pacemaker AICD

Question 1

indications for pacemaker therapy

Answer 1

symptomatic bradycardia (slow ventricular rate
symptomatic heart block

Question 1

components of a pacemaker

Answer 1

electronic pulse generator
pacemaker electrodes

Question 2

single lead unipolar pacemaker

Answer 2

lead placed in atrium or ventricle
produce large spike on the ECG
sensing and pacing in the chamber where the lead is located
more likely to be affected by electromechanical interference

Question 3

Dual chamber bipolar pacemaker

Answer 3

one lead located in the atrium and one in the ventricle
sensing and pacing in both chambers mimicking the normal heart function
less affected by electromechanical interference

Question 4

NASPE BPEG code First

Answer 4

paced
A atrium
V ventricle
Dual

Question 5

NASPE BPEG code second

Answer 5

sensed
A
V
D

Question 6

NASPE BPEG third

Answer 6

response
I inhibited
T triggered
D dual

Question 7

pacing

Answer 7

stimulating of the chamber to mimic normal heart function
produces a spike on the ECG

Question 8

inhibited response

Answer 8

response of the pacemaker is controlled by the activity of the patients heart
only function when the patients heart isn’t beating

Question 9

triggered response

Answer 9

response when it senses intrinsic heart activity
triggered by each p wave

Question 10

capture response

Answer 10

the heart has responded to the stimulus by producing an appropriate complex

Question 11

failure to capture

Answer 11

may occur with low battery or poor connection
the pacemaker is discharging the impulse but there is no responding cardiac contraction

Question 12

Pacemaker insertion procedure

Answer 12

1. check if patent IV and that the defibrillator, emergency cart, and approriate meds are available
2. get consent
3. obtain vital signs and EKG rhythm prior and connect to monitor continuously before during and after
4. anesthetize the area locally
5. portable chest x ray to confirm placement

Question 13

nursing monitoring post pacemaker insertion

Answer 13

monitor for bleeding hematoma and infection

Question 14

pacemaker insertion complications

Answer 14

movement and dislocation of the lead
bleeding and hematoma
ventricular ectopy or VT from wall stimulation
infection
cardiac tamponade
hemothorax/ pneumothorax
hiccups –> generator is pacing the diaphragm
pacemaker syndrome

Question 15

pacemaker syndrome

Answer 15

most common in VVI
fatigue
chest discomfort
SOB
activity intolerance
postural hypotension

Question 16

pacemaker cautions (electromagnetic interference)

Answer 16

never get an exposed MEI because it can alter or erase the program memory or kill the battery
request a hand search at airport or other areas
household appliances are fine

Question 17

Automatic implantable cardioverter defibrillator

Answer 17

detects and terminates life threatening episodes of tachycardia or fibrillation
specifically ventricular

Question 18

high risk populations who would get treated with AICD

Answer 18

dilated cardiomyopathy
hypertrophic cardiomyopathy
arrythmogenic right ventricular dysfunction
idiopathic prolonged QT syndrome

Question 19

CPR with an AICD

Answer 19

rescuers in contact with the patient may feel tingling
don’t place defibrillator over device
check the device after defibrillation

Question 20

Electrophysiologic studies

Answer 20

invasive cardiac Cath to evaluate and treat dsrythmias
patient is conscious but lightly sedated

Question 21

cardiac cath

Answer 21

perdormed in a specially equipped lab by an electrophysiologist

Question 21

cardiac ablation

Answer 21

destruction of the causitive cells using radiofrequency (heat) or cold temperature