7. Avoid lg magnets, MRI, security devices in stores (don't stand in them),
8. if ICD fires call MD; if it fires more than once or if s/s are occurring with firing: call EMS
9. wear medic alert ID & carry ICD card & current list of meds
10. CG should learn CPR
power source placed over pec on nondominant side & pacing wires through R atrium & 1 or both ventricles
Where will PPM be placed?
surgery or cath lab
Pre-op care for PPM?
may do hibiclens etc
Action if hiccups occur after placement of PPM?
need to inform MD: may be r/t pacing wire touching diaphragm
1. do not allow pt to sleep or turn on R side for about 1 month
2. do not raise arm where PPM placed
3. HOB elevated & bedrest X 24h
4. no pullover shirts X 1 month
5. keep immobilizer on until MD D/C's order
power source outside body & sheath with wires in it placed in jugular or femoral vein
When can pt ambulate after placement of temp pacemaker?
30min to 1h after procedure
Tx for dig toxicity?
digibind & may put in temporary pacemaker until it works
3 types of temporary pacemakers?
transvenous, epicardial, & transcutaneous
Purposes of transvenous pacemaker?
1. use until underlying cause is found
2. bridge for PPM
3. prophylactic in case of brady or tachy dysrhthmias post op
When is TCP used?
Where are pads placed for TCP?
one on anterior & one on posterior of chest
Pt teaching with TCP?
will be painful but is temporary
Monitoring for pt with any type of pacemaker?
will have EKG monitoring
2 types of pacemaker malfunctions & their effects?
failure to sense: doesn't sense underlying rhythm: can cause firing during QT
failure to capture: pacemaker firing doesn't cause contraction: can cause bradycardia or asystole
5 complications of pacemaker placement?
4. failure to capture/sense
5. perforation of atrial or ventricular septum
4 actions to prevent complications with pacemaker placment?
1. prophylactic IV ABX before & after
2. postinsertion CXR for lead placement & pneumothorax
3. observation of insertion site
4. continuous EKG
S/S of pneumothorax?
1. chest pain
2. tachycardia & tachypnea
PPM discharge instructions?
1. limit arm & shoulder mvmt & do not: Lift arm above shoulder on PPM side, lift anything heavier than newspaper/fork, do yard work, use rifle, hit,
2. report s/s of infection/bleeding
3. do not get wet until MD says
4. avoid direct blows, close proximity to high-output electric getnerators, MRI, anti-theft devices, metal detectors (tell airport security), lean directly over open hood of running car, have cell phone in breast pocket