Question

The patient has a permanent cardiac pacemaker. On the electrocardiographic tracing, you notice a spike before each P wave. What action should you take?

A. Assess the patient for syncope.
B. Document the findings.
C. Notify the physician.
D. Take blood pressure in both arms.

Answer 1

A spike before each P wave on an ECG from a patient with a cardiac pacemaker typically indicates that the pacemaker is active. An increased frequency of QRS complexes suggests an increased heart rate. Documenting and informing the physician about any ECG changes is critical for patient care.

Step-by-step explanation:

When analyzing an electrocardiographic (ECG) tracing from a patient with a permanent cardiac pacemaker, noticing a spike before each P wave is indicative of the pacemaker functioning as it should, sending electrical impulses to the heart to initiate a heartbeat. If there is a noted increase in the frequency of the QRS complexes, this would generally mean an increase in the heart rate or pulse. However, these findings should be documented carefully and it is standard practice to notify the physician about any abnormal patterns or changes in the patient's ECG to ensure proper evaluation and care. Taking blood pressure in both arms or assessing for syncope may not be directly relevant unless there are symptoms that warrant such actions. It is always important to consider the patient's clinical presentation in its entirety and not solely rely on ECG tracings.