Which is the correct statement regarding defibrillation of a patient with a permanent pacemaker?
Place one defibrillation paddle directly over the pacemaker generator.
Use pediatric size paddles.
Never defibrillate a patient with a permanent pacemaker.
Avoid placing the defibrillation paddles near the pacemaker generator.
The Correct Answer is D
A. Place one defibrillation paddle directly over the pacemaker generator: Placing a defibrillator paddle directly over the pacemaker can damage the device or its leads and may interfere with pacemaker function. This placement increases the risk of permanent pacemaker malfunction and is therefore avoided.
B. Use pediatric size paddles: Pediatric paddles are designed for children and deliver lower energy shocks. Using pediatric paddles on an adult patient is inappropriate because it may not provide adequate energy to successfully defibrillate the heart.
C. Never defibrillate a patient with a permanent pacemaker: Having a permanent pacemaker is not a contraindication for defibrillation. In life-threatening arrhythmias, defibrillation should not be withheld; instead, appropriate precautions are taken to minimize pacemaker damage.
D. Avoid placing the defibrillation paddles near the pacemaker generator: Proper defibrillation technique involves positioning paddles or pads so that the electrical current does not pass directly through the pacemaker. This protects the device while allowing effective defibrillation of the myocardium, ensuring patient safety and device integrity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. sinus arrhythmia: Sinus arrhythmia is a normal variation in heart rate that occurs with the respiratory cycle, typically seen as a benign increase in heart rate during inspiration and a decrease during expiration. It does not compromise cardiac output or cause symptoms, so a pacemaker is generally not indicated.
B. post cardiac surgery: After cardiac surgery, patients may develop transient conduction disturbances such as heart block or significant bradyarrhythmias. A pacemaker may be indicated if these conduction abnormalities persist and result in hemodynamic instability, as it helps maintain adequate cardiac output during recovery.
C. third-degree AV block: Third-degree atrioventricular (AV) block represents complete dissociation between atrial and ventricular activity, often leading to severe bradycardia and risk of syncope or sudden cardiac arrest. Permanent pacemaker implantation is a primary treatment to restore ventricular pacing and prevent life-threatening complications.
D. bradyarrhythmias: Symptomatic bradyarrhythmias, including sinus node dysfunction or high-grade AV block, can lead to dizziness, syncope, or heart failure due to insufficient cardiac output. Pacemaker therapy provides electrical stimulation to maintain adequate heart rate and improve symptoms, making it a standard indication.
Correct Answer is B
Explanation
Rhythm: sinus, regular
Rate: 38b/min
P wave: Present, normal
PR interval: Prolonged
QRS: Narrow, 0.04 seconds
Rhythm interpretation: Second degree AV block Type I
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