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19 Cards in this Set

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WHAT ARE THE 2 TYPES OF INVASIVE TEMPORARY PACING?
1.TRANSVENOUS-UNDER FLUROSCOPY,A CATHERTER CONTAINING 2 LEAD WIRES IS PERCUTANEOUSLY PUT THROUGH A VEIN TO THE RT VENTRICLE
2.EPICARDIAL-WIRES THREADED ON THE EPICARDIAL SURFACE
COMPLICATIONS OF INVASIVE TEMPORARY PACING:
1.INFECTION OR HEMATOMA AT WIRE SITE
2.ECTOPIC COMPLEXES,LOSS OF CAPTURE,OVERSENSING,DISSLOCATION
3.BLEEDING
4.HEMOTHORAX DURING INSERTION
5.HICCUPS
WHAT ARE THE 2 TYPES OF PACEMAKERS?
1.TEMPORARY-NON SURGICAL(FOR SHORT TIME)
2.PERMANENT-PULSE GENERATOR IMPLANTED IN POCKENT IN ANTERIOR CHEST
PERMANENT PACEMAKER
1.PERFORMED FOR CONDUCTION D/O
2.POWERED BY LITHIUM BATTERY-LASTS 10 YRS
3.RATE RESPONSIVENESS
4.HYSTERESIS-SLOWS RATE 10-20 BEATS
NURSING:ACTIV RESTICTED 24 HRS**
WHAT ARE THE MOST COMMON MODES OF PACING?
1.VVI
2.DVI
3.DDD
PACING MODALITIES (ICHD IDENTIFICATION MODE)
1.CHAMBER PACED (VAD)
2.CHAMBER SENSED (VADO)
3.RESPONSE (ITDO)
VENTRICULAR PACING
REGULAR RHYTHM
NO P WAVES
PACER ARTIFACT-BIG BLIP
QRS IS WIDE
ATRIAL PACING
REGULAR PACING
P WAVE NORMAL
P-R INTERVAL NORMAL
PACER ARTIFACT-SPIKE
QRS WIDTH IS NORMAL
TROUBLESHOOTING FOR FAILURE TO CAPTURE (PACEMAKER FAILS TO STIMULATE IMPULSES),FAILURE TO SENSE(APICAL RATE HIGH),& FIRING LOSS (NO PACING SEEN):
S/S:APICAL RATE IS BELOW PACEMAKER SETTING
-PACEMAKER SPIKE NOT FOLLOWED BY QRS
-CONTINUOUS SENSE/PACE
CAUSE:DISPLACEMENT OF LEAD,CATHETER
SOLUTION:**TURN PT ON LEFT SIDE TO AID CATHETER CONTACT W/MYOCARDIUM
WHAT IS TEMPORARY PACING USED FOR?
1.SYMPTOMATIC,ATROPINE REFRACTORY BRADYDYSRHYTHMIAS
2.HEART BLOCKS
3.ASYSTOLE
4.TO TERMINATE SYMPTOMATIC TACHYDYSRHYTHMIAS AS IN A FIB OR FLUTTER
IMPLANTABLE CARDIOVERTER/DEFIBRILLATOR
FOR CLTS WHO HAVE VT OR FV UNRELATED TO MI
-PSYCHOLOGIAL PROFILE DONE (FOR FEAR W/ICD)
-LEADS INTRODUCED PERCUTANEOUSLY
-ACTIVATED/DEACTIVATED W/ MAGNET
**PT MAY BECOME UNCONSIOUS AFTER SHOCKED
SYNCHRONOUS (DEMAND)
PACEMAKERS SENSITIVITY IS SET TO SENSE THE CLT'S OWN BEATS
ASYNCHRONOUS (FIXED RATE)
DOESNT SENSE PTS BEAT
-FIRES AT FIXED RATE REGARDLESS
USED FOR ASYSTOLE OR SEVERE BRADYCARDIA
PACEMAKER
INTERVENTION THAT USES A PULSE GENERATOR (POWER SOURCE) TO DELIVER AN ARTIFICIAL STIMULUS TO THE HEART TO CAUSE ELECTRICAL DEPOLARIZATION & MYOCARDIAL CONTRACTION
NON-INVASIVE TEMPORARY PACING
2 LARGE ELECTRODES ATTACHED TO PT & CONNECTED TO THE EXTERNAL PULSE GENERATOR WHICH OPERATES ON BATTERY OR AC
-USED IN AN EMERGENCY (TO PROVIDE DEMAND VENTRICULAR PACING)
WHERE DOES THE PACEMAKER DELIVER THE STIMULUS?
TO THE RIGHT ATRIUM,RT VENTRICLE, OR BOTH
PROCEDURE FOR APPLYING PACEMAKER
1.WASH SKIN W/SOAP & WATER
2.PLACE 1 ELECRODE ON PT'S BACK ON THE LFT SIDE BET THE SPINE & SCAPULA & BEHIND THE HEART
3.ANTERIOR ELECTRODE APPLIED TO CHEST OVER HEART,ON FEMALE..UNDER BREAST
4.SET RATE AS ORDERED
5.SET STIMULATION
6.TAKE VS PALPATE R RADIAL PULSE/CAROT
3 COMPLICATIONS FROM NTP (NON INVASIVE TEMPORARY PACING)
1.DISCOMFORT
2.LOSS OF CAPTURE
3.INAPPROPIATE PACING
INVASIVE TEMPORARY PACING
EXTERNAL,BATTERY-OPERATED PULSE GENERATOR
-WIRES GO THROUGH VEIN
-PT DOESNT FEEL STIMULATION