A client with myocardial infarction has been transferred from a coronary care unit to a general medical unit with cardiac monitoring via telemetry. A nurse plans to allow for which of the following client activities?
A. Strict bed rest for 24 hours after transfer.
B. Bathroom privileges and self-care activities.
C. Unsupervised hallway ambulation with distances under 200 feet.
D. Ad lib activities because the client is monitored.
Correct Answer: B. Bathroom privileges and self-care activities
On transfer from the CCU, the client is allowed self-care activities and bathroom privileges. Supervised ambulation for brief distances is encouraged, with distances gradually increased (50, 100, 200 feet). A patient on telemetry should be visualized hourly. With every ECG alarm, the patient should be visualized and assessed (refer to Nursing Assessment Clinical Guideline). It is the responsibility of nursing staff to know the whereabouts of their patient at all times – toilet doors should not be locked – however, laminated signs may be used on doors instead
Option A: Patients should be assessed daily for the appropriateness of cardiac telemetry. Acutely unwell patients at risk of life-threatening arrhythmias should be on strict bed rest and continuously monitored on the bedside monitor and close to emergency equipment. The AUM will be involved in all aspects of care, from patient assessment and daily reviews for appropriateness of telemetry.
Option C: All health professionals involved in the patient’s care will know how far the patient is allowed to mobilize while on telemetry. The patient is required to remain within the boundaries of the hospital telemetry signal. If the patient requires a procedure or treatment outside the telemetry boundary, the patient will require a suitable portable cardiac monitoring device.
Option D: The patient will be supervised by a parent or nurse at all times when mobilizing, this is to ensure patient safety. The primary nurse will be aware of the patient’s location at all times. The ANUM should be consulted if the patient needs to cease telemetry monitoring for personal hygiene. In this case, the patient should be supervised at all times, and the medical team made aware.
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