Term
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Definition
| Electronic devices used to initiate heart beat when the intrinsic electrical system cannot effectively generate a rate adequate to support CO. may be used temporarily, supportively, or permanently. |
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Term
| What are some indications for pacemakers? |
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Definition
| Bradydysrhythmias: sinus brady, sick sinus, heart blocks. Tachydysrhythmias: overdrive pacing (supraventricular & ventricular). Used to support CO after CV surgery, and used for diagnostic studies. |
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Term
| What is a transcutaneous pacing route for a pacemaker? |
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Definition
| It's noninvasive, emergency setting. Patient discomfort due to higher energy levels. |
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Term
| What is an epicardial pacing route? |
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Definition
| Used in CV surgery, can be ventricular and/or atrial |
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Term
| What is transvenous pacing route? |
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Definition
| Through subclavian or internal jugular to right atrium or right ventricle |
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Term
| How does a fixed rate or asynchronous pacemaker work? |
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Definition
| Delivers a pacing stimulus at a set rate regardless of teh occurrence of spontaneous myocardial depolarizations. Occurs in non-sensing modes. |
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Term
| How does a deman or synchronous pacemaker work? |
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Definition
| Delivers a pacing stimulus only when the heart's intrinsic pacemaker fails to function at a predetermined rate. The pacing stimulus is either inhibited or triggered by the sensing of intrinsic activity. |
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Term
| How does an Atrioventricular (AV) pacemaker work? |
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Definition
| Sequential (dual chamber) - delivers a pacing stimulus to both the atrium and ventricle in physiologic sequence with sufficient AV delay to permit adequate ventricular filling. |
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Term
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Definition
| the point at which depolarization occurs is termed threshold and is indicated by a myocardial response to the pacing stimulus (capture). Can be determined by gradually decreasing the output setting until 1:1 capture is lost. Output set 2-3times threshold. |
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Term
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Definition
| Regulates the ability of the pacemaker to detect the heart's instrinsic electrical activity measured in millivolts and determines the size of the intracardiac signal that the generator will recognize. Sense indicator light signals intrinsic activity. |
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Term
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Definition
| Only in dual chamer generators. Regulates the time interval between the atrial and ventricular pacing stimuli, is analogous to PR interval (150-250 milliseconds) |
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Term
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Definition
| Spike seen on ECG tracing as the pacing stimulus is delivered to the heart. a P wave is visible after the pacing artifact in the atria is being paced and a QRS complex follows a ventricular pacing artifact. |
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Term
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Definition
| failure of the pacemaker to deliver the pacing stimulus resulting in disappearance of pacing artifact even though patient's rate is less than set rate. Check batter, wires, connections, EMI = loss of capture |
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Term
| Undersensing abnormalities |
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Definition
| undersensing is the inability of the pacemaker to sense spontaneous myocardial depolarization which results in competition between paced complexes and the heart's intrinsic rhythm. Pacing artifacts occur after patient complex |
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Term
| Oversensing abnormalities |
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Definition
| results from the inappropriate sensing of extraneous electrical signals leading the unnecessary triggering or inhibiting of stimulus output |
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Term
| How can we, as nurses, prevent pacemaker malfunction? |
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Definition
| Keep the pacemaker from dropping on the floor, keep it in a pouch attached on the patient. |
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Term
| How can we protect ourselves from micro shock? |
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Definition
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Term
| Where are some important infection control techniques? |
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Definition
| Wash hands. Assess and monitor site of insertion of pacemaker. Change bandages as ordered. |
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Term
| What are some things we need to teach our patient? |
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Definition
| Don't pull any of the wires out. Teach patient/family why restraints may need to be used. Teach about infection control. |
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Term
| What is an implantable Cardioverter Defibrillator (AICD)? |
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Definition
| Electrical Device capable of identifying and terminating life-threatening ventricular dysrhythmias. Contains sensing electrodes and defibrillation electrodes. |
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