Adjunct Devices Flashcards
What are 4 indications for intraaortic balloon pump (IABP) placement?
AMI with any of the following complications: Cardiogenic shock, VSD, Severe MR; Severely decompensated CHF, persistent angina awaiting definitive care, refractory ventricular arrhythmias due to ischemia, low cardiac output in patients waiting for revascularization (CABG)
What are the expected benefits of IABP therapy?
Improvement in coronary perfusion, reduction of afterload, improved end-organ perfusion
The IABP inflates during systole. True or False.
False. The balloon inflates during diastole. This allows a backward flow of blood to improve circulation to the coronary arteries. It also forces blood forward to improve circulation to organs.
Other than assays to determine therapeutic anticoagulation, what is the MINIMUM daily lab for a patient on an IABP?
Renal function, CBC
A patient has normal electrolytes and renal function at the initiation of IABP therapy. The potassium acutely increases while the creatinine remains within normal limits. What do you suspect?
Hemolysis of the RBCs by the pump
Assuming sterile technique was used when the IABP was placed, sepsis would not commonly occur unless the IABP was left in longer than ______ days.
Seven days
A patient with chronic atrial fibrillation is exhibiting sinus pauses on EKG. A primary indication for placement of a permanent pacemaker is sinus pauses of _______ seconds or more.
5 seconds. Patients may be symptomatic with shorter pauses (confusion, syncope). Evaluation of the patient’s symptoms then dictates indications for pacemaker placement.
A patient has a VVI pacemaker in place. What does the first letter of a pacemaker code indicate?
The chamber being paced
What does it indicate if a pacemaker is “rate-responsive”?
The device is equipped with a sensor that can increase or decrease the patient’s heart rate when it perceives a need.
The special pacing mode of a pacemaker that can terminate ventricular tachycardia is_____?
ATP = Anti-tachycardia pacing
When reviewing the EKG of a patient with a pacemaker, what indicates the pacing stimulus?
Pacemaker spike
What is the most common insertion technique/approach for permanent pacemaker placement?
Transvenous approach
Random spikes on an EKG of a patient with a pacemaker indicates_________________?
Failure to sense. Sensing is when the pacemaker recognizes the heart’s own (intrinsic) initiation of an electrical stimulus from the SA or AV node. If sensing properly, the pacemaker should not fire and allow natural conduction to occur.
What are 3 indications for placement on an ICD?
Coronary artery disease with an LVEF < 35%
Cardiomyopathy with an LVEF < 35%
Life-threatening episodes of ventricular tachycardia that is not amenable to traditional medical therapy
When performing a physical assessment of a patient with an LVAD, what is the recommended method to evaluate the heart rate and blood pressure?
Doppler ultrasound of the brachial artery
