Pace Makers Flashcards
What do pace makers do
Electrical currant to stimulate depolarization
7 indications for pace maker
2nd degree type 2
3rd degree block
Sick sinus syndrome
Sinus arrest
Symptomatic bradycardia
Afib w/ slow ventricular response
Cardiac surgery
Temporary vs permanent pacemakers
Temporary
-transcutaneous (skin)
-transvenous
-epicardial
Permanent
-atrial
-ventricular
-dual chamber (AV)
Different modes of pacemaker
Demand
(safer)
Fixed rate
(can cause R on T)
Demand mode on pacemaker
Paces heart when no intrinsic or native path is sensed
Ex. Rate set at 60 (pacemaker only pace if HR drops under 60)
Fixed rate pace maker mode (asynchronous)
What it does
Risk?
Paces heart at a set rate
-independent of activity generated by the heart
(Risk of R on T)
Rate of a pacemaker
Number of impulses delivered per min to atrium, ventricle or both
Trancutaneous pacemaker requires what
More mA (milliamps)
-have to go through wall of chest
What do these mean?:
Spike in front of P waves
Spike in front of QRS
Spike infront of both
P wave: atrial paced
QRS: ventricular paced
Infront of both: AV paced
Failure to capture
What is it
Tx
Pacer fires but no depolarization noted (no p waves or QRS after)
Tx:
Increase mA
Reposition pt on left side
Replace battery
Check connections
Failure to pace or fire
What does that mean
Tx
Absense of pacer spike
Tx:
Check batteries/generator
Prepare to transcutaneous pace
Call MD
Electromagnetic interference
When does it usually happen
In demand mode
Pacer senses electrical activity outside heart (equipment)
Postop care for pacemaker patient
OOB once stable (out of bed)
Limit arm and shoulder activity (dislodge pacemaker)
Monitor insertion site (bleeding/infection)
Pace maker complications
Perforation (cardiac tamponade)
Pneumothroax
Rapid hiccuping
Infection
Bleeding
Ventricular irritation
Electrode fracture
Thromboembolism
