Pacemaker Rhythms - Adult Nursing Care I

True or false the more severe the heart block or rhythm the slower the HR and the need there is for a pacemaker to help recreate the electrical conductivity?

True

What part of the pacemaker is considered the power source and generates electrical currents (impulses)?

Pulse generator

What part of the pacemaker carries electrical currents generated from pulse generator to the heart to stimulate depolarization?

Pacing leads

What are the 3 types of temporary pacemakers?

1. Transcutaneous

2. Transvenous

3. Epicardial

A permanent pacemaker is ______________

Implanted

Are these are complications for what type of pacemaker?

- Skin burns including third degree

- Interference with sensing

- Discomfort from electrical stimulation of the skin and muscles

- Use of sedative or analgesics usually necessary in clients d/t discomfort

Temporary pacemakers

What type of temporary pacemaker involves large electrodes placed on a client's chest?

Transcutaneous Pacing (TCP)

Transcutaneous Pacing (TCP) is used for what kind of abnormal heart rhythm that is unresponsive to atropine or when atropine is not immediately available

Bradycardia

Transcutaneous Pacing (TCP) is used as a "bridge" until what kind of pacing can be accomplished or the cause of bradycardia is reversed?

Transvenous pacing

Type of temporary pacemaker that involves a electrode being introduced in a central vein such as the subclavian, femoral, brachial, internal or external jugular.

Transvenous pacing

Type of temporary pacemaker where leads are placed directly onto or through the epicardium and is typically done during cardiac surgery

Epicardial pacing

Type of pacemaker that is implanted in the pectoral region of the chest just below the right or left clavicle

Permanent pacemaker

Permanent pacemakers are powered by a lithium battery. What is the average life of a pacemaker?

8-10 years

What letter in a pacemaker code is responsible for the chamber(s) paced meaning the number of heart chambers that a pacemaker is programmed to stimulate?

The first letter

What does O stand for in pacemaker codes?

None

What letter in a pacemaker code is responsible for which chamber(s) of the heart the pacemaker is actively monitoring for electrical activity?

The second letter

What letter in a pacemaker code is responsible for the action the device takes when it detects intrinsic electrical activity (a heartbeat) from the heart?

The third letter

What's it called when the pacemaker senses intrinsic cardiac activity (a heartbeat from the patient's own heart), it will respond by delivering a pacing impulse, essentially "triggering" the pacemaker to fire and stimulate the heart muscle?

Triggered

What's it called when the pacemaker senses electrical activity from the heart (intrinsic rhythm), it will withhold its own pacing stimulus, essentially pausing its activity because the heart is beating on its own and doesn't need additional pacing?

Inhibited

This type of pacing has an electrode placed in the right atrium

Atrial pacing

What kind of pacing produces a pacemaker spike followed by a P wave?

Atrial pacing

Atrial pacing is used when this node is diseased or damaged but conduction through AV junction and the ventricles is normal.

The SA node is diseased or damaged

This type of pacing has an electrode placed in the right ventricle

Ventricular pacing

What kind of pacing produces a pacemaker spike (downward) followed by a wide QRS complex?

Ventricular pacing

A pacemaker complication where the device is not delivering an electrical stimulus to the heart when it should

Failure to pace

A pacemaker complication where the pacemaker delivers an electrical impulse, but it does not successfully stimulate the heart muscle to contract

Failure to capture

A pacemaker complication where the device is unable to detect the heart's natural electrical signals, leading to the pacemaker delivering unnecessary pacing spikes even when the heart is beating on its own

Failure to sense

A pacemaker complication where the device is unable to properly detect the heart's natural electrical signals

Undersensing

A pacemaker complication that occurs when it detects electrical signals it shouldn't, which can cause it to inhibit pacing.

Oversensing

All of these are other complications that can happen because of a ______________:

- Myocardial perforation

- Bleeding

- Pneumothorax

- Dysrhythmias

- Infection

Pacemaker

A small device that's surgically implanted in the chest to monitor and correct irregular heart rhythms. For minor changes, the ICD may deliver a low-energy shock that feels like a painless fluttering. For more serious changes, the ICD may deliver a higher energy shock that can feel painful. The shock usually restores a normal heartbeat within a second.

An implantable cardio-defibrillator (ICD)