The nurse suspects that a patient's pacemaker is malfunctioning. What should the nurse assess when analyzing this patient's rhythm strip? Select all that apply.

Question

Quizplus · Accepted Answer

1. Failure to pace occurs when the pacemaker fails to deliver an electrical stimulus (fire) when it should have fired. This can be seen on the ECG as an absence of pacer spikes when the patient's heart rate is less than the demand pacer rate is set, indicating that the pacemaker did not fire.
2. Failure to capture occurs when the pacemaker fires but the chamber that is being paced (atria or ventricles or both) does not depolarize. This is seen on the ECG strip as a pacer spike that is not followed by a P wave or QRS complex.
3. Failure to sense occurs when the pacer fails to recognize, or sense, the heart's natural electrical activity. This is seen on the ECG as pacer spikes that occur too closely behind the patient's QRS complex.
4. Oversensing occurs when the pacer senses extraneous electrical stimuli, or artifact, for actual atrial or ventricular depolarization and therefore fails to fire. This is seen on the ECG as pacemaker spikes that are at a slower rate than the pacemaker's preset rate or no paced beats even though the patient's heart rate is slower than the pacer's preset rate.
5. A pacemaker does not discharge.

The Nurse Suspects That a Patient's Pacemaker Is Malfunctioning