Atrial Fibrillation

Patient Profile
E.W., a 76-year-old white man, comes to the emergency department after a syncopal episode at a local restaurant. He is accompanied by two friends.

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Subjective Data

Has been feeling weak for a few days
Became dizzy and fainted while awaiting his dinner
Takes one medication, a “water pill” for high blood pressure
Objective Data

Physical Examination

Blood pressure 92/50, pulse 125 and irregular, respirations 24, temperature 97° F
Alert and oriented
Lung sounds clear in all fields
Diagnostic Studies

ECG monitor shows atrial fibrillation
Discussion Questions

1. What is atrial fibrillation?

2. What are your priority actions at this time?

3. What additional history should you obtain from E.W.?

4. Describe the risks associated with atrial fibrillation.

5. E.W. is placed on diltiazem (Cardizem), warfarin (Coumadin), and dronedarone (Multaq). What is the purpose of each of these medications in treating E.W.’s atrial fibrillation?

Case Study Progress
E.W. is admitted with a diagnosis of new onset of atrial fibrillation. Despite medical therapy, 12 hours later, he is still experiencing dizziness, and his systolic blood pressure remains below 100. A transesophageal echocardiogram is done, showing E.W. does not have any blood clots, so the physician elects to perform a cardioversion.

6. What instructions should you give E.W. to prepare for a cardioversion? What do you tell him to expect during the procedure and what nursing assessments will you be performing?

Discussion Instructions and Guidelines:

Please utilize APA formatting. (You do not need to do a title page & no abstract)

If you need assistance with APA formatting, please utilize the writing lab on campus. (Writing Lab phone is 561-868-3794 and it is located in TC 214 and the hours are M-R 8a-7p, F 8a-5p, S 9a-2p)

You must respond to one other student’s posting.

Address all assigned discussion questions thoroughly and a minimum of 50 words for your follow up response to a fellow student is required.

Engages in meaningful dialogue. Responses to peers can not just be “I agree” or “Good job” or simply restating what the original post says.

You may correct an incorrect answer of a peer or simply elaborate by offering more detail regarding one of the topics being discussed.

Demonstrates understanding in your own words without plagiarizing.

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