercise is often appropriate earlier than two days, but not in all cases, and should be guided by the healthcare provider.

D) No heavy lifting for two months:
After the insertion of a biventricular pacemaker (which is often used in cases of heart failure), the patient should avoid heavy lifting and strenuous activities for at least 6-8 weeks to allow the lead wires to properly stabilize within the heart and to reduce the risk of dislodging the pacemaker leads. Lifting objects heavier than 10-15 pounds (4.5-7 kg) can strain the chest muscles and disrupt pacemaker lead placement.

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Correct Answer is ["90"]

Explanation

Given:

Ordered dose of Alteplase: 0.9 mg/kg

Client weight: 220 pounds

Step 1: Convert the client's weight from pounds to kilograms:

1 pound (lb) = 0.453592 kilograms (kg)

Client weight in kg = 220 lbs x 0.453592 kg/lb = 99.76824 kg

Step 2: Calculate the total dose of Alteplase:

Total dose (mg) = Ordered dose (mg/kg) xClient weight (kg)

Total dose (mg) = 0.9 mg/kg x 99.76824 kg

Total dose (mg) = 89.801416 mg

Step 3: Round to the nearest whole number:

Total dose (mg) ≈ 90 mg

A. Measure heart chamber pressures to assess for heart failure B. Determine cardiac output during the procedure. C. Evaluate the extent of the occlusion of the coronary arteries involved D. Prevent extensive myocardial damage

Correct Answer is D

Explanation

A) Measure heart chamber pressures to assess for heart failure:
Measuring heart chamber pressures is an important diagnostic tool in assessing heart failure, but it is not the primary goal in the case of a STEMI (ST-Elevation Myocardial Infarction). In STEMI, the primary goal is to identify and treat the blockage in the coronary arteries that is causing the heart attack.

B) Determine cardiac output during the procedure:
Cardiac output is a useful measurement for assessing heart function, but it is not the main focus during the treatment of STEMI. While monitoring cardiac output may be part of the overall care, the urgent priority in STEMI management is to restore blood flow to the affected myocardial tissue as quickly as possible to minimize damage, not to measure cardiac output.

C) Evaluate the extent of the occlusion of the coronary arteries involved:
While evaluating the extent of coronary artery occlusion is part of the process during a cardiac catheterization, the immediate priority for a patient with STEMI is to treat the blockage, not just evaluate it. While the angiogram will reveal the blockage, the treatment goal is to restore perfusion to the affected area of the heart through procedures such as balloon angioplasty or stent placement.

D) Prevent extensive myocardial damage:
This is the correct answer. The main goal of treatment for STEMI is to prevent extensive myocardial damage. In a STEMI, the coronary artery is blocked, depriving the heart muscle of oxygen, which can cause significant damage or death of the myocardial tissue. The most effective way to limit the extent of damage is to restore blood flow as quickly as possible, often through emergent procedures like percutaneous coronary intervention (PCI) or fibrinolytic therapy.

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The nurse is caring for a client with a permanent biventricular pacemaker. What should the nurse include in the discharge teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with an acute stroke must receive Alteplase 0.9 mg/kg. The client weighs 220 pounds. How should the client receive? (Round to the nearest whole number, do not use trailing zeros)

Correct Answer is ["90"]

Explanation

A client admitted to the Emergency Department with a suspected STEM. The nurse anticipates that this client will be immediately prepared for the cardiac catheterization laboratory as the goal of treatment is to:

Correct Answer is D

Explanation

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