EKGs and Defibrilation Flashcards
Pacemaker
electronic device that provides electrical stimuli to heart muscle, can be permanent or temporary
Complications of Pacemaker Use
Infection, bleeding/ hematoma formation, dislocation of lead, skeletal muscle or phrenic nerve stimulation, cardiac tamponade, pacemaker malfunction
Cardioversion
current delivery is synchronized with pt’s ecg
Defibrilation
current delivery is unsynchronized
Safety measures for defibrilation
Ensure good contact between skin, pads, and paddles
o Use conductive medium, 20 to 25 pounds of pressure
Place paddles so they do not touch bedding or clothing and are
not near medication patches or oxygen flow
If cardioverting, turn synchronizer on
If defibrillating, turn synchronizer off
Do not charge device until ready to shock
Call “clear” three times; follow checks required for clear
o Ensure no one is in contact with patient, bed, or equipment
ICD
Device that detects and terminated life threatening episodes of tachycardia and fibrillation (Anti tachycardia pacing)
Nursing Assessment of permanent electronic devices
ECG, CXR, CO and hemodynamic instability, incision site, signs of ineffective coping, level of knowledge and education needs of family and patient
Arrythmia
Disorders of formation or conduction (or both) of
electrical impulses within heart
Can cause disturbances of
o Rate
o Rhythm
o Both rate and rhythm
Potentially can alter blood flow and cause
hemodynamic changes
Diagnosed by analysis of electrographic waveform
Atrial Arrythmias
PAC, Atrial Flutter, afib
Ventricular Arrythmias
PVC, Vtach, vfib, ventricular asystole
Normal Electrical Conduction
SA node (sinus node)
AV node
Conduction
Bundle of His
Right and left bundle branches
Purkinje fibers
Depolarization = stimulation = systole
Repolarization = relaxation = diastole
Conduction Abnormalities
First-degree AV block
Second-degree AV block, type I (Wenckebach)
Second-degree AV block, type II
Third-degree AV block