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Cardiopulmonary - Exam I > 8: Rehab after Pacemaker > Flashcards

8: Rehab after Pacemaker Flashcards

1
Q

What is a pacemaker?

A

Electronic pulse generator is implanted and used to create an artificial action potential to control certain arrhythmias. Can be unipolar or bipolar systems

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2
Q

What are 6 indications for a pacemakers?

A
  1. Sinus bradycardia
  2. Sinus arrest
  3. SA node block
  4. A-fib with slow ventricular response
  5. Tachy-brady syndrome
  6. Heart block
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3
Q

What type of lead is shown in the diagram?

A

Unipolar

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4
Q

What type of lead is shown in the diagram?

A

Bipolar

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5
Q

What side will the pacemaker likely be implanted into?

A

Usually left, try to insert in the non-dominant side

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6
Q

What are the pacemaker leads attached to?

A

Heart - can be single or dual chamber

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7
Q

What are the 6 causes of non-capture of a pacemaker?

A
  1. Lead perforation or fracture
  2. Lead displacement
  3. MI
  4. Tissue changes
  5. Metabolic imbalance
  6. Generator component failure
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8
Q

What does the first letter of pacemaker code stand for?

A

Indicated the chamber being paced

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9
Q

What does the second letter of pacemaker code stand for?

A

Indicated the chamber being sensed

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10
Q

What does the third letter of pacemaker code stand for?

A

Indicates the response to sensing

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11
Q

What does the fourth letter of pacemaker code stand for?

A

Indicated the programmability

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12
Q

What does the fifth letter of pacemaker code stand for?

A

Indicated an anti-tachyarrhythmia function

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13
Q

What are goals for PT following implantation of a pacemaker?

A
  1. Improve mobility, endurance, and function
  2. Assist medical staff in setting parameters
  3. Assess functioning
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14
Q

When should you initiate mobility following a pacemaker?

A

The day after surgery or as soon as able

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15
Q

What are the restrictions following pacemaker implantation?

A

Shoulder flexion and ABD less than 90 to allow for adherence of lead wire to muscle tissue. Also pushing and pulling in bed mobility

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16
Q

What are signs of non-capture of a pacemaker?

A

Poor HR response, excessive fatigue, SOB, dizziness

17
Q

What is the purpose of the CAEP?

A

Evaluation of rate-responsive pacemakers

18
Q

Describe the protocol for the CAEP

A

Begin with 1.5 METS, and increase every two minutes by 1 MET for 10 minutes

19
Q

When should you initiate resistance training following pacemaker implantation?

A

2 months to allow for lead to significantly scar to the heart tissue

19
Q

Describe subacute or outpatient rehab following a pacemaker

A

Intervals with more rest, aerobic and resistance exercise with the goal of 40-60 minutes at 11-13 RPE

20
Q

What do you have to be mindful of during warm-up and cool down with a pt with a pacemaker?

A

They require longer time, 15 minutes usually

Cardiopulmonary - Exam I (19 decks)

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