A patient is being monitored by continuous ECG after placement of a transvenous pacemaker. "Loss of capture" is seen on the ECG. Which nursing intervention may correct this situation?
a. Position the patient on the left side. c. Increase the rate as ordered.
b. Decrease the milliamperes as ordered. d. Monitor the patient in a different lead.
A
"Loss of capture" most often can be attributed either to displacement of the pacing electrode or to an increase in threshold as a result of drugs, metabolic disorders, electrolyte imbalances, or fibrosis or myocardial ischemia at the site of electrode placement. In many cases, increasing the output (mA) may elicit capture. For transvenous leads, repositioning the patient to the left side may improve lead contact and restore capture.
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