NR 341 COMPLEX ADULT HEALTH EXAM 2 - UNIT 3 + 4 : 140+ QUESTIONS AND
CORRECT ANSWERS|A+ GRADE
Pacemakers - (ANSWER)Permanent and temporary.
stimulate contractions.
Atria = P-wave stimulation (spike right before)
Ventricle = QRS stimulation (spike right before)
Dual Pacemaker - (ANSWER)Better than single pacemaker b/c CARDIAC OUTPUT IS
INCREASED AND MINICS HEART MUCH CLOSER than a single one.
@#$%^&*()
Will see P-wave and QRS complexes for each paced beat (A-V paced).
Transcutaneous Pacemaker (external) - (ANSWER)Temporary, noninvasive.
Need to give enough sedation and pain meds.
Attached to D-fib and put in pacer mode to shock heart.
Permanent Pacemaker (internal) - (ANSWER)Invasive and need informed concent for Dr.
Need to explain risks and complications.
Clean chest and make sure it's sterile.
Complications of internal pacemakers - (ANSWER)Malfunctions, leads can get displaces,
battery can die, pneumothorax, can irritate phrenic nerve/stimulation (hiccups).
A - paced EKG - (ANSWER)Pacing stimulus directed to heart and a pacer spike is seen on
EKG strip. Vertical line followed by a P-wave (atrail pacing)
V - paced EKG - (ANSWER)Pacing stimulus directed to heart and a pacer spike is seen on
EKG strip. Vertical line followed by a QRS complex (ventricular pacing).
Each pacemaker spike needs to be followed by a... - (ANSWER)complex (p-wave or QRS)
Failure to Capture - (ANSWER)Electrical charge to myocardium is insufficient to produce
atrial or ventricular contraction.
What can failure to capture result in? - (ANSWER)Serious bradycardia or asystole.
What causes failure to capture w/ pacemakers? - (ANSWER)Pacer lead damage, battery
failure, dislodgement of electrode, electrical charge set too low, fibrosis od electrode tip.
What to do if see EKG of pacemaker with no complex? - (ANSWER)Assess first and then
notify Dr. Means electrical charge is not strong enough to cause contraction.
, NR 341 COMPLEX ADULT HEALTH EXAM 2 - UNIT 3 + 4 : 140+ QUESTIONS AND
CORRECT ANSWERS|A+ GRADE
Pacemaker Placement - (ANSWER)PLaced in the OR or Cath Lab.
24 hr stay.
Left arm should not be lifted more than 90 degrees (no greater than shoulder level).
Pacemaker patient education - (ANSWER)Monitor incision site, Monitor/check HR 1x/day,
always carry pacemaker ID card, NO MRIs (contraindicated bc of magnet), can't have
@#$%^&*()
security wand waved over them (notify security), can't walk through metal detector.
Notify Dr. if chest pain, palpitations, hiccups, SOB, dizziness.
Cardioversion - (ANSWER)Indicated for fast rhythms w/ a pulse.
Elective procedure - need to have consent, have crash cart ready, enough sedation and
pain medication (can have skin burns)
Prior to a cardioversion procedure... - (ANSWER)Echocardiogram needs to be done to r/o
risk of blood clot dislodgement (placed on anticoagulants)
Internal Cardioversion - (ANSWER)*AICD* - pacemaker w/ ability to shock.
Pacing capabilities - A paced, V paced, or both.
What meds are people with an AICD on? - (ANSWER)Amiodarone (antiarrythmic)
AICD teaching - (ANSWER)Same as regular pacemaker + need to let Dr. know if a shock
occurs.
when to call rapid response - (ANSWER)Pt is deteriorating and has a pulse (low cardiac
output, change in LOC, hypotension, wheezes, stridor, unexpected/abnormal change).
CODE procedure - (ANSWER)Person has arrested and recognition, BEGIN CPR RIGHT
AWAY, documentation happens during CODE and to the minute, stop CPR when person is
about to get shocked (staff must be clear)
How to treat V-tach (no pulse) - (ANSWER)CPR, defib, epi
How to treah V-fib - (ANSWER)CPR, defib, epi
How to treat asystole - (ANSWER)CPR, Epi
CORRECT ANSWERS|A+ GRADE
Pacemakers - (ANSWER)Permanent and temporary.
stimulate contractions.
Atria = P-wave stimulation (spike right before)
Ventricle = QRS stimulation (spike right before)
Dual Pacemaker - (ANSWER)Better than single pacemaker b/c CARDIAC OUTPUT IS
INCREASED AND MINICS HEART MUCH CLOSER than a single one.
@#$%^&*()
Will see P-wave and QRS complexes for each paced beat (A-V paced).
Transcutaneous Pacemaker (external) - (ANSWER)Temporary, noninvasive.
Need to give enough sedation and pain meds.
Attached to D-fib and put in pacer mode to shock heart.
Permanent Pacemaker (internal) - (ANSWER)Invasive and need informed concent for Dr.
Need to explain risks and complications.
Clean chest and make sure it's sterile.
Complications of internal pacemakers - (ANSWER)Malfunctions, leads can get displaces,
battery can die, pneumothorax, can irritate phrenic nerve/stimulation (hiccups).
A - paced EKG - (ANSWER)Pacing stimulus directed to heart and a pacer spike is seen on
EKG strip. Vertical line followed by a P-wave (atrail pacing)
V - paced EKG - (ANSWER)Pacing stimulus directed to heart and a pacer spike is seen on
EKG strip. Vertical line followed by a QRS complex (ventricular pacing).
Each pacemaker spike needs to be followed by a... - (ANSWER)complex (p-wave or QRS)
Failure to Capture - (ANSWER)Electrical charge to myocardium is insufficient to produce
atrial or ventricular contraction.
What can failure to capture result in? - (ANSWER)Serious bradycardia or asystole.
What causes failure to capture w/ pacemakers? - (ANSWER)Pacer lead damage, battery
failure, dislodgement of electrode, electrical charge set too low, fibrosis od electrode tip.
What to do if see EKG of pacemaker with no complex? - (ANSWER)Assess first and then
notify Dr. Means electrical charge is not strong enough to cause contraction.
, NR 341 COMPLEX ADULT HEALTH EXAM 2 - UNIT 3 + 4 : 140+ QUESTIONS AND
CORRECT ANSWERS|A+ GRADE
Pacemaker Placement - (ANSWER)PLaced in the OR or Cath Lab.
24 hr stay.
Left arm should not be lifted more than 90 degrees (no greater than shoulder level).
Pacemaker patient education - (ANSWER)Monitor incision site, Monitor/check HR 1x/day,
always carry pacemaker ID card, NO MRIs (contraindicated bc of magnet), can't have
@#$%^&*()
security wand waved over them (notify security), can't walk through metal detector.
Notify Dr. if chest pain, palpitations, hiccups, SOB, dizziness.
Cardioversion - (ANSWER)Indicated for fast rhythms w/ a pulse.
Elective procedure - need to have consent, have crash cart ready, enough sedation and
pain medication (can have skin burns)
Prior to a cardioversion procedure... - (ANSWER)Echocardiogram needs to be done to r/o
risk of blood clot dislodgement (placed on anticoagulants)
Internal Cardioversion - (ANSWER)*AICD* - pacemaker w/ ability to shock.
Pacing capabilities - A paced, V paced, or both.
What meds are people with an AICD on? - (ANSWER)Amiodarone (antiarrythmic)
AICD teaching - (ANSWER)Same as regular pacemaker + need to let Dr. know if a shock
occurs.
when to call rapid response - (ANSWER)Pt is deteriorating and has a pulse (low cardiac
output, change in LOC, hypotension, wheezes, stridor, unexpected/abnormal change).
CODE procedure - (ANSWER)Person has arrested and recognition, BEGIN CPR RIGHT
AWAY, documentation happens during CODE and to the minute, stop CPR when person is
about to get shocked (staff must be clear)
How to treat V-tach (no pulse) - (ANSWER)CPR, defib, epi
How to treah V-fib - (ANSWER)CPR, defib, epi
How to treat asystole - (ANSWER)CPR, Epi
