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26 Cards in this Set

  • Front
  • Back
goal of pacing
maintian CO
-ability of pacing stim to depolaize chamber
-recognized when pacing spike is followed by appropriate waveform
capture
-ability of pacemaker to detect intrinsic cardiac activity to be able to respond appropriately
sensing
Absence of pacing stimulus where one should be
Failure to discharge
-Ck battery, connections
-r/o electrical interference
-may need emergent temp pacer
Inability of pacer to sense pt's own intrinsic beats. pacer seen firing on ST segments and R waves, etc.
Undersensing
-increase sensitivity i.e. reduce mV setting (set too high)
-lead dislodgment
Strength of electrical impulse from pacer measured in
mA
Output/Stim threshold
Strength of electrical impulse from heart measured in
mV
Sensing/sensitivity
Occurs when pacer senses stray electrical signals. Pacer fires impulses at slower rate then programmed for.
Oversensing
Decrease sensitivity i.e. increase mV setting (set too low)
Pacer spikes not followed by waveforms (ie P wave or QRS wave)
Failure to capture
Ck pt for S&S dec CO
-lead dislodgment/connections
-increase output (mA)(set too low)
-Check labs
-
mA too low causes
Failure to capture
mV set too low causes
Oversensing
Must increase setting (thus decreasing sensitivity)
mV set too high causes
Undersensing
Must decrease setting (thus increasing sensitivity)
Impt teaching for pt in hosp with transvenous pacer
Keep arm/leg straight
Position-chambers paced
1
Position-chambers sensed
2
Position-response to sensing
3
Position-rate modulation
4
Pacer set to I in 3rd position (response to sensing). Pacer only fires if pt's own intrinsic rate drops below set rate (say 70)
Demand pacing
I=pacer being inhibited
Mode used to test pacers fxn (ie approp firing/capture) on Dr visit
asynchronous
VVI
Single lead pacer
In ventricle
On demand
-Often used for temp vent pacers
DDD
Dual lead
Ventricle and atrium
Paces and senses (works as on demand but also can trigger a qrs based on sensed p wave)
-Often used for perm pacer
DDDR
Dual lead
Ventricle and atrium
Paces and senses
Also speeds up or slows rate in response to sensor output
T/F
Nurses can change settings on pacers
T for temp pacer
F for perm pacer
ICD must get checked how often
q2-3 mo
T/F
Pt with ICD can stop antiarrhythmic Rx
F-Treated no differently. In emergent situations can still be shocked as well
indicate in class 3/4 HF
Bivent ICD