An artificial pulse generator is indicated for the treatment of?

Appeared in: SCTIMST Staff Nurse - 2015 (Set-B)

Explanation

An artificial pulse generator, also known as a pacemaker, is primarily indicated for treating symptomatic bradyarrhythmias (abnormally slow heart rates).
Complete heart block, or third-degree AV block, is a severe condition where electrical impulses from the atria fail to conduct to the ventricles.
This dissociation results in a very slow ventricular escape rhythm (20-40 bpm), which cannot maintain adequate cardiac output, leading to symptoms like syncope and dizziness.
A pacemaker provides an external electrical stimulus to ensure the ventricles contract at a safe, physiological rate, thereby restoring normal circulation.

Option A: Sinus tachycardia is a heart rate greater than 100 bpm. A pacemaker is designed to speed up a slow heart, not slow down a fast one.
Option B: Atrial fibrillation is a tachyarrhythmia characterized by a chaotic, irregular, and often rapid ventricular response. The primary treatment goals are rate control, rhythm conversion, and stroke prevention with anticoagulants.
Option D: Supraventricular tachycardia (SVT) is a rapid heart rhythm. A pacemaker would be counterintuitive as it would not address the fast rate.

Clinical Relevance

Nursing practice connection: Knowing Indications for Pacemaker Therapy helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Recognizing complete heart block on an ECG is a critical skill for nurses, as it signifies a high-risk situation requiring immediate intervention.
For an unstable patient with complete heart block, the nurse's priority is to prepare for emergency transcutaneous pacing while awaiting the medical team.
Patient safety involves educating patients with new pacemakers on activity restrictions, signs of infection at the implant site, and the importance of carrying their pacemaker identification card.

How to Approach the Question

First, identify the key term in the question: 'artificial pulse generator'. Recognize this as a pacemaker.
Recall the primary function of a pacemaker, which is to generate electrical impulses to treat a heart that is beating too slowly (bradycardia).
Next, evaluate each of the four options by classifying the heart rhythm as either a bradycardia (slow) or a tachycardia (fast).
Sinus tachycardia, atrial fibrillation, and supraventricular tachycardia are all forms of tachycardia.
Complete heart block is a severe form of bradycardia.
Based on this analysis, conclude that the pacemaker is indicated for the only bradycardic condition listed: complete heart block.

Concept Tested & Keywords

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E6 Medicine Harrison 22e Part 1 p. 1961-1963

Practise the full SCTIMST Staff Nurse - 2015 (Set-B)

Attempt every question from this paper in a timed mock, then review the full solution for each one.