What is a common nursing observation after pacemaker insertion?

• A. Monitor for dehydration and electrolyte imbalance only.
• B. Monitor for lead displacement, infection, and device malfunction; assess for pocket pain and perform wound care.
• C. Monitor lung function exclusively.
• D. Check for weight gain and appetite changes.

Answer: (B)

Key idea: after a pacemaker insertion, the most important nursing focus is on the device site and function—watching for lead position, infection, and any device malfunction, and caring for the pocket wound.

Leads must stay properly in place, because displacement can prevent the pacemaker from delivering the intended pacing. The generator pocket is at risk for infection, hematoma, or wound dehiscence, so inspecting the incision for redness, warmth, drainage, swelling, and increased pain is essential, and proper wound care helps reduce infection risk. Device malfunction can manifest as inappropriate sensing or failure to pace, which may require reprogramming or clinical intervention, so ongoing assessment of the patient’s rhythm, stability, and symptoms is critical.

Other issues like dehydration and electrolyte imbalance, exclusive lung function assessment, or weight and appetite changes aren’t the primary nursing observations tied to the immediate post-insertion focus. They may be relevant in broader care, but they don’t address the key risks after pacemaker placement.