The patient has a permanent pacemaker in place with a demand rate set at 60 beats/min.The cardiac monitor is showing a heart rate of 44 beats/min with no pacemaker spikes.The nurse recognizes this as:
A) normal pacemaker function.
B) failure to capture.
C) failure to pace.
D) failure to sense.

Question

Quizplus · Accepted Answer

Failure to pace or fire occurs when the pacemaker fails to initiate an electrical stimulus when it should fire.The problem is noted by absence of pacer spikes on the rhythm strip.Causes of failure to pace include battery or pulse generator failure,fracture or displacement of a pacemaker wire,or loose connections.This is not normal pacemaker function.When the pacemaker generates an electrical impulse (pacer spike)and no depolarization is noted,it is described as a failure to capture.On the ECG,a pacer spike is noted,but it is not followed by a P wave (atrial pacemaker)or a QRS complex (ventricular pacemaker).When the pacemaker does not sense the patient's own cardiac rhythm and initiates an electrical impulse,it is called failure to sense.Failure to sense manifests as pacer spikes that fall too closely to the patient's own rhythm,earlier than the programmed rate.

The Patient Has a Permanent Pacemaker in Place with a Demand