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Details

Pacemaker
PM/AICD
21
Other
Graduate
09/17/2014

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Cards

Term
What physiologic variable determines the rate in a rate responsive pacemaker
Definition
minute ventilation
Term
What type of pacing can be used to avoid competition with patient's intrinsic rhythm?
Definition
Demand Pacing
Term
What type of pacing should be used when pt's do NOT have an intrinsic/underlying ventricular rhythm?
Definition
Fixed Rate (does not "sense"; paces at a set constant rate)
Term
Decreasing energy output on a PM is done for which of the following reasons?
a. conserve battery life
b. to regain "capture"
c. check threshold
d. Decrease diaphragm and pectoral muscle stimulation
e. increase diaphragm and pectoral muscle stimulation
Definition
a, c, d

(b & e apply to increasing the output/voltage)
Term
What happens when a magnet is placed over pacemakers (typically)?
a. pm reverts to asynchronous pacing
b. overdrive pacing
c. pm turns off
Definition
a
Term
True of False; sensitivity is the highest amplitude signal that will be detected by the sensor and interpreted as a beat/cardiac event?
Definition
False; Sensitivity is the lowest amplitude
Term
Of the following sensivity settings; which is the lowest?
a. 1.6
b. 2.0
c. 2.5
Definition
a
the lower the mv number/"fence" the higher the sensitivity
Term
True or False; Pacemakers do not have a refractary period
Definition
False; There is a period of time after paced/sensed event in which pacer will be insensitive to incoming signals
Term
Threshold is?
a. amount of current needed for electrical activation/capture
b. the lowest signal at which a heart beat is detected by the PM
Definition
a
(b is the definition of sensitivity)
Term
In VOO mode what chamber is sensed and which is paced?
a. Ventricle is paced. NO chambers sensed
b. ventricle paced; dual sensing
c. dual paced; no sensing
Definition
a
Term
What would be the NBG code for a pacer that was pacing, sensing, & responsive to both chambers & had the ability to modulate the rate based on pt's MV, and could repsond to tachycardia via overdrive pacing?
a. DDDRS
b. DDDVD
c. DDDRP
Definition
c. DDDRP
Term
What is the purpose of Pacer magnets? (choose all that apply)
a. treat Pacer-related emergencies
b. produce pacer-behavior that demonstrates battery life
Definition
b
NEVER intended to treat pacemaker emergencies or prevent EMI effects
Term
Pre-operatively, for a nursing home pt whose medical history is unknown, and you are uncertain if pt has an implanted pacing/defib device, What test could be done to confirm it?
Definition
chest x ray
Term
What is the best way to determine if a pt is pacer dependent?
Definition
Pacemaker interrogation
Term
To prepare a pt with an implanted pm/aicd for surgery and EMR is likely to occur what 3 things should be done?
Definition
1. Rate response should be off
2. tachyfuntion should be OFF (by placing magnet)
3. if pt is pacer dependant put pm in asynchronis mode by placing magnet
Term
What drug (in addition to basic ACLS drugs) should be in the room when pt's have a pacemaker?
Definition
Isuprel (pure Beta 1 agonist)
Term
True or False; During ECT: Pacemakers usually are not impacted; but ICD type should be disabled
Definition
True
Term
During an Cardioversion or Defibrillation of a pt with an implanted device; where should the pads be placed (producing the least current running through the device)?
Definition
Anterior & Posterior
Term
How often does the battery in an ICD need to be changed?
Definition
every 3-6 years (designed to deliver 120 shocks)
Term
What additional monitoring should be done on pt's undergoing ICD insertion?
a. 5 lead EKG
b. 2x good running IVs
c. crash cart w/drugs
d. defibrillators; external pads ON pt prior to start of procedure
e. all of the above
Definition
e: VF is induced via R on T phenomenon)to determine threshold and proper functionng
Term
True or False; BIventricular pacer insertion requires GETA
Definition
False; no difference in pt outcomes w/ GETA vs sedation (institution/provider/pt determined)
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