A patient with a permanent pacemaker suddenly develops persistent hiccups occurring at the same rate as the pacemaker's pacing rate. What is the priority nursing action?

Appeared in: NORCET-11 Prelims

Explanation

Persistent hiccups synchronized with pacemaker rate indicate possible diaphragmatic stimulation from lead displacement.
This is a potentially serious complication requiring immediate provider notification.
Prompt escalation prevents further complications such as ineffective pacing or organ injury.

Option B: Assessment is important but does not address the urgent need for escalation in suspected device malfunction.
Option C: Treats only the symptom and may delay intervention for a potentially life-threatening complication.
Option D: Hiccups synchronized with pacing are not normal and may indicate a serious complication.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Priority nursing action for pacemaker complications presenting as persistent hiccups in the correct sequence, documenting the action clearly, and monitoring for the expected response.
Nurses must recognize device-related complications and escalate care without delay to prevent harm.
Early reporting can prevent progression to cardiac tamponade, ineffective pacing, or organ injury.
What if? If the hiccups were not synchronized with the pacemaker rate, initial assessment and symptomatic management would be appropriate before escalation.

How to Approach the Question

Identify the clinical cue: hiccups synchronized with pacemaker rate.
Recall that this is a sign of possible lead displacement or device malfunction.
Recognize that device complications require immediate escalation, not just assessment or symptomatic treatment.
Eliminate options that delay provider notification or treat only symptoms.
Choose the action that prioritizes patient safety and urgent intervention.

Concept Tested & Keywords

Concept Tested: Priority nursing action for pacemaker complications presenting as persistent hiccups
Stem keywords: permanent pacemaker, persistent hiccups, pacing rate
Lead-in keywords: priority nursing action
Clinical cues: Hiccups occurring at the same rate as pacemaker pacing

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E6 Nursing Brunner Adult Health 3SA Vol 1 Part 1 p. 123-125

Practise the full NORCET-11 Prelims

Attempt every question from this paper in a timed mock, then review the full solution for each one.