Atrial Fibrillation Paper

• o History and physical examination in conjunction with pulse oximetry, ABG analysis, and chest X-ray are the initial diagnostic

To further explain Joe’s rapid heart rate, the student may request an electrocardiogram to investigate any presenting heart arrhythmia's.

Hi Roseann. Good Job. Your Unit 7 Initial Post is very informative. Her verbal report of fatigue, bilateral lower lobe crackles, skin is cool to touch, +2 edema in bilateral ankles, and heart rate of 112 are signs and symptoms of congestive heart failure. Her medical history of high blood pressure and coronary artery disease could also lead to heart failure. My focus would be is to teach her with CHF symptom management and to prevent exacerbation. To avoid hospitalization I would educate and give her a list of preventable measures such as avoiding salts, measuring her weight every morning, and fluid restrictions. I would advise S.P to notify her doctor with weight gain over 2 pounds. Medication compliance is also important in managing her

Cardiac dysrhythmias come in different degrees of severity. There are heart conditions that you are able to live with and manage on a daily basis and those that require immediate attention. Atrial Fibrillation is one of the more frequently seen types of dysrhythmias (NIH, 2011). The best way to diagnosis a heart condition is by reading a cardiac strip (Ignatavicius &Workman, 2013). Cardiac strips play an chief part in the nursing world allowing the nurse and other trained medical professionals to interpret what the heart is doing. In a normal strip, one can clearly identify a P wave before every QRS complex, which is then followed by a T wave; in Atrial Fibrillation, the Sinoatrial node fires irregularly causing there to be no clear P

Acute Myocardial Infarction: I think this condition is the most likely diagnosis because she has been experiencing hypertension and central chest pain. She is more than 55 years old. She has been suffering hyperlipidemia. She has skin pallor. In addition, there is ST segment elevations, T wave inversions, and Q waves in ECG.

Cardiovascular. Client denies chest pain, palpitations, murmurs, any arrhythmias, hypertension, awakening at night with shortness of breath, or dizzy spells. Client has not had an electrocardiogram.

Atrial fibrillation is the most frequent cardiac arrhythmia. There has always associated risk of clot formation and embolization that can lead to ischemic stroke. A large number of these ischemic events could be prevented by timely anticoagulation. Warfarin has been used for decades for this purpose, but there are many problems for the patients due to warfarin therapy like there is continuous need of INR monitoring, many food and drug interactions of the drug, late onset of action and risk of major bleeding. Anticoagulation with the Novel oral anticoagulants e.g. Dabigatran, rivaroxaban, apixaban, endoxaban led to similar or even lower rates of ischemic stroke and major bleeding compared to an adjusted dose of warfarin (INR 2-3) in patients

Atrial fibrillation is the most commonly encountered arrhythmia (abnormal heart rhythm) in the United States, diagnosed in approximately 1% of the population or 2.5 million people (Nottingham, 2010). Atrial fibrillation has always been of interest during this author’s healthcare career. It is always out there, insidiously hiding, causes a multitude of symptoms and problems. This author remembers puzzling over the presentation of atrial fibrillation and it’s management. Identification is always the first challenge. Banner and Lauck (2013) cite Falk (2001) acknowledging the wide presentation of symptoms from asymptomatic to life threatening. Patient specific options can be confusing and challenging to navigate. Treatment algorithms include pharmacology, electrophysiological interventions, and surgery (Berry, Padgett, & Holton, 2015). This author believes, given the prevalence and consequences of mismanagement, the study of relevant evidence based practice in the treatment of atrial fibrillation is a worthy concentration. For many patients, nurses are the first point of contact in the healthcare system. This demands nursing leadership in the areas of identification, treatment and education for atrial fibrillation.

must be considered as a red flag, which may be an indication of heart failure. Vital signs

A diagnosis may start with routine bloodwork to rule out non cardiac conditions that could be triggering tachycardia. A chest x-ray may also be performed to see if there is any cardiomegaly present. In my case, and in most cases, it starts with a 12 lead ECG. According to Ellis and Rottman (Dec. 04, 2015) “the classic ECG features are as follows:

It is my impression/diagnosis that Salma had vasovagal episode without reaching syncope, which we discussed during last ER visit and advised Salma to improve her fluid intake. Also Selma had a complete right bundle branch block on ECG, despite having normal cardiac anatomy on echocardiogram and no prior cardiac surgeries. Although this is more often seen in congenital heart disease and post cardiac surgical repair of certain congenital heart defects, it could be also seen in ischemia, myocarditis , cardiomyopathy and valvular heart disease . All of which ,Selma doesn't have signs of on her physical exam, ECG or echocardiogram. In very small group, it could be a normal variant which could explains this findings in Salma.

During inspection of the heart assessment observe abnormal finding. Inspect the jugular vein and the carotid artery. Note pallor or cyanotic skin color, temperature, turgor, texture, and clubbing of finger. Observe for swelling, edema and ulceration. Clubbing is a sign of chronic hypoxia caused by a lengthy cardiovascular or respiratory. Poor cardiac output and tissue perfusion is noted by cyanosis and pallor. For dark-skinned, inspect his mucous membranes for pallor. Decreases or absent of pulse with cool, pale, and shiny skin, and hair loss to the area, and the patient may have pain in the legs and feet may indicate arterial insufficiency. Ulcerations typically occur in the area around the toes, and the foot usually turns deep red when dependent

The first initial step in the diagnosis of heart palpitation is through one's description of the palpitations that is the approximate age of the person when first noticed palpitation and the circumstances under which it occurs are crucial, also information about tea, coffee and caffeine intake .It is also important to know how it started and stopped and approximately how slow or fast the pulse rate was during an attack. Also testing of thyroid gland function though blood test are also important baseline investigations

Due to the patient’s cardiac history, I would ask the patient’s onset of her fatigue and how long her fatigue has it been. Fatigue can be a warning sign of heart attack. I would try to find out the time her fatigue occur and worsen. According to Jarvis (2012), decreased cardiac output may cause fatigue and it worsens in the evening. Likewise, I would ask S.P when did she started taking Metoprolol and Aspirin. Many heart and high blood pressure medications can cause fatigue. They may slow down the pumping action of the heart, tone down the nervous system. It seems like S.P is exhibiting signs of Congestive Heart Failure such as: fatigue, 2+ edema of the bilateral ankles, and bilateral lower lobes crackles. A tired feeling and difficulty with

On one of my patients, Mr. Y, as I was doing his vital signs I noticed his heart rate and pulse was extremely slow and irregular. I decided to take it for a second time because there was a huge gap between his heart rate. I assessed Mr. Y and asked about his past medical history and what were his usual vital signs. He then said to me his heart rate and pulse is like due to his Pacemake; which helped me understood more about his health.**