Pacemaker Basics
This device sends electrical impulses to help the heart beat when it’s too slow.
This occurs when the pacemaker fires but the heart doesn’t respond.
What is failure to capture?
Example: Pacing spikes without QRS complexes.
Nurses must ensure this is taped to the generator or kept nearby.
What are spare batteries?
Example: AA batteries taped to the generator for emergencies.
This condition causes sudden breathlessness due to air in the bloodstream.
What is an air embolism?
Example: Requires Trendelenburg and oxygen.
Patients with a TVPM wire must remain in this position.
What is bed rest?
Example: Until cleared by physician.
This type of pacing wire is inserted through a vein and sits in the right ventricle.
What is a transvenous pacing wire?
This happens when the pacemaker doesn’t fire at all.
What is failure to pace?
Example: No pacing spikes on the monitor.
Nurses must document this measurement every shift.
What is pacemaker wire length?
Example: From sheath hub to wire hub.
This complication may cause muffled heart sounds and low BP.
What is cardiac tamponade?
Example: May need pericardiocentesis.
Patients should avoid using this grooming device.
What is an electric razor?
Example: Risk of electrical interference.
This term describes when the heart responds to the pacemaker’s impulse.
What is capture?
Example: Seen as a QRS complex following a pacing spike.
This sensing issue causes the pacemaker to fire too often.
What is undersensing?
Example: Pacemaker misses intrinsic beats and paces unnecessarily.
Nurse must remind physicians to use this
What is the lock that comes with the Arrow sheath adapter
This occurs when the pacing wire moves from its original position.
What is lead dislodgement?
Example: Loss of capture and change in wire length.
Patients should report this symptom that may indicate pacing issues.
What is chest pain or palpitations?
Example: Could signal failure to capture
This setting controls the strength of the impulse delivered to the heart.
What is output (measured in mA)?
Example: Increasing mA from 5 to 6 may restore capture.
This issue causes the pacemaker to mistake other signals for heartbeats.
What is oversensing?
Example: Muscle tremors or large T waves inhibit pacing.
Nurses must monitor this to confirm mechanical capture.
What is the radial pulse?
Example: Pulse matches QRS complexes.
This condition may cause asymmetric chest expansion and tracheal deviation.
What is pneumothorax?
Example: Requires chest tube insertion.
This test is ordered after pacemaker insertion to confirm wire placement.
What is a chest X-ray?
Example: Ensures proper wire positioning.
This setting controls how well the pacemaker detects the heart’s own beats.
What is sensitivity (measured in mV)?
Example: Lowering mV from 2 to 0.8 makes the pacemaker more sensitive.
This adjustment can fix undersensing.
What is decreasing the mV setting?
Example: Changing sensitivity from 2 mV to 0.8 mV.
Nurses must ensure this monitor setting is enabled.
What is pace detect?
Example: Allows detection of pacing spikes on telemetry
This infection sign may include fever and purulent drainage.
What is central line site infection?
Example: Requires blood cultures and antibiotics
Nurses should educate patients not to touch this equipment.
What is the pacing wire or pulse generator?
Example: Risk of dislodgement or malfunction.