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Chapter 1: Problem 18

The nurse is assisting the RN with discharge instructions for a client with an implantable defibrillator. What discharge instruction is essential? A. "You cannot eat food prepared in a microwave." B. "You should avoid moving the shoulder on the side of the pacemaker site for 6 weeks." C. "You should use your cellphone on your right side." D. "You will not be able to fly on a commercial airliner with the defibrillator in place."

Short Answer

Expert verified
The essential discharge instruction for a client with an implantable defibrillator is to avoid moving the shoulder on the side of the pacemaker site for 6 weeks. This allows the incision to heal and helps prevent dislodging the leads connecting the heart to the device.

Step by step solution

01

Option A

"You cannot eat food prepared in a microwave." This instruction is not essential for a client with an implantable defibrillator. Microwave ovens do not interfere with the functioning of an implantable defibrillator. Therefore, this statement is not correct and can be disregarded.
02

Option B

"You should avoid moving the shoulder on the side of the pacemaker site for 6 weeks." This instruction is essential for a client with an implantable defibrillator. Restricting movement of the shoulder on the side of the device allows the incision to heal and helps prevent dislodging the leads connecting the heart to the device. Thus, this is a crucial discharge instruction for the client.
03

Option C

"You should use your cellphone on your right side." Using a cellphone on the right side is a helpful recommendation for clients with an implantable defibrillator. Though not necessarily essential, it can help minimize the possibility of interference with the device, especially if the device is implanted on the left side of the chest.
04

Option D

"You will not be able to fly on a commercial airliner with the defibrillator in place." This statement is not correct. Clients with implantable defibrillators can indeed travel on commercial airlines. However, they should inform airport security about the device and request a manual search instead of going through metal detectors or full-body scanners to avoid potential interference with the defibrillator. Based on the analysis of the options, the essential discharge instruction is:
05

Correct Answer

B. "You should avoid moving the shoulder on the side of the pacemaker site for 6 weeks."

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Key Concepts

These are the key concepts you need to understand to accurately answer the question.

Nursing Care
Nursing care for patients with an implantable defibrillator is centered around ensuring safety and promoting adequate healing post-procedure. A fundamental aspect of this care involves educating patients about how to manage their daily activities while preventing complications. The nurse's role includes monitoring the patient's recovery, observing for any signs of infection at the incision site, and providing support and reassurance during the emotional adjustment to living with a heart device.
Patient Education
Patient education is critical to the success of any treatment plan involving an implantable defibrillator. It includes teaching patients about the importance of following the restrictions on shoulder movement, the use of electronic devices, and understanding the sensations they might feel when the defibrillator functions. For example, patients should be taught to recognize and respond to signs of a potential device malfunction or complications. Clarity on activity levels, incision care, and follow-up appointments is also essential.
Postoperative Instructions
After the implantation of a defibrillator, there are specific postoperative instructions that must be communicated clearly to the patient. These typically include limiting the movement of the affected arm to avoid dislodging the leads, keeping the incision dry and clean, and recognizing symptoms that necessitate prompt medical attention. These instructions help to prevent complications, such as lead displacement or infection, that can impact the device's efficacy and patient health.
Medical-Surgical Nursing
Medical-surgical nursing, especially in the context of implantable defibrillators, involves a holistic approach to patient care that integrates the technical knowledge of the surgical procedure with a compassionate understanding of the patient's needs. Nurses must be adept at managing physical health, such as wound care, and also addressing the psychosocial aspects, including the patients' concerns about living with an internal medical device. A key part of medical-surgical nursing care in this scenario is ensuring the patient has the necessary resources, support, and information to manage their health post-discharge effectively.

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Most popular questions from this chapter

A new diabetic is learning to administer his insulin. He receives \(10 \mathrm{U}\) of \(\mathrm{NPH}\) and \(12 \mathrm{U}\) of regular insulin each morning. Which of the following statements reflects understanding of the nurse's teaching? A. "When drawing up my insulin, I should draw up the regular insulin first." B. "When drawing up my insulin, I should draw up the NPH insulin first." C. "It doesn't matter which insulin I draw up first." D. "I cannot mix the insulin, so I will need two shots."

The client is receiving heparin for thrombophlebitis of the left lower extremity. Which of the following drugs reverses the effects of heparin? A. Cyanocobalamine B. Protamine sulfate C. Streptokinase D. Sodium warfarin

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A client with suspected renal disease is to undergo a renal biopsy. The nurse plans to include which statement in the teaching session? A. "You will be sitting for the examination procedure." B. "Portions of the procedure will cause pain or discomfort." C. "You will be given some medication to anesthetize the area." D. "You will not be able to drink fluids for 24 hours before the study."

A new nursing graduate indicates in charting entries that he is a licensed practical nurse, although he has not yet received the results of the licensing exam. The graduate's action can result in what type of charge: A. Fraud B. Tort C. Malpractice D. Negligence
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