PaceMakers

Question 1

Packmacker Types

Answer 1

Transcutaneous pacing (TCP): External
Epicardial: Transthoracic
Endocardial: Transvenous

Question 2

Pacing Indications

Answer 2

Temporary: Prophylaxis after open heart surgery, AMI, bradycardia, bradydysrhythmias

Permanent: 2nd/ 3rd heart block, A fib w/ slow ventricular response, cardiomyopathy, SA node dysfunction, tachydysrhythmia

Question 3

Complications

Answer 3

local infection, pneumothorax, bleeding, hematoma, disclocation of lead, cardiac perforation

Question 4

Pacemarker (General)

Answer 4

Battery replacement surgeries Q10 yrs (less to be safe)
Check pt pulse to confirm effectiveness of Pacemaker
* Should be reg
Pt Education: Check radial pulse every morning, Keep a log ( > 60 bpm)

Question 5

Malfunctions

Answer 5

Failure to Pace: Pulse generator or battery problem, broken wire, loose connection

Failure to Capture: Low Battery, leads in wrong place

Failure to Sense: overcompensates, fires w/ no relation !

Question 6

Pacemaker

Capture

Answer 6

Depolarization of Chamber following pacer spike

Question 7

Atrial Pacing

Answer 7

Spike before P wave

Question 8

Ventricular Pacing

Answer 8

Spike before QRS ( looks like PVC?)

Question 9

AV Sequential Pacing

Answer 9

Spike before P wave + before QRS
(dual chamber pacemaker)

Question 10

Nursing Management

Answer 10

Airport ( NO metal detectors)
NO MRI (ever!)
Lifting Precautions (6-8wks)
* Sling 6-8 wks
* no lifting arm above shoulder height
* no lifting > 5lbs

Infections
Log of heart rates
Chest X rays
No showering 3-5 days