60 Questions
What is the purpose of turning off the defibrillator portion of an AICD in a patient receiving palliative care?
To prevent it from shocking the patient if their heart rhythm slows or increases
Where are the pads placed in a transcutaneous pacemaker?
Between anterior and posterior of the patient
What is the typical size of an AICD?
Size of a silver dollar
For which type of pacemaker is it necessary to be intubated during placement?
Intracardiac pacemaker
What does TEE stand for in medical imaging?
Transesophageal Echocardiogram
What must a patient undergoing outpatient TEE have before eating or going home?
Fully awake and a gag reflex
What is the purpose of an ICD (Implantable Cardioverter Defibrillator)?
To deliver an electrical shock when abnormal heart rhythms are detected
Where can an Intracardiac pacemaker be placed?
During open heart surgery and attached to heart muscle
What is the main difference between a Transthoracic and Transesophageal Echocardiogram?
The position of the patient during the procedure
What action should be taken if no issue is found after 48 hours following epicardiac pacemaker placement?
It can be removed
What is the primary purpose of cardioversion?
To deliver a timed electrical current to the heart
When is elective cardioversion considered appropriate?
For dysrhythmias lasting longer than 48 hours
In preparation for cardioversion, which medication is typically held?
Digoxin
What is the primary purpose of defibrillation?
To restore a normal heart rhythm in emergency situations
What distinguishes between monophasic and biphasic defibrillators?
The direction of energy delivery and energy requirement
What is the typical voltage range used in cardioversion compared to defibrillation?
$50-100$ joules vs. $120-360$ joules
What is the primary function of a pacemaker?
To deliver electrical stimuli to the heart
What distinguishes between fixed and demand pacemakers?
Their ability to sense and respond to the heart's rhythm
Which complication can arise from having a pacemaker inserted?
Ectopy from irritation of electrodes/PVCs
What are the criteria that an Implantable Cardioverter Defibrillator (ICD) typically responds to in order to shock?
Heart rate exceeding a set level and changes in the isoelectric line segment
What must be monitored before, during, and after a TEE procedure?
Blood pressure, heart rate, and oxygen saturation
What does a patient need to have before a TEE procedure?
NPO status for at least 6 hours
What is the advantage of a TEE procedure?
Determines clotting in heart and more thorough than TTE
What type of patient with heart disease may require a TEE procedure?
New diagnosis of AFIB
post-cardiac catheterization, what should be checked?
Neuro checks, Swelling at site, back pain, make sure pt is latying flat and legs immobilized
What is the gold standard for diagnosing heart disease?
Cardiac Catheterization
What is an important nursing care consideration post-cardiac catheterization?
Patient must lay flat for at least 6 hours
During a cardiac catheterization procedure, what is monitored post-op?
BUN, PT/aPTT, INR, H&H, Platelets and electrolytes
In case of an allergy to contrast during cardiac catheterization, what would be administered pre-procedure?
Benedryl Prednisone, and steroid
What is the purpose of turning off the defibrillator portion of an AICD in a patient receiving palliative care?
To prevent it from shocking the heart into rhythm
What distinguishes a Transcutaneous pacemaker from an implanted generator or implanted leads pacemaker?
Being temporary in nature
What type of diagnostic testing is commonly used to help diagnose heart conditions through imaging?
Echocardiograms
Where are the pads typically placed in a Transcutaneous pacemaker?
Between anterior and posterior of the patient
What is the purpose of an Automated Implantable Cardioverter Defibrillator (AICD) other than serving as a pacemaker?
To act as a defibrillator
In which type of pacemaker placement would a patient have open heart surgery done and then have this pacemaker placed into them? & if there is not dysrhythmias or bradycardia for 48 hours it can be removed.
epicardiac pacemaker
When is it important to remember that a patient undergoing outpatient TEE must be fully awake?
Before eating or going home
What distinguishes an Actual Pacemaker with AICD from other types of pacemakers?
Containing an Automated Implantable Cardioverter Defibrillator component
'If no issue is found after 48 hours following Intracardiac pacemaker placement, what action can be taken?'
'The device can be removed'
What is the common site for placement of a Tranvenous pacemaker?
Internal jugular vein
What should a nurse do if a patient's site where cardiac catheterization was done is swelling?
Compress the site and call for help
What medication should a patient with borderline renal function have before a cardiac catheterization procedure?
Oral mucamist mixed with OJ
What is the responsibility of a nurse during cardioversion?
Set up IV access, oxygen, BP cuff
In case of an emergency defibrillation, what is the next step if multiple shocks are not effective?
Consider Amiodarone or Cardioversion
What should be present in a patient to successfully defibrillate?
Absence of a pulse
What is the primary purpose of external electrical therapy such as defibrillation?
To treat tachyarrhythmias by depolarizing heart muscle cells
What should be monitored post-cardiac catheterization besides lab values?
Pulses and site for swelling
What is the correct response if a patient has severe back pain during a cardiac catheterization?
Place in reverse Trendelenburg position
What medication may or may not be given during IV site insertion for cardiac catheterization?
Heparin
What is the indication for urgent cardioversion?
Ventricular fibrillation lasting longer than 48 hours
What is the purpose of holding Digoxin before cardioversion?
To reduce the risk of arrhythmias
In which scenario is defibrillation typically used?
Pulseless ventricular tachycardia
What distinguishes monophasic defibrillators from biphasic defibrillators?
Energy delivery in one direction
Which heart blocks require need for a pacemaker?
Second degree & Third degree
What should be done immediately after implanting a pacemaker?
Get a chest X-ray to check lead placement and for pneumothorax
When would an ICD typically shock a patient?
When the patient's heart rate is rises a set level & changes in isoelectric line segment
What is a significant difference between fixed and demand pacemakers?
'Fixed' pacemakers are set to pace but not sense, while 'demand' pacemakers respond to heart rhythm firing only when needed.
What does Twiddler syndrome refer to in relation to pacemakers?
Patient manipulation leading to dislodged electrodes due to excessive touching
What meds are used during start of CPR
Epinephrine every 3-5min
If CPR epi and defibrillation are not working what would be the next step?
Adminster Amiodarone 300mg IV push
You see a bradycardic EKG what is the first step in caring for this patient
Administer atropine 1amp IV push to stabilize HR & place pacemakers to pace
Explore adjunctive modalities and management techniques involving external electrical therapy for the heart. Learn about treatments such as cardioversion, defibrillation, pacemakers, and ICD (implantable cardioverter defibrillator). Understand the types of pacemakers including transcutaneous, tranvenous, and intracardiac placements.
Make Your Own Quizzes and Flashcards
Convert your notes into interactive study material.
Get started for free
