Nurses Helping Nurses
allnurses Network: Central | Jobs | Books | Newsletter
allnurses: A Nursing Community for Nurses
Home General News Blogs Articles Students Region Specialty Degrees F.A.Q.
Cardiac Nursing /

please help if you would......



Did You Know?
allnurses is the largest community for nurses on the web. We now have over 388,480 members! Join today to network with other nurses, laugh, share, and much more.

Mar 30, 2009 11:42 PM

please help if you would......

by bebop1

Hi....I work in a LTC unit, and have a pt with a pacemaker. she has afib, and she is "going all over the place". at one moment her heart rate will be 40, but most of the time her heart rate is in the 110-130's.

the md states the pacer will not kick in unless the heart rate is less than 50. I thought ( please tell me if I am wrong) there are pacers that will "make the heart increase and decrease" if you will. I asked the doctor and he said no.

but he wants a pacemaker check anyways by phone.

can anyone help a little LTC nurse here? or what do I need to look at or assess? please help me..... Pt does c/o of sob when the hr gets high, but after rest it goes down???what do I need to look at? I have contacted her cardio md and have gotten an appt for her over the "house doctors" head. because I think something is going on. I told the house md...he said..."whatever"

any suggestions?


Share

Search Tags
None
Top

 
Advertisement
Sponsored Links
 
Reply
1 Comment
No. 1
from dianah
Old Mar 31, 2009, 12:10 AM

Default Re: please help if you would......
If the pacer's lower rate is set at 50, it should 'kick in' if the patient's own rate falls below 50. In otherwords, the patient should not have a heart rate of 40 IF the pacer is working as it should.
Is the patient's appointment with her Cardiologist who runs a pacemaker clinic? At a pacemaker clinic appointment, trained staff (or a representative from the company who made the unit implanted in the pt) will interrogate the pacemaker (not just over the phone), check its settings and battery life and determine if it is working properly or needs reprogramming or ? ?

Many times atrial fib produces RVR = rapid ventricular response, which produces SOB and hemodynamic instability. Treatment is beta blockers to slow heart rate, however sometimes heart rate is slowed too much. Pacemaker is then implanted to keep heart rate from dropping too low, so higher doses of beta blockers can be used to keep heart rate down. Pacemaker gives added margin of safety for medication dosage.

Good thing you got pt an appt! Follow your gut.

Here's one site I found when I did a google search for "pacemaker atrial fibrillation:"

http://health.yahoo.com/heart-treatm...-hw159813.html


You might try other words for the search. Good luck!
Top

2 Readers Gave Kudos
 
Reply




Thread Tools


Who's Online
401 members
3,854 guests
4,255

0

The hard to reach on-call doctor, and its effects on...

0

Woman charged with passing off prescription drug as...

0

Paralysed Belgian misdiagnosed as in coma for 23 years

1

Man in "Vegetative State" was conscious for 23...

2

Interesting article on ThedaCare's Collaborative Care Model

7

Possible breakthrough regarding MS

63

16th Philly area hospital to stop delivering babies: Mercy...

10

Really interesting article on Indian open hearts

7

High-Tech Pump Does What Her Heart Can't

6

Air Force RN Found Not Guilty






Currently Reading This Page: 1 (0 members & 1 guests)

Interested in the hottest topics of the week? Subscribe to the Nurse-zine Newsletter.
Enter email address: