tailieunhanh - HANDBOOK OF CARDIAC PACING – PART 7

Dấu hiệu quan trọng thường xuyên tại đầu tiên sau đó giảm dần thói quen 8. Vết thương mặc quần áo kiểm tra hệ thống thoát nước và tụ máu 9. Đánh giá tình trạng hô hấp (tràn khí màng phổi) 10. Màn hình điện tâm đồ nhịp điệu cho loạn nhịp tim, nắm bắt và cảm nhận thích hợp | 88 Handbook of Cardiac Pacing Table . Common postoperative orders 1. PA and Lateral chest X-ray within 2 hrs for lead placement and to evaluate for pneumothorax 2. Ice pack to incision site 3. IV antibiotics usually one additional dose 4. Oral and parenteral analgesics 5. Maintain head of bead 30 angle 6. Resumption of diet 7. Vital signs frequently at first then tapering to routine 8. Wound dressing check for drainage and hematoma 9. Respiratory status evaluation for pneumothorax 10. Monitor ECG rhythm for arrhythmias capture and appropriate sensing 11. Restrict movement of ipsilateral arm for 24 hours 12. Full pacemaker evaluation prior to discharge with activation of any special features and adjustment of the sensor if present Table . Predischarge teaching 10 Wound care instructions include the following 1. Continually assess wound for signs and symptoms of infection. 2. Keep wound clean and dry for 1 week. 3. Cover the incision with plastic when bathing. 4. Remove steri-strips after 7 days. Do not wait until they fall off. Activity restrictions 1. No lifting greater than 10 pounds for 2 weeks. 2. No repetitive arm extension over the head for 2 weeks. 3. If the patient is pacemaker dependent driving should be restricted for 2 weeks or as determined by the physician. Otherwise 48 hours is usually sufficient to allow the patient to recover from any anesthesia and for the incisional pain to subside Restrictions against electromagnetic interference 1. Arc welding 2. MRI 3. Diathermy 4. Therapeutic radiation over the pacemaker 5. Electronic article surveillance scanners 6. Metal detectors 7. Supermarket checkout scanners 8. Cell phones 9. Electric blankets Contact the pacemaker clinic if 1. Symptoms prior to implant return 2. The pulse rate seems too slow or too fast 3. Dizziness lightheadedness or syncope occurs 4. Unusual shortness of breath or chest pain develops 5. Muscle twitching around the pacemaker is present Preoperative Operative and Postoperative .