Question

A client has an epicardial pacemaker. The nurse observes the presence of a pacing spike but no QRS complex on the client's electrocardiograph (ECG) tracing. How does the nurse interpret this event?

a. Loss of capture
b. Ventricular fibrillation
c. Failure to sense
d. A normal tracing

Answer 1

A pacing spike without a QRS complex on an ECG suggests 'loss of capture', where the epicardial pacemaker's impulse fails to provoke ventricular contraction, thus requiring prompt medical attention.

Step-by-step explanation:

When a nurse observes the presence of a pacing spike without a subsequent QRS complex on a client's electrocardiograph (ECG) tracing from an epicardial pacemaker, this can be interpreted as a loss of capture. A loss of capture means that the electrical impulse from the pacemaker was not sufficient to cause the heart's ventricles to contract, which led to an absence of the QRS complex following the pacing spike. This condition requires immediate attention, as it indicates that the heart may not be pumping effectively. Other ECG abnormalities, such as ventricular fibrillation and third-degree blocks, present different patterns that are distinguishable from loss of capture on an ECG.