My patient today had a very irregular HB...The only way to describe it is, it kinda went "lub-dub-lub" and then a pause...then the pause would be at a varying length before the next contraction would begin, and it was always the three sounds grouped together like that. I did not get the apical rate because I didn't know how to count it...Do you just count each sequence of 3 as one contraction? I know this is probobly a stupid question but we have only been taught how to count a normal heartbeat, not an irregular one....and is there a website or something that has an audio of the different types of heart abnormalities? So in the future I don't look like a doofus when I'm trying to describe them to the nurses?
Anyways, her periphreal pulses were weak and thready and pedal pulses not palpable. Blood pressure was extremely difficult to measure but I got it at 140/72...but everything else was normal. She has a dx of diabetes, hypertension and hyperlipidemia, and bacteremia, but no history of any heart problems. What could be causing this? And what could I do for a NANDA? I was thinking "Decreased cardiac output r/t alteration in heart rate, rhythm and conduction AEB cardiac arrythmia, weak and thready periphreal pulses"
When I go back tommorow, I will have the same pt...are there other things I should be assessing that might help with the dx?