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Principles 2** > shortened PM > Flashcards

shortened PM Flashcards

1
Q

1). Describe the 2 basic things a pacemaker system consist of.

__________: Electrical impulses are formed in the _________ and transmitted to the endocardial or myocardial surface of the heart resulting in a mechanically induced contraction; power source or battery

______: insulated wires that deliver electrical impulses from the ____________ to the heart; senses cardiac depolarization

A

Pulse generator, pulse generator

Lead(s), pulse generator

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2
Q

________ = the body tissue is part of the circuit

________ = body tissue contact is essential for grounding

A

Bipolar

Unipolar

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3
Q

_______ detection of chamber tissue depolarization

________ generated stimulus causes chamber depolarization

_________ pacer does not detect a chamber depolarization

________ stimulus fails to cause a chamber depolarization

A

Sense:

Capture:

Failure to sense:

Failure to capture:

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4
Q

indications for a pacemaker:

Chronic \_\_\_\_\_\_
Chronic \_\_\_\_\_\_\_\_ and \_\_\_\_\_\_\_ block
AV heart block after \_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_ dysfunction
Hypersensitive \_\_\_\_\_ and neurally mediated syndromes (neurogenic syncope)
Children and adolescents with \_\_\_\_\_\_
\_\_\_\_\_\_\_ cardiomyopathy
Cardiac \_\_\_\_\_\_\_
Termination of \_\_\_\_\_\_\_\_\_\_
A

Chronic AV heart block
Chronic bifascicular and trifascicular block
AV heart block after acute MI
Sinus node dysfunction
Hypersensitive carotid sinus and neurally mediated syndromes (neurogenic syncope)
Children and adolescents with bradycardia
Dilated cardiomyopathy
Cardiac transplantation
Termination of tachydysrhythmias

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5
Q

_________ pacemakers typically target either the right atrium or right ventricle.

________ pacemakers stimulate both the right atrium and the right ventricle.

A

Single chamber

Dual chamber

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6
Q

_________ controls HR by sensing physiological or nonphysiological signals other than the atrial rate

Biventricular pacing: functional hemodynamic abnormalities with ______ _______ contraction – related to conduction delays – leads to prolonged _________, compromised _______ time, and ineffective atrial contribution to _______.

A

Rate adaptive:

asynchronous ventricular
isovolumetric time
diastolic filling
LV filling

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7
Q

indications for ICD:
Cardiac arrest due to _____

Drug resistant VT with ______
impact causing syncope

Patients with _________ and a history of sudden death with documented sustained ____

_______ for patients with coronary artery disease and non-sustained VT

A

VT/VF
hemodynamic
coronary artery disease, VT
Prevention

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8
Q

3 various functions of ICDs

A
  • Anti-tachycardia pacing
  • Anti-bradycardia pacing
  • Cardioversion and defibrillation
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9
Q

what is meant by dependency on the device.

  • Verbal history or written medical record of syncope from a __________
  • History of _______ requiring device
  • Device evaluation that shows _____________ activity
A

bradyarrhythmia requiring device

AV node ablation

no spontaneous ventricular

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10
Q

Recall three things that can alter capture thresholds.

A

Hypoxia, hypercapnia, and acidosis

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11
Q

Effects of common drugs given perioperatively can have on cardiac function.

  • _______ and ______ (high doses): bradycardia (increased in pts with bradycardia)
  • ____, ______, and ______: prolong QT
  • ______ agents (high doses; ex. volatiles): polymorphic VT
A

Dexmedetomidine and fentanyl

Haldol, methadone, and ondansetron

Inhalation

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12
Q

how electromagnetic interference (EMI) can affect a pacemaker and an AICD?

• Signals for other sources which the pacemaker or ICD sense

• Most common source: ________
- _____ cautery worse than _____

• Other sources: AC power supplies, microwaves (waves with frequencies up to 1011 Hz), ventilators, monitors

A

Electrocautery

- Unipolar worse than bipolar

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13
Q

Pacemaker response to EMI:

  • Inhibition due to _______
  • Paces _______
  • Triggers _____________
  • _____ myocardium at lead site
  • Energy damages _________ or battery or reprograms it
A 
ventricular oversensing
asynchronously
atrial or ventricular fibrillation
Burns 
pulse generator circuit
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14
Q

Defibrillator response to EMI:

  • Inappropriate _______
  • Failure to _______
  • R_________
  • _______ myocardium at lead site
  • Energy damages _________
A 
shock delivery
deliver shock
Reprogrammed 
Burns
pulse generator circuit
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15
Q

variety of measures to prevent EMI effects on devices.

  • Determine if reprogramming to asynchronous or disabling rate adaptive functions is necessary
  • Disable ____________ function
  • Suggest ________ ________ or harmonic scalpel
  • Temporary pacing and defibrillating capabilities
A

antitachyarrhythmia

bipolar electrocautery

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16
Q

variety of measures to prevent EMI effects on devices continued

  • Ensure cautery grounding pad is as far from the ___________ as possible
  • Ensure pulse generator and leads are not located between the ________ _____ and the __________!
  • Utilize ______ _____ of cautery with the lowest strength possible
  • Programmer readily available
  • Monitor for arrhythmias and be prepared to treat
  • If defibrillation is necessary, use the ___________ placement of paddles and _________ _____ dose of electrical energy possible.
A

pulse generator

operative site and the grounding pad!

short bursts

anterior-posterior

lowest effective

17
Q

If necessary to defibrillate, there will be an __________ threshold causing a loss of capture and the need for prompt insertion of a ___________ or a ___________

A

acute increase in stimulation

transvenous pacer or transcutaneous pacer.

18
Q

Describe what the REED switch does on a pacemaker.

A

STOPS sensing and adjusts the pacer to ASYNCHRONOUS pacing mode.

19
Q

Describe what a magnet does to a pacemaker and what it does to a defibrillator.

A

ICD: disables the shock device, but pacing continues
Pacemaker: converts pacer to asynchronous mode when placed over the generator

20
Q

Describe what is meant by asynchronous with regard to a pacemaker. What happens?

A

Pacer delivers stimuli at a fixed rate (normally 70-72 bpm) independent of the heart’s intrinsic beat.

21
Q

Understand pacemaker coding and how it relates to more selection.

  • The first letter refers to the chamber(s) being ______
  • The second letter refers to the chamber(s) being _______

• The third letter refers to the ________:
o T = Triggered D = Dual (inhibited and triggered*)
o I = Inhibited O = No response

A

paced
sensed
pacemaker’s response to a sensed event

22
Q

In a _______ mode, “triggered” means that when an intrinsic event is sensed, a pace is triggered immediately thereafter.

In a _______ mode, “triggered” means that a sensed atrial event will initiate (trigger) an A-V delay

A

single chamber

dual chamber

Principles 2** (14 decks)

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