A patient with a newly implanted pacemaker presents with signs of fatigue, intermittent dizziness, and mild shortness of breath. The nurse notes a blood pressure of 90/58 mmHg and a heart rate of 58 beats per minute. Considering these clinical cues, which nursing actions and patient teaching points should the nurse prioritize to optimize patient outcomes? (Select all that apply)

A newly implanted pacemaker regulates cardiac rhythm, atrial/ventricular sensing, and electrical pacing thresholds to correct bradyarrhythmias and conduction defects. Post-implant care focuses on preventing lead dislodgement, monitoring device function, and minimizing electromagnetic interference, while ensuring adequate tissue perfusion and cardiac output. Rationale: A. Resuming driving immediately is unsafe in a patient with symptoms of hypoperfusion such as dizziness and hypotension. These findings suggest inadequate cardiac output or possible pacemaker malfunction, increasing risk of syncope and accidents. Driving should be restricted until stable device function is confirmed. B. Symptoms such as chest pain, syncope, and lightheadedness indicate decreased cardiac output or pacemaker dysfunction and are not expected after implantation. Clients must be instructed to seek immediate medical attention rather than simply track these symptoms, as they may signal life-threatening complications. C. Regular pacemaker interrogation is essential to assess battery status, lead integrity, and pacing thresholds. Follow-up evaluations ensure appropriate device function and early detection of malfunctions contributing to bradycardia, hypotension, or inadequate cardiac pacing. D. Restricting ipsilateral arm elevation prevents lead dislodgement during the initial healing period. Excessive shoulder movement can disrupt electrode positioning in the myocardium, leading to loss of capture or sensing abnormalities. E. Avoiding electromagnetic interference prevents disruption of device sensing and pacing function. Strong magnets and certain medical equipment can inhibit or trigger inappropriate pacing, and clients must inform all healthcare providers about the implanted device before procedures.