ASAP: A-Fib Nursing Considerations

[Alloush, BSN, MSN]

Hello Nurses

am ALi ... a nursing student (BSNIV) in the American University of Beirut (Lebanon)

i have a case study about a patient with high rate A-Fib

i did everything but because i lack experience .. i wasnt able to define the best nusring consideration for such patients

i searched literature and websites for that but everything i found wasnt satisfactory and wasnt direct to the point .....

So if u please may u list some nursing consideration that u think may fit to my case study ... or may u please give me a certain link that discuss this issue ???

Thank You in Advance :)

[Daytonite, BSN, RN]

hi, alloush, and welcome to allnurses! :welcome:

patients with atrial fibrillation may have a history of palpitations, fatigue, dyspnea, chest pain, or syncope. they may have any of the following symptoms: irregular pulse, possible tachycardia, hypotension, signs of heart failure, or respiratory distress. the doctor will generally test cardiac enzymes to see if there is myocardial damage, thyroid function for possible hypothyroidism, chest x-ray to determine if there is pulmonary edema, an echocardiogram to see if there is any valvular disease, check for left ventricular dysfunction or atrial blood clots, do an ekg looking for irregular rhythms and may have the patient wear a holter monitor for 24 hours to diagnose paroxysmal atrial fibrillation.

there are a number of treatments that can be done for atrial fib:

1. electrical cardioversion
   
2. insertion of a pacemaker
   
3. ablation

in addition, the doctor will often order

• low fat, low sodium diet
  
• possibly fluid restriction
  
• rest periods as needed
  
• medications
  • calcium channel blockers
    
  • beta-adrenergic blockers
    
  • antiarrhythmics
    
  • cardiac glycosides
    
  • anticoagulation

nursing considerations:

• you would expect the patient to not be able to tolerate activity very well
  
• the patient will probably become easily fatigued
  
• expect the patient to be anxious about their condition
  
• the patient may not comply and take the medication that is ordered

nursing goals:

• the patient should report ways to reduce activity intolerance
  
• the patient should be able to tell you what things help to give him more energy and decrease his feeling of fatigue
  
• have the patient identify effective coping mechanisms in order to manage his anxiety
  
• the patient will verbalize understanding of the medications he is ordered to take and why.

some nursing interventions (all nursing interventions are based upon the problems and symptoms that the patient has):

• plan for frequent rest periods
  
• encourage the patient to talk about his feelings and concerns about his condition
  
• give prescribed medications as ordered
  
• take vital signs while the patient is at rest and after physical activity
  
• monitor for signs and symptoms of embolism
  
• measure intake and output
  
• do daily weights
  
• observe for any abnormal bleeding
  
• teach the patient about atrial fibrillation, it's diagnosis and treatment
  
• teach the patient about the adverse effects of the medications he is taking
  
• teach the patient when to notify the doctor of any symptoms or side effects of medication that he is having
  
• instruct the patient on how to take his pulse
  
• if the patient is on anticoagulants, instruct them on anticoagulation precautions

you can find more information about atrial fibrillation by exploring the websites listed on this thread:

https://allnurses.com/forums/f205/medical-disease-information-treatment-procedures-test-reference-websites-258109.html - medical disease information/treatment/procedures/test reference websites

• http://www.fpnotebook.com/cv28.htm - atrial fibrillation
  
• http://www.webmd.com/a-to-z-guides/heart-disease-atrial-fibrillation-basics - atrial fibrillation

nursing considerations (or nursing interventions) are almost always based upon the symptoms a patient has. so, in doing this assignment, you need to list the symptoms of atrial fibrillation. what will the doctor order for those symptoms? what will you as a nurse have to do to carry out those orders? what are some things that you as a nurse can do for those symptoms without a doctor's order?

you can see examples of student case studies on these two websites. you are basically being asked to write a care plan in an essay form:

• http://learn.sdstate.edu/craigg/ercases.html
  
• http://learn.sdstate.edu/craigg/ersp01.html

[Alloush, BSN, MSN]

Thank you for ur help :)

i appreciate that

[surviveslu]

1. afib pt suddenly becomes tachy (140's), what do you do?

2. afib pt suddently have BP 70/40's, what do you do?

[Nurse Kyles, BSN, RN]

I seriously love stumbling upon these old threads with replies from Daytonite. Such thorough & thoughtful answers always.

[whichway]

Thank you so much for bringing back this thread and introducing Daytonite's wisdom to a newbie. I'm in the beginning of med-surg 1 and still trying to organize my thoughts. I came to this thread to see if my thoughts are on the right track. So I open the thread and I'm introduced to Daytonite's postings. Wow! What treasures!