A. Fib (M4E) Flashcards
1
Q
risk factors
A
- advanced age w/ valvular heart disease
- HTN
- inflammatory or infiltrative disease
- CAD
- congenital disorder
- HF
- diabetes
- obesity
- hyperthyroidism
- pulmonary HTN
- embolism
- obstructive sleep apnea
- alcohol consumption
- post- open heart Sx
2
Q
S&S
A
- irreg pulse
- dizziness
- weakness
- dyspnea
- syncope
- palpitations (skipped or extra beats)
- dec BP
- asymptomatic (sometimes)
3
Q
nursing considerations
A
- assess VS, electrolytes, hepatic/renal Fx
- monitor for HF
- monitor for S&S of clots (risk of stroke)
- teaching on drug-drug interactions, ADE
4
Q
diagnostic tests
A
- 12 lead ECG
- Holter Monitor
- platelets, PTT, PT-INR
- digoxin level
- electrolytes
5
Q
cardioversion
A
- using electricity or drugs to make HR back to normal
- for onset less than 48 hrs or on anticoagulants for 4 wks or for unstable pt
6
Q
maze procedure
A
- open heart Sx
- small incisions made through atria - creates scar tissue
- only used when having heart Sx for other reasons
7
Q
dysrhythmias/arrhythmias
A
- abnormalities of electrical conduction which can affect HR or cardiac rhythm
- associated w/ certain conds such as MI, HTN, valve problems, digoxin toxicity, dec and high K+, CHF, stroke, pulm disease
8
Q
paroxysmal a. fib
A
- when HR converts to normal sinus rhythm spontaneously or with interventions in 7 or less days
- sudden onset
9
Q
persistent a. fib
A
- continuous
- symptoms last over 7 dats
- may need to have procedures to convert to NSR
10
Q
long-standing a. fib
A
- continuous
- symptoms over 12 mo
- cardioversion won’t stop it
- may be awaiting procedures
11
Q
permanent a. fib
A
- persistent
- decision made to not restore HSR
- procedures failed or are contraindicated or not wanted
12
Q
goal of interventions
A
- convert or maintain NSR
- slow ventricular rate (optimize CO)
- prevent embolic events
13
Q
drugs used to treat A. fib
A
- beta blockers
- Ca+ channel blockers
- antidysrhythmic drugs
- anticoagulants
14
Q
beta blockers
A
- multiple indications
metoprolol: - beta 1 blockage –> reduces HR, contractility
- ADE: bradycardia, reduced CO, AV heart block, rebound cardiac excitation when discontinued
- nursing considerations: apical HR, BP, not likely to cause bronchoconstriction or hypoglycemia
15
Q
Ca+ channel blockers
A
diltiazem:
- drug and food interactions: digoxin, grapefruit juice
- lower BP by arteriolar dilation and directly dec HR
- ADE: constipation, compromised cardiac Fx (bradycardia, dec contractility)
- nursing considerations: cardiac assessments, GI assessments
