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XIO > Pacemakers > Flashcards

Pacemakers Flashcards

1
Q

conduction problems are blocks, like

A

1st or 2nd degree

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2
Q

premature atrial complexes can be what part of the heart?

A

atria or ventricles. it just means that they come early.

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3
Q

premature atrial complexes in atria are usually caused by (Art also gets irritated)

A

irritation

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4
Q

premature atrial complexes - how is the rate and rhythm?

A

rate usually normal. rhtym usually normal just comes early.

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5
Q

premature atrial complexes (PAC) - P waves

A

comes early, PR interval normal usually. QRS normal.

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6
Q

if irregular rhtym, always

A

take apical for a full minute

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7
Q

In most cases PACs are not a sign of

A

heart disease. Common in Cardio myopathy (a disease of the heart muscle that makes it harder for the heart to pump blood to the rest of the body)

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8
Q

treatment for PAC - lifestyle modifications

A

No smoking, loose weight if overweight, heart healthy diet, exercise regularly, limit alcoholic drinks to a maximum of 1 drink/day for women and 2 drinks/day for men (varies with individual)

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9
Q

PAC nursing implications - If patient is symptomatic, what is the treatment?

A

If patient is symptomatic (presyncope, syncope, angina, dyspnea) expect treatment with calcium channel blockers or beta blockers .

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10
Q

if aFib lasts more than a couple of days, we have to put them on (not blockers)

A

anticoagulants for 2 weeks before we can cardiovert

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11
Q

aFib atrial rate

A

400 - 600 bmp. ventricular is just irregular, depending on how well the AV node is blocking the extra beats.

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12
Q

big caution with aFib

A

development of clots

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13
Q

aFib treatment - calcium channel blockers

A

help slow the heart rate by blocking the number of electrical impulses that pass through the AV node into the ventricles

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14
Q

aFib treatment - digoxin

A

Digoxin to help slow the heart rate by blocking the number of electrical impulses that pass through the AV node into the ventricles

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15
Q

mitral and tricuspid diseases - what heart rhthym?

A

atrial flutter

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16
Q

Ventricular Tachycardia

A

when 3 or more PVCs (premature ventricular contractions) occur in succession at a rate greater than 100 bpm

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17
Q

coronary artery disease - what heart rhtyhm will you see? (CAD is tachy)

A

coronary artery disease is MOST common with ventricular tachycardia

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18
Q

vfib - less than 3 mm is what type?

A

fine, the other is coarse

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19
Q

vtach turns into vfib in about (not 5)

A

3 min

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20
Q

vfib treatment

A

CPR, precordial thump, defibrillation, medications. Dfib - the faster the better

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21
Q

pulseless electrical activity - PATCH FOR MD

A

P = Pulmonary embolus.
A = Acidosis
T = Tension pneumothorax. C = Cardiac tamponade
H = hypovolemia***(most common cause of pulseless), hypoxia, hypo or hyper thermia, hypo/hyperkalemia
M = MI
D = drug overdose (digoxin, calcium channel blockers)

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22
Q

2nd degree heart block - 2 types

A

mobitz type 1, mobitz type 2

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23
Q

2nd degree heart blocks - what happens?

A

some, but not all atrial impulses are blocked from the ventricles

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24
Q

mobitz type 1

A

delay at AV node, longer and longer PR interval. eventually you have no QRS

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25
Q

mobitz type 2 (no QRS w/ 2)

A

conduction delay at the AV node, PR interval long overall, constant for all beats. SUDDEN QRS drop d

26
Q

mobitz type 1 and 2 treatment and 3rd degree heart block (Mozart is serious)

A

pacemaker bc it can eventually turn into complete heart block

27
Q

3rd degree heart block

A

ALWAYS need a pacemaker. we don’t know if we’re going to have a cardiac output or not. P waves normal, QRS sometimes wide. other times, QRS not there at all. don’t stree their heart.

28
Q

anyone with a HR under 40 gets

A

a pacemaker

29
Q

Hypokalemia (U lay down with T)

A

Flattened T waves, prominent U wave

30
Q

hyperkalemia

A

Tall, pointy T waves

31
Q

severe hyperkalemia (big kalema severely loves QVC)

A

Widened QRS complexes

32
Q

pacemakers can be placed in

A

atria and ventricle, or one or the other

33
Q

demand pacemakers

A

only work if you need them to

34
Q

failure to pace (spike my pace)

A

spike on pacemaker right before QRS, a line.

35
Q

pacemaker problems (failure)

A

Failure to Pace, failure to sense, failure to capture

36
Q

failure to capture (can’t capture P, or QRS)

A

Pacer spike is noted on ECG but not followed by P waves or QRS complexes

37
Q

failure to sense

A

Is when the pacemaker doesn’t sense patient’s rhythm and starts an electrical impulse

38
Q

when to worry with pacemaker***

A

ALWAYS WORRY IF THE RATE DROPS BELOW THE SET RATE

39
Q

pacemaker post-operative care - and what to do with arm?

A

Postoperative care
Monitor incision
Most common complication is electrode displacement
Immobilize arm to allow wires to imbed
ROM to prevent frozen shoulder

40
Q

pacemaker pt teaching

A

Check pulse daily
ID card
Avoid microwaves (most are ok now)/MRI’s
Avoid contact sports

41
Q

signs pacemaker is not working

A

Presyncope/syncope
Weakness
Arrhythmia, palpitations, tachycardia/bradycardia
Dyspnea
Constant twitching of muscles in chest or abdomen
Frequent hiccups
Angina, chest pain
Confusion, extreme drowsiness

42
Q

common problems with pacemakers

A

Battery depletion
Loose or broken wire between heart and pacer
Lead dislodgment or gets pulled out
Electronic circuit failure
Electrolyte imbalance
Electromagnetic interference (generators, medical equipment)
Cyber attack
Change in condition that requires pacemaker reprogramming

43
Q

ICD is for ppl with (Tachy needs the ICD)

A

vtach, vfib

44
Q

ICD can detect

A

life threatening arrhythmias and then cardioverts, defibrillates and/or paces and records ECG

45
Q

The newer subcutaneous ICD delivers the energy at the

A

left sternum from sites near the left axilla

46
Q

nursing intervention for ICD

A

ECG assessment
CXR
Nursing assessment
CO and hemodynamic stability
Incision site
Signs of ineffective coping
Level of knowledge and education needs of family and patient

47
Q

ICD discharge teaching

A

Postoperative complications
Follow up appointments
Battery life

48
Q

ICD - Electrical interference issues - cell phones?

A

Cell/mobile devices (keep at least 6 inches/15 cm away from implantation site
Security systems and held metal detectors (airports)
Medical equipment (MRI, MRA not recommended

49
Q

Cardiogenic shock - loss of how much volume?

A

Due to primary cardiac disorder
Caused by inability of heart to contract effectively
Generally occurs with loss of 40% or greater of left ventricular volume
Stroke volume and cardiac output are reduced.

50
Q

Heart attack as a cause of

A

cardiogenic shock: Damaged heart muscle results in reduced force of contractions, reduced stroke volume, and reduced cardiac output.

51
Q

signs of heart attack - BP?

A

decreased BP, narrow pulse pressure

52
Q

ICD - lifting and exercising?

A

No lifting more than 5 pounds
No contact sports, strenuous exercise or swimming, bicycling, bowling, vacuuming (above shoulder activities)

53
Q

ICD - driving?

A

No driving for at least one month and up to 6 months if implanted for previous VT, VF

54
Q

ICD - how far to keep away from Power generators?

A

Power generators (keep at least 2 feet/0.6 meters away)

55
Q

ICD - how far to keep headphone devices?

A

MP3 player headphones devices (keep at least 6 inches/15 cm away from implantation site)

56
Q

signs of a heart attack - HR?

A

tachy or bradycardia

57
Q

heart attack - breathing?

A

tachypnea

58
Q

heart attack - skin?

A

pale, cool, clammy skin, mottled, anxiety, cynatoic

59
Q

heart attack - pulse?

A

jugular vein distention, weak or absent peripheral pulse

60
Q

heart attack - urine?

A

decreased urine output

XIO (372 decks)

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