Thisnursing care planforis for patients who have received a Permanent Pacemaker Placement. This care plan includes a diagnosis with interventions and goals for nurses with thefollowing conditions:Impaired Physical Mobility & Disturbed Self-Concept.The purpose of a pacemaker to is maintain a normal, adequate heart rate for a patient. Patientswho have received a permanent pacemaker have had problems with the heart’s natural pacemaker, known as the AV node (atrioventricular node). These patients have been diagnosed with sick sinus syndrome, complete heart block (third-degree heart block) etc. A permanent pacemaker is usually placed under the left subclavicular area. However, due to small chest size a patient may have a permanent pacemaker placed under the right subclavicular area.
Patients who have received a permanent pacemaker can experience impaired physical mobility due to the activity restrictions required. In addition, the patient can have a disturbed self-concept because they feel they must now depend on the pacemaker to live, which makes the patient feel like they have lost their health.
Below is a case scenario that may be encountered as a nursing student or nurse in a hospital setting.
What are nursing care plans? How do you develop a nursing care plan? What nursing care plan book do you recommend helping you develop a nursing care plan?
This care plan is listed to give an example of how a Nurse (LPN or RN) may plan to treat a patient with those conditions.
Important Disclosure: Please keep in mind that these care plans are listed for Example/Educational purposes only, and some of these treatments may change over time. Do not treat a patient based on this care plan.
Care Plans are often developed in different formats. The formatting isn’t always important, and care plan formatting may vary among different nursing schools or medical jobs. Some hospitals may have the information displayed in digital format, or use pre-made templates. The most important part of the care plan is the content, as that is the foundation on which you will base your care.
Nursing Care Plan for: Impaired Physical Mobility & Disturbed Self-Concept for patients with Permanent Pacemaker Placement
If you want to view a video tutorial on how to construct a care plan in nursing school, please view the video below. Otherwise, scroll down to view this completed care plan.
Scenario |
| A 72-year-old male presented to the ER “not feeling well”. The EKG showed he was in sick sinus syndrome. Immediately, the patient was rushed to the cath lab for placement of a permanent pacemaker. The patient was then transferred to your unit for 23 hours observation. When you arrive to the patient’s room, he is wearing the arm immobilizer and has a clean, dry dressing over his pacemaker site. You assist the patient to the bathroom and he comments, “It is hard moving around normally with this sling on but I hear you can displace those lead wires if you’re not careful”. You note the patient does have limitations in his physical activity. When the patient is back in bed, you complete your assessment and note his vital signs are within normal limits. The bedside cardiac monitor shows the patient’s heart is being paced at 65 beats per minute (bpm). The patient seems like he has “a lot on his mind” and you ask him how he is doing. The patient tells you he is thankful for the pacemaker but feels he has lost control over his health and must depend on “a piece of electronics” to keep him alive. He states it is weird and he feels like a bionic man. |
Nursing Diagnosis: |
Disturbed Self-Concept related to perceived loss of health and dependence on pacemaker as evidence by patient states he feels he has lost control over his health and must depend on a “piece of electronics” to keep him alive. Impaired Physical Mobility related to activity restrictions and fear of lead displacement as evidence by patient exhibiting limitations in his physical mobility. |
Subjective Data: |
“It is hard moving around normally with this sling on but I hear you can displace those lead wires if you’re not careful”.The patient seems like he has “a lot on his mind” and you ask him how he is doing. The patient tells you he is thankful for the pacemaker but feels he has lost control over his health and must depend on “a piece of electronics” to keep him alive. He states it is weird and he feels like a bionic man. |
Objective Data: |
-A 72-year-old male presented to the ER “not feeling well”. The EKG showed he was in sick sinus syndrome. Immediately, the patient was rushed to the cath lab for placement of a permanent pacemaker. The patient was then transferred to your unit for 23 hours observation. When you arrive to the patient’s room, he is wearing the arm immobilizer and has a clean, dry dressing over his pacemaker site.The bedside cardiac monitor shows the patient’s heart is being paced at 65 beats per minute (bpm). |
Nursing Outcomes: |
| -The patient will demonstrate understanding and coping skills about the importance of the pacemaker placement by discharge.-The patient will verbalize increased positive feelings regarding the pacemaker placement by discharge. -The patient will verbalize an increase control over his health by discharge. -The patient will remain feel from any falls during his hospitalization due to limited mobility. -The patient will describe three ways to prevent injury to self and pacemaker by utilizing 4 alternative methods for activity until healing period is complete by discharge. |
Nursing Interventions: |
| -The nurse will encourage and educate the patient about the importance of the pacemaker daily.-The nurse will help the patient develop an understanding that he is in control of his health not the pacemaker daily. -The nurse will build up the patient emotionally by complimenting on his health status and hard work daily.-The nurse will assess the patient’s self-image daily.-The nurse will assess and remove any clutter in the patien’ts room upon entering the room every time. -The nurse will ensure call light is in accessible area for patient usage upon arrival to room every time. -The nurse will teach the patient three ways to prevent injury to self and pacemaker with 4 alternative methods for activity by discharge. |
