EKGs and Defibrilation

Question 1

Pacemaker

Answer 1

electronic device that provides electrical stimuli to heart muscle, can be permanent or temporary

Question 2

Complications of Pacemaker Use

Answer 2

Infection, bleeding/ hematoma formation, dislocation of lead, skeletal muscle or phrenic nerve stimulation, cardiac tamponade, pacemaker malfunction

Question 3

Cardioversion

Answer 3

current delivery is synchronized with pt’s ecg

Question 4

Defibrilation

Answer 4

current delivery is unsynchronized

Question 5

Safety measures for defibrilation

Answer 5

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

Question 6

ICD

Answer 6

Device that detects and terminated life threatening episodes of tachycardia and fibrillation (Anti tachycardia pacing)

Question 7

Nursing Assessment of permanent electronic devices

Answer 7

ECG, CXR, CO and hemodynamic instability, incision site, signs of ineffective coping, level of knowledge and education needs of family and patient

Question 8

Arrythmia

Answer 8

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

Question 9

Atrial Arrythmias

Answer 9

PAC, Atrial Flutter, afib

Question 10

Ventricular Arrythmias

Answer 10

PVC, Vtach, vfib, ventricular asystole

Question 11

Normal Electrical Conduction

Answer 11

SA node (sinus node)
AV node
Conduction
Bundle of His
Right and left bundle branches
Purkinje fibers
Depolarization = stimulation = systole
Repolarization = relaxation = diastole

Question 12

Conduction Abnormalities

Answer 12

First-degree AV block
Second-degree AV block, type I (Wenckebach)
Second-degree AV block, type II
Third-degree AV block