Question

Pacemaker

-what are the indication

-what are types

-what are Moses

-what to monitor and nursing care

-interpret rhythm strip of patient with pacer and identify problem

ICD

-what are indications

-what are nursing care and monitoring

Care of patient after coronary artery bypass grafting

-what is CABG?

-what are the indication

-what are types of grafts

-what are preop

-explain about this surgery -cardioplegia, bypass, mediastinum and pleural drainage tubes, epicardial wires

-what are postop care; how to rule out cardiac tamponade, how to manage heart rate, how to manage preload, afterload and contractility

-what are postop concerns; including low cardiac output, bleeding, cardiac tamponade, renal involvement, hypothermia, neurological hypoxia, pain, fever (explains each concerns in detail)

-what are acute care

-what would happen during cardiac arrest and pulmonary arrest

-what are incision sites

-what are pharmacological intervention

-what are lifestyle changes

What are Relevant patient and family teaching related to pacemakers, icd and cabg?

Answer 1

Pacemaker

INDICATION:

• Sinus node dysfunction
• High grade AV block or chronic bifascicular block
• Neurocardigenic syncope
• Acute MI
• Hypertrophic cardiomyopathy
• Congenital Heart Disease
• Post Heart transplantation
• Bundle branch block

TYPES:

There are three types of pacemaker available they are

• Single- chamber pacemaker (it has one lead connected to one chamber if the heart)
• Dual-chamber pacemaker (it has two leads connected to both chambers of the right side of the heart
• Biventricular pacemaker( used in Cardiac resynchronization therapy )

MOSES:

Moses Cone is a surgeon who has inserted pacemaker via leg by a procedure named cardiac catheterization

NURSING CARE AND MONITORING:

The nursing care includes

• observation of patient for any complications
• monitoring of vitals especially Heart rate
• help patient to undergo rehabilitative and adaptation to the newer environment with the pacemaker
• Health educate about the function of pacemaker
• Encourage the necessity for proper follow up and medication

RYTHM STRIP TO IDENTIFY PROBLEM :

When a patient is having normal or native rhythmic pattern then there is no EGG changes

If the lead is in Right Ventricle then it causes Left bundle branch block

If the lead is in Left Ventricle then it causes Right bundle branch block