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N202 Exam 3 Unit 2 > Pacemaker > Flashcards

Pacemaker Flashcards

1
Q

Provide extrinsic electrical stimuli to–> contraction (depolarization)

A

Pacemaker

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2
Q

Pacemaker that senses low HR & fires w/in predetermined pd

A

Demand (Synchronous) Pacer

Require 3 wire system

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3
Q

2 Types of Demand Pacers

A

Single-chamber (most pop)

Dual-chamber

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4
Q

Pacer in atrium or ventricle/ sense and pace

A

Demand Single Chamber

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5
Q

Sense and pace atrium & ventricle

A

Demand Dual Chamber

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6
Q

Before applying temporary pacers

A

sedate the pt, wash and trim (never use a razor)

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7
Q

Pads of temporary pacers are placed

A

anterior-posteror or anterior-apex

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8
Q

Sedation for permanent pacemaker placement

A

IV conscious sedation under local anesthesia

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9
Q

3 functions of permanent pacemakers

A
  1. sensing (pulse generator sees intrinsic beats)
  2. Firing (pg delivers stimulis)
  3. Capturing (heart responds)
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10
Q

VVI

A

commonly used
Ventricle paced, sensed, inhibit
Pace maker fires if it doesn’t sense heart beat

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11
Q

DDD

A

commonly used for heart block/ sick sinus syndrome

Triggered by sensing AV (PR) interval expiring

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12
Q

DDD does not work for

A

A-fib

P waves unable to be paced

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13
Q

ECG spike occurs on time, but not followed by a QRS

A

Failure to capture

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14
Q

ECG shows spikes occurring after QRS but earlier than it should

A

Failure to sense

Turn off Temp Pacers

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15
Q

under-sensing (generator does not sense intrinsic beats aka

A

Failure to sense
May/ may not capture
Hits on T wave–> R on T –>V Tach

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16
Q

Causes of Failure to Sense

A

Problems with interface
Sensitivity Set too High
Pacer at fixed rate/ asynchronous

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17
Q

Periods of brady w/ NO SPIKES on ECG

A

Failure to pace

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18
Q

Keep Cell phones/ MP3 headphones, iPods, Ipads…etc

A

6 ft away

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19
Q

Most common cause of pulmonary edema

A

Left side HF

20
Q

Abnormal accumulation of fluid in alveoli & interstitial spaces

A

Acute Pulmonary Edema

21
Q

Crackles, wheezing, dullness to percussion…

A

pleural effusions

22
Q

1st Line drug
decreases afterload & PAP
Increase CO
Limits Myocardial remodeling

A

ACE inhibitors

23
Q

SE ACE Inhibs

A

Low BP, Renal insufficiency, cough

24
Q

VAD can be used up to

A

2 years

25
Q

Diet for Acute HF

A

DASH

2g Na+, avoid dairy and canned foods

26
Q

Teach Acute HF/PE

A

2g+ Na+, No dairy/ canned food
Fluid restrictions <2000ml/d
No more than 2lbs/d
Rest

27
Q

20% of anterior MI’s develop

A

Cardiogenic shock (LAD)

28
Q

Preferred drug tx of Cardio Shock w/ NO hypotension

A

Dobutamine

29
Q

Counterpulsation

A

inflation/deflation cycle of IABP

30
Q

Most common artery used for CABG

A

Internal Mammary Artery

31
Q

Most common vein used for CABG

A

Saphenous

32
Q

Pre-op stop smoking

A

1 wk to 1 mo prior

33
Q

Immediately prior to CABG

A

EKG, Type n X, CXR, Coag studies, CBC, UA, Lytes, BUN, Creat, Liver panel, Pulmonary Funx, ABG’s

34
Q

Normal PaCO2

A

35-45 mmHG

35
Q

Normal HCO3

A

22-26 mEq/L

36
Q

PaO2

A

80-100mmHG

37
Q

SaO2

A

> /= 96%

38
Q

Increased PaCO2 > 45mmHg

A

(hypercapnea)

39
Q

No sign of compensation
Bicarbonate WNL
PaCO2 level increased
pH decreased < 7.35

A

Acute respiratory acidosis

40
Q

pH decreased
PaCO2 elevated
HCO3 elevated

A

Partially compensated respiratory acidosis

41
Q

pH – low, normal level
PaCO2 - elevated
HCO3 – (Bicarbonate) - elevated to compensate

A

Fully compensated respiratory acidosis

42
Q

Post PTCA

A 
Bedrest 3-4h
HOB flat for 30 min, then 30 degrees
Leg straight (restraint/sandbag)
Log Roll
EKG post-procedure
43
Q

D/C Teaching PTCA

A 
No heavy lifting 1-2wks
Norm activity in 1-2wks 
MD approval for work
Medications 
Deit
44
Q

Primary indicator for a VAD

A

Failure to wean patients of the heart lung machine

45
Q

Contraindications for VAD

A

Aortic valve insufficiency
Major CVA/prolonged cardiac arrest with brain damage
Sepsis/make limiting comorbidities
Body surface area

N202 Exam 3 Unit 2 (3 decks)

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