T E XTB O
OK P
ICT U R
E
MEDICAL DIAGNOSIS CLINICAL SIGNS/SYMPTOMS MEDICAL MANAGEMENT
NAM E
:
Atrial fibrillation
DES C RI P
T IO N
:
“It is characterized by a total
disorganization of atrial electrical activity
because of multiple ectopic foci. It results in
loss of effective atrial contraction The
dysrhythmia may be paroxysmal (i.e.,
beginning and ending spontaneously) or
persistent (lasting more than 7 days).1
Atrial fibrillation is the most common,
clinically significant dysrhythmia with
respect to morbidity and mortality rates
and economic impact. Its prevalence
increases with age.8” (Lewis 2019 p763)
SI G NS/ S
Y M P
T O M
S :
Feelings of a fast, fluttering or pounding
heartbeat, called palpitations.
Chest pain.
Dizziness.
Fatigue.
Lightheadedness.
Reduced ability to exercise.
Shortness of breath.
Weakness.
COMPLI C
A T IO N
S
:
Atrial fibrillation results in a decrease in CO
because of ineffective atrial contractions (loss of
atrial kick) and/or a rapid ventricular response
(RVR). Thrombi may form in the atria because of
blood stasis. An embolized clot may move through
arteries to the brain, causing a stroke. Atrial
fibrillation accounts for as many as 20% of all
strokes.
MEDIC A L MAN A
G EMENT :
calcium channel blockers (diltiazem)
Beta blockers (metoprolol),
amiodarone, digoxin
warfarin
S U R
G ICAL M
ANA G EMEN T
:
AV nodal ablation, the destruction
of the AV node.
Maze Procedure- intervention that
stops atrial fibrillation by
interrupting the ectopic foci that are
causing the dysrhythmia. Incisions
are made in both atria, and
cryoablation (cold therapy) is used
to stop the formation and
conduction of ectopic signals and
restore normal sinus rhythm.
permanent ventricular pacemaker.
NURSING MANAGEMENT
Concept
Decreased Cardiac Output r/t alteration
in heart rate and rhythm
Concept
Activity Intolerance r/t Condition of
circulatory problems (dizziness, presyncope,
or syncopal episodes
Concept
Ineffective Tissue Perfusion r/t decreased
cardiac output
N U RSING IN T E R
VEN T IO NS
: N U RSING IN T E R
VEN T IO NS
: N U RSING IN T E R
VEN T IO NS
:
1. Assess heart rate and rhythm 1. Assess the patient’s perceived and
actual restrictions as well as the severity
1. Intervene with cardioversion.
2. Place on a cardiac monitor; monitor
for dysrhythmias, especially atrial
fibrillation.
2. Monitor vital signs and mental status. 2. Place the patient in an upright
position.
3. Monitor bowel function. Provide stool
softeners as ordered. Instruct the client
to avoid straining when defecating.
3. Balance rest periods with activity. 3. Closely monitor lab values and tests.
REFERENCE(S)
Kwong, M.H.D.R.C.R.D.H. J. (2019).Lewis's Medical-Surgical Nursing(11th ed.). Elsevier Health
Sciences (US).https://pageburstls.elsevier.com/books/9780323551496
