Atrial Fibrillation

Question 1

A-fib =

Answer 1

most common dysrhythmia seen in the clinical practice. It can impair quality of life, cause considerable morbidity and mortality, and impose a large economic burden

Question 2

AF is associated w/

Answer 2

loss of muscle mass and atrial fibrosis

Question 3

AF causes serious problems in older people=

Answer 3

stroke
heart failure
hypertension
thromboembolic event
Coronary heart disease
Diabetes mellitus
Heart failure
Mitral valve disease

Question 4

Risk factors:

Answer 4

older age
obesity
caucasion race
excessive alcohol

Question 5

Assess AF=

Answer 5

Ventricular response is usually 120-200 bpm
AF=350-600 bpm
No clear P waves, no atrial contractions, loss of atrial kick, and irregular ventricular response = decreases ventricular filling and reduces cardiac output, furthur impairing the heart’s perfusion ability

Question 6

Interventions: AF

Answer 6

Drug therapy: calcium channel blockers, beta blockers, anticoagulants
CHADS scoring system: Congestive heart failure, Hypertension, Age over 75, Diabetes mellitus, Stroke)

Question 7

Cardioversion is a

Answer 7

synchronized countershock that may be performed (1) in emergencies for unstable ventricular or supreventricular tachydysrhythmias or (2) electively for stable tachydysrhythmias that are resistant to medical therapies

Question 8

If unsure of AF, what may be performed to assess for clot formation in the left atrium:

Answer 8

A transesophageal echocardiogram (TEE)

Question 9

During Cardioversion:

Answer 9

one electrode is placed on the left of the precordium and the other is placed on the right next to the sternum

Question 10

Nursing care after cardioversion=

Answer 10

Maintain airways
Adm O2
Assess vitals
Adm antihysrhythmic drugs as prescribed
Monitor for dysrhythmias
Assess for chest burns from electrodes
Provide emotional support
Document results of cardioversion

Question 11

Invasive procedure that may be used to destroy an irritable focus causing a supraventricular or ventricular tachydysrhythmia

Answer 11

Radiofrequency catheter ablation

Question 12

In AF, pulmonary vein isolation and ablation creates

Answer 12

scar tissue that blocks impulses and disconnects the pathway of the abnormal rhythm

Question 13

Other nonsurgical management for AF:

Answer 13

Bi-ventricular pacing
Anti-tachycardia pacing
Implantable atrial defibrillators

Question 14

Open chest surgical technique often performed with coronary artery bypass grafting (CABG):

Answer 14

Surgical maze procedure