When providing discharge instructions to a patient with a new permanent pacemaker The nurse teaches the patient to?

Discharge Instructions for Pacemaker Implantation

You have had a procedure to insert a pacemaker. Once inside your body, this small electronic device helps keep your heart from beating too slowly. A pacemaker can't fix existing heart problems. But it can help you feel better and have more energy. As you recover, follow all of the instructions you are given, including those below.

Activity

• Follow the instructions you are given about limiting your activity.
• If you are fitted with an arm sling, keep your arm in the sling for as long as your doctor tells you to. Most often, the sling will be removed the next day. But you may be told to sleep with it on for a period to prevent damage to the pacemaker while it's healing.
• Don't raise your arm on the incision side above shoulder level or stretch your arm behind your back for as long as directed by your doctor. This gives the leads a chance to secure themselves inside your heart.
• Don't drive until your doctor says it's OK. Have someone drive you home after the procedure.
• Ask your doctor when you can expect to return to work. Depending on the type of work you do, you may have limits until your doctor says it's OK for unrestricted activity.
• You can still exercise. It's good for your body and your heart. Talk with your doctor about an exercise plan and the types of exercise to limit the risk of damaging your pacemaker.

Other precautions

• Follow your doctor's directions carefully for wound care. If there is a dressing, ask whether you should remove it or keep it on until your next visit. Never put any creams, lotions, or products like peroxide on an incision unless your doctor tells you to. Don't get the incision wet until your doctor says it's OK.
• Take your temperature every day and check your incision for signs of infection. These include redness, swelling, drainage, and warmth. Do this for 7 days, or as advised by your doctor.
• Learn to take your own pulse. Keep a record of your results. Ask your doctor what pulse rate means you should call for medical attention.
• Before you have any treatment, tell all healthcare providers, including your dentist, that you have a pacemaker.
• You will be given an ID card that has information about your pacemaker. Always carry this card with you. You can show this card if your pacemaker sets off a metal detector. Also show it so you don't need to be screened with a hand-held security wand.
• Be careful when using cell phones and other electronic devices. Keep them at least 6 inches away from your pacemaker. It's safest to hold all cell phones to the ear farthest from your pacemaker or use the speaker mode setting. Don’t carry your phone or electronic device in your chest pocket, over the pacemaker. Experts advise carrying your cell phone and other electronics in a pocket or bag below your waist. Most cell phones and electronic devices don't interfere with pacemakers. But some cell phones and electronic devices such as smart watches use powerful magnets for wireless charging that may interfere with how your pacemaker works. The magnet used for charging or other magnet accessories can also interfere with how your pacemaker or ICD works. These devices should be kept at least 12 inches away from your pacemaker when wirelessly charging or stored. Follow any other instructions given to you by your healthcare provider or from the maker of your pacemaker.
• Stay away from strong magnets. Examples are those used in MRIs or in hand-held security wands. Some pacemakers are now safe to use with MRI scanners. Ask your doctor if you have such a pacemaker.
• Stay way from strong electrical fields. Examples are those made by radio transmitting towers, "ham" radios, and heavy-duty electrical equipment.
• Don't lean over the open hood of a running car. A running engine creates an electrical field. Most household and yard appliances will not cause any problems. If you use any large power tools, such as an industrial arc welder, talk with your doctor.
• Your doctor may give you a list of other devices and procedures to stay away from.

Follow-up care

• See your cardiologist in the next 7 to 10 days. Call and make an appointment as soon as you get home.
• Make regular follow-up appointments with your doctor. He or she will check the pacemaker to make sure it's working properly.
• Plan on having periodic checkups with your healthcare provider to assess the battery life of your pacemaker. Depending on your device and how much your body uses the pacing functions of the pacemaker, you will need a new device generator implanted at some point. This is generally about every 5 to 7 years.
• Some pacemakers have a built-in antenna that can send information such as trouble alerts over the internet to your doctor. Ask your doctor if your pacemaker is capable of remote monitoring.

When to call your healthcare provider

Call 911 if you have:

• Chest pain
• Severe trouble breathing

Call your healthcare provider right away if you have any of these:

• Dizziness
• Lack of energy
• Fainting spells
• Twitching chest muscles
• Rapid pulse or pounding heartbeat
• Shortness of breath
• Pain around your pacemaker
• Fever above 100.4° F (38° C) or higher, or as directed by your healthcare provider
• Other signs of infection such as redness, swelling, drainage, or warmth at the incision site
• Your incision is not healing or your incision separates or opens
• Hiccups that won't stop
• Redness, severe swelling, drainage, worsening pain, bleeding, or warmth at the incision site
• If your pacemaker generator feels loose or like it is wiggling in the pocket under the skin

StayWell last reviewed this educational content on 11/1/2019

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

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