Basics
What heart rhythm problem are pacemakers most commonly used to treat?
Bradycardia
What is one of the main reasons a patient may need pacing?
Symptomatic bradycardia
What are the three main purposes of temporary pacemakers?
Support ventricular contractility, control HR, and maintain CO
Which procedure is planned and synchronized with the patient's cardiac rhythm?
Cardioversion
What term describes the heart's ability to generate its own electrical impluse spontaneously and repeatedly?
Automaticity
Name two signs that could indicate pacemaker failure
Bradycardia - decreased BP - decreased UOP - ECG changes - SOB
What does an AV block mean in simple terms?
The electrical signal has trouble getting from the Atria to the Ventricles
Which temporary pacemaker uses pads placed on chest and/or back?
Transcutaneous pacing (TCP)
Which procedure is an emergency and uses an unsynchronized shock?
Defibrillation
What term describes myocardial cells responding to an electrical stimulus?
Excitability
A patient with a pacemaker develops SOB and a HR of 42bpm. What should the nurse suspect and what should she anticipate to do?
Pacemaker failure - apply O2, notify provider, get crash cart and anticipate transcutaneous pacing
An electrical signal of the heart is coming from somewhere else in the heart that isn’t the SA node is called?
An ectopy - usually an extra/abnormal beat
Which temporary pacemaker uses wires inserted through a central vein and advanced into the heart?
Transvenous pacing
Why must cardioversion be synchronized with the patient's rhythm?
to avoid delivering the shock during a T wave - could cause a ventricle arrhythmia
What term describes the movement of an electrical impulse from cell to cell?
A patient with a pacemaker has decreased UOP, BP, and a new ECG change. What do these findings suggest?
Pacer may be failing causing inadequate CO/perfusion
Name four reasons a patient may require pacing
Symptomatic bradycardia/arrhythmias - AV blocks - trauma - drugs - electrolyte imbalances - pacer malfunctions - suppression of ectopy
A patient has symptomatic bradycardia that is not responding to atropine, which pacing method can be used in an emergency?
Transcutaneous pacing
A patient has an atrial arrhythmia and is scheduled for an electrical shock. Which procedure should the nurse expect?
Synchronized cardioversion
What term describes the heart's ability to push blood through the body?
Contractility
The nurse notices that the pacemaker is sending a pacing spike, but the patient's heart does not contract afterward. What is this called?
Loss of capture
It can provide electrical stimulus to maintain an adequate HR and CO when the heart's normal rhythm is inadequate
Loss of capture
A patient is coding with a V-fib rhythm. The nurse preps the defibrillator. Does she need to wait for consent before delivering a shock?
A pacing spike after a QRS is called?
Capture