ECG Question #16
A client is being discharged following insertion of a permanent pacemaker. The nurse determines that the client requires further instruction on safety precaution after the following statement:
- “I will avoid having radiological Magnetic Resonance Imaging”
- “I understand that initially, the site may be slightly bruised, swollen, and tender”
- “I can lift the farm gate that weighs 20 pounds once I get home and settled”
- “I will not raise my affected arm close to the site above the level of my heart for the first couple of weeks.”
A new pacemaker requires limitation of physical activity, including no lifting, pulling, or pushing more than 5 pounds. Other limitations include limiting tasks like sweeping in repetitive motions, keeping the area free from pressure (such as tight clothing or suspenders), and not raising the arm on the affected side above the level of the heart for the first few weeks. The pacemaker insertion site may be bruised, swollen, tender, and instructions may include gentle washing of incision site, and not applying lotion or powder. MRIs should be avoided as the strength of the magnet in the device would cause the pacemaker to malfunction.