Crazy first clinical day of the semester

Nursing Students General Students

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Specializes in ICU, Emergency Department.

So, today, I felt like I was in a tornado.

Today was my first day of clinical in my third semester of a 2 yr ADN program. I'm just starting three weeks on a tele floor, and I've never done tele before so everything is quite new to me. We spent the first two hours of the day in preconference discussing cardiac anatomy and issues, paperwork, rules, ethical issues, etc. Then, for the last hour of our day, we went up to the floor.

My pt was a 65 yo female diagnosed two days ago with Rapid AFib c RVR. Granted, I've heard of AFib before but have not studied it extensively. Currently, her HR swings from the 110s-130s at rest and up to 150s when ambulating. I got to the floor, introduced myself, did a head to toe and noticed her heart rate was quite irregular. RP & PP +, so she does have good perfusion. She described her symptoms as heart palpitations, DOE and moderate to severe epigastric pain when ambulating (but no pain at rest). I went with her to have an Echo done, which was really interesting to say the least. She's currently on bedrest except up to the bathroom, until her third set of cardiac enzymes is drawn.

I have no experience with AFib, but the nurse stated that she treated the patient with Protonix and Maalox (assuming stomach upset) when the pt c/o pain. The patient stated that she had a watery BM but was not passing much gas, and the treatment had not seemed to improve her condition much.

So now, I'm wondering, however, if the epigastric pain she's experiencing is possibly related to the AFib? Anyone have any ideas?

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