Pacemaker - ATI templates and testing material. PDF

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Summary

ATI templates and testing material....

Description

ACTIVE LEARNING TEMPLATE:

System Disorder

Cruz ST UDENT NAME Melyn _____________________________________ Pacemaker: interpreting rhythm strip DISORDER/DISEASE PROCESS __________________________________________________________

Alterations in Health (Diagnosis) Inadequate conduction of electrical impulses through the SA node

Pathophysiology Related to Client Problem Battery operated device that electronically stimulates the heart when the natural pacemaker of the heart fails to maintain an acceptable rhythm

29 REVIEW MODULE CHAPTER ___________

Health Promotion and Disease Prevention Avoid direct blows or injury to generator site Wear a sling out of bed and do not raise arm above shoulder for 1-2wks

ASSESSMENT

SAFETY CONSIDERATIONS

Risk Factors Systemic bradycardia Complete heart block Sick sinus syndrome Sinus arrest Atrial tachydysrhythmias

Expected Findings When a pacing stimulus is delivered to the heart, a pacer spike will be seen on the cardiac monitor or ECG strip. The pacer spike, a verticle line, should be followed by a P wave or QRS complex

Laboratory Tests None

Diagnostic Procedures Chest x-ray ECG or EKG Stress test Holter monitoring

PATIENT-CENTERED CARE

Nursing Care Document the time and date of insertion, model, settings, rhythm strip, presence of adequate pulse and BP, and client response Continuously monitor heart rate and rhythm

Therapeutic Procedures Obtain a chest x-ray to assess lead placement and for pneumothorax, hemothorax, or pleural effusion

ACTIVE LEARNING TEMPLATES

Minimize shoulder movement initially to allow leads to anchor, and provide a sling Monitor incision site for bleeding, hematoma formation, or infection Following pacemaker insertion, assess for hiccups, which can indicate that the generator in pacing the diaphragm

Complications Medications Analgesics

Client Education Temporary pacemakers are used only in controled facilities with continuous ECG monitoring Permanent pacemakers: Carry at all times, follow restrictions, report dizziness, fainting, fatigue

Interprofessional Care Cardiologist

Improper sensing or pacing electrical charge being outside the heart Insufficient pacemaker settings Lead wire placement and function Poor battery function Arrhythmias Infections at insertion site...