Nursing Dx for atrial fibrillation

[olivejuice06]

I need some help coming up with 5 nursing diagnosis for a patient with atrial fibrillation. The patient is currently on Tikosyn therapy but is having reoccuring atrial fib. She has hx of anemia, shortness of breath with activity, high blood pressure, and has had two strokes in nov 08 and sept 09. Anything would be greatly appreciated.

thank you.

[Fig77]

Here is an easy one

Activity intolerance r/t sob and high bp secondary to afib aeb (any evidence u noticed during assesment/observation).

[olivejuice06]

thanks. :)

[Daytonite, BSN, RN]

nursing diagnoses are based upon abnormal data you collected during your assessment of the patient. nursing assessment consists of:

• a health history (review of systems) - hx of anemia, shortness of breath with activity, high blood pressure, and has had two strokes in nov 08 and sept 09
  
• performing a physical exam - no information provided. with shortness of breath with activity there should be specific symptoms you should have observed. did you do a respiratory and cardiac assessment?
  
• assessing their adls (at minimum: bathing, dressing, mobility, eating, toileting, and grooming) - no information provided. since this patient has a history of 2 previous strokes what kind of adl self care deficits are there? what assistance does the patient need with adls? those are nursing jobs.
  
• reviewing the pathophysiology, signs and symptoms and complications of their medical condition - you need to look up the pathophysiology, signs and symptoms and complications of atrial fibrillation. this information will be needed for the etiology(ies) of some of your nursing diagnostic statements:
  
  • http://www.merck.com/mmpe/sec07/ch075/ch075e.html - atrial fibrillation
    

  [*]reviewing the signs, symptoms and side effects of the medications/treatments that have been ordered and that the patient is taking - none listed other than the tikosyn (dofetilide)

  • http://www.drugs.com/pro/tikosyn.html
    

nursing diagnoses are based upon the patient's responses to their medical diseases and conditions as well as the stressors they are experiencing. this information comes from the abnormal data collected during your nursing assessment. that abnormal data becomes the signs and symptoms, or evidence, of the nursing problems (nursing diagnoses) you determine the patient has. unless you do this initial assessment, any diagnosing you do is guesswork and that is not very scientific.

[cjcsoon2bnp, MSN, RN, NP]

I'm just thinking off hand here with not much sleep so keep that in mind. When I think of A.Fib I'm thinking of: Decreased Cardiac Output, Risk for Injury and Activity Intolerance. Maybe Ineffective Tissue Perfusion? I'm not really sure because I would need more assessment info. on your patient before I could start with nursing diagnoses but that is what I'm thinking off the top of my head. I could probably think of more but I'm out of it right now lol

!Chris