A nurse is creating a plan of care for a client who has a newly implanted transcutaneous pacemaker. Which of the following interventions should the nurse include in the plan?

Nursing care for a client with a newly implanted transcutaneous pacemaker focuses on pain management, monitoring cardiac rhythm, and preventing complications at the insertion site. A temporary pacemaker uses electrical impulses to stimulate cardiac contractions when intrinsic heart rate is inadequate. Clients often experience discomfort due to electrical stimulation of the chest wall muscles. Supportive care is essential to improve tolerance and ensure effective pacing therapy. Rationale: A. Placing a pressure dressing over the incision site is not indicated because it can interfere with device function and increase discomfort. Pacemaker insertion sites require a sterile dressing rather than compression. Excess pressure may also impair circulation and increase the risk of tissue injury or device displacement. B. Administering an analgesic is appropriate because transcutaneous pacing commonly causes discomfort due to skeletal muscle stimulation from electrical impulses. Clients may experience chest wall pain or muscle twitching. Providing pain relief improves comfort, tolerance of therapy, and cooperation with treatment while the pacemaker is in use. C. Instructing the client to restrict arm movement for 1 week is not typically required for a transcutaneous (external) pacemaker, as movement restrictions are more relevant for permanent implanted devices. While general caution may be advised, strict immobilization is not necessary in this case. The priority concern is comfort and monitoring, not long-term mobility restriction. D. Applying antibiotic ointment to the skin around the site is not recommended unless specifically prescribed because it can alter skin integrity or interfere with dressing adherence. Infection prevention is primarily achieved through sterile dressing care and proper site monitoring. Routine topical antibiotic use is not standard practice for pacemaker care.