Question

MetroPCS LTE 1:07 AM dl-mail.ymail.com Final Conduction problems of The heat 1. A patient, Janis Smith 24, who received a permanent atrioventricular pacemaker for the diagnosis of sick sinus rhythm, a disorder that leads to periods of tachycardia and periods of extreme bradycardia or sinus arrest. The nurse received the end-of-shift report and arrives at Ms. Smiths's room where she assesses the patient's incision dressing on the upper left chest and it is dry. The patient's left arm is edematous and ecchymotic and twice the size The patient states that her left arm feels numb and tingling. The distal pulses are present and at baseline. None of the findings weree noted in the end-of-shift report. the other arm What nursing management should the nurse provide immediately? Explain the general care of the patient after receiving an implanted pacemaker.

Answer 1

A. The nurse should immediately keep the arm on the side of pacemaker higher than the head and should inform the physician regarding the condition of the patient.

B. Care to be given to the patient after receiving an implanted pacemaker are :-

-Prophylacticantibiotic therapy

-Post CXR: pacer location, pneumothorax

-Assessment of insertion site for bleeding

-EKG monitoring: firing, capture, sensing

-Bedrest until stable

-Minimal arm and shoulder activity; avoid lifting arm over shoulder level for 1 week or per physician orders

-Monitor for bleeding and infection

#. Discharge teaching should be done for someone that just had a pacemaker implanted

-Follow-up care - MD appts, interrogation, phone checks

-Watch for infection

Keep incision dry for 4 days

-Avoid lifting arm above shoulder level until HCP approves

-Avoid direct blows to site

-Avoid MRI

-Microwaves safe

-Antitheft devices in stores airport security alarm

-Monitor pulse - have parameters per MD; should not be below set rate

-Carry pacemaker info card at all times.

-Medic Alert ID or bracelet