Which intervention by a new nurse who is caring for a patient who ...

[captainjonesify]

Which intervention by a new nurse who is caring for a patient who has just had an implantable cardioverter-defibrillator (ICD) inserted indicates a need for more education about care of patients with ICDs?
 
  a. The nurse assists the patient to do active range of motion exercises for all extremities.
  b. The nurse assists the patient to fill out the application for obtaining a Medic Alert ID.
  c. The nurse gives amiodarone (Cordarone) to the patient without first consulting with the health care provider.
  d. The nurse teaches the patient that sexual activity usually can be resumed once the surgical incision is healed.

Question 2

After providing a patient with discharge instructions on the management of a new permanent pacemaker, the nurse knows that teaching has been effective when the patient states
 
  a. I will avoid cooking with a microwave oven or being near one in use.
  b. It will be 1 month before I can take a bath or return to my usual activities.
  c. I will notify the airlines when I make a reservation that I have a pacemaker.
  d. I won't lift the arm on the pacemaker side up very high until I see the doctor.

[vish98]

Answer to Question 1

ANS: A
The patient should avoid moving the arm on the ICD insertion site until healing has occurred in order to prevent displacement of the ICD leads. The other actions by the new nurse are appropriate for this patient.

Answer to Question 2

ANS: D
The patient is instructed to avoid lifting the arm on the pacemaker side above the shoulder to avoid displacing the pacemaker leads. The patient should notify airport security about the presence of a pacemaker before going through the metal detector, but there is no need to notify the airlines when making a reservation. Microwave oven use does not affect the pacemaker. The insertion procedure involves minor surgery that will have a short recovery period.