RN Nursing · Dysrhythmias · Practice question
The nurse is providing discharge teaching to a client with a permanent pacemaker. Which statement indicates understanding?
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"I can continue to have MRIs for my back pain."
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"I should avoid standing near microwave ovens."
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✓
"I need to check my pulse every day and report any significant changes."
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"I will never be able to use a cell phone again."
Answer & explanation
Correct: "I need to check my pulse every day and report any significant changes."
Daily pulse monitoring is an essential component of permanent pacemaker self-care. The client should check the pulse at the same time each day and report a rate lower than the pacemaker's programmed rate, irregular rhythms, or other significant changes to the provider, as these can indicate pacemaker malfunction. This statement correctly reflects an understanding of safe pacemaker management. Stating the ability to continue having MRIs is incorrect because traditional pacemakers are generally contraindicated for standard MRI due to the strong magnetic field, which can interfere with the device; newer MRI-conditional devices require specific protocols. Avoiding microwave ovens is outdated advice; modern pacemakers are shielded against household microwaves, which do not pose a significant risk. Stating that cell phone use must be permanently avoided is also inaccurate; clients should be instructed to keep cell phones at least six inches from the pacemaker site and to hold them to the ear on the opposite side, but use is not prohibited. Only the daily pulse-checking statement represents accurate, current patient teaching for pacemaker recipients.
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