Page 1692 - Saunders Comprehensive Review For NCLEX-RN

h. Instruct the client on activities to avoid,
including contact sports, to prevent
trauma to the AICD generator and lead
wires.
i. Report any fever, redness, swelling, or
drainage from the insertion site.
j. Report symptoms of fainting, nausea,
weakness, blackouts, and rapid pulse
rates to the PHCP.
k. During shock discharge, the client may
feel faint or short of breath.
l. Instruct the client to sit or lie down if
she or he feels a shock and to notify the
PHCP.
m. Advise the client to maintain a log of
the date, time, and activity preceding
the shock; the symptoms preceding the
shock; and postshock sensations.
n. Instruct the client and family in how to
access the emergency medical system.
o. Encourage the family to learn CPR.
p. Instruct the client to avoid
electromagnetic fields directly over the
AICD, because they can inactivate the
device.
q. Instruct the client to move away from
the magnetic field immediately if
beeping tones are heard, and to notify
the PHCP.
r. Keep an AICD identification card in the
wallet and obtain and wear a
MedicAlert bracelet.
s. Inform all PHCPs that an AICD has
been inserted; certain diagnostic tests,
such as MRI, and procedures using
diathermy or electrocautery interfere
with AICD function.
VI. Pacemakers
A. Description: Temporary or permanent device that provides
electrical stimulation and maintains the heart rate when the
client’s intrinsic pacemaker fails to provide an adequate rate
B. Settings
1. A synchronous (demand) pacemaker senses the
client’s rhythm and paces only if the client’s intrinsic
rate falls below the set pacemaker rate for stimulating
depolarization.
2. An asynchronous (fixed rate) pacemaker paces at a
preset rate regardless of the client’s intrinsic rhythm

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