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Male Resident CB 90+ (Nursing Dx:
Risk for ineffective cerebral tissue…
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Atrial fibrillation
- Causes
1.1. Heart valve disease
1.2. CAD
1.3. HTN
1.4. PE
1.5. Cardiothoracic surgery
1.6. Heart Failure
1.7. Congenital Heart Disease
1.8. Excessive alcohol or caffiene intake
1.9. Hyperthyroidism
- What is it?
2.1. Irregular beating of the atria
2.1.1. EKG showing afib2.1.1.1. no P wave, wavy baseline instead
2.2. Rapid heart rate2.2.1. 110 to 180 beats per minute
- Symptoms
3.1. Palpitations
3.1.1. may give feeling of need to cough
3.2. SOB3.2.1. increases with activity
3.3. presyncope, syncope, or dizziness
3.4. chest pain/pressure
3.5. weakness/fatigue
- Treatment
4.1. Rate Control
4.1.1. Betablockers4.1.1.1. metoprolol or carvedilol4.1.2. calciumchannel blockers4.1.2.1. diltiazem4.1.3. Cardiac glycoside4.1.3.1. Digoxin4.1.4. Permanent Pacemaker
4.2. Anticoagulation Management4.2.1. CHADS2 score of 2 or more4.2.1.1. Pradaxa or Coumadin
4.3. Rhythm Contorl4.3.1. Antiarrhythmia medication4.3.1.1. Tikosyn4.3.1.1.1. must be hospitalized for initiation4.3.1.2. Sotalol4.3.1.3. Amiodarone4.3.1.3.1. side effects4.3.1.4. Flecainide4.3.1.5. Propafenone4.3.2. Ablation4.3.2.1. Targeted/focal4.3.2.1.1. return to NSR if successful4.3.2.2. AV node4.3.2.2.1. often symptom control, not rhythm control4.3.2.2.2. destroys ability of AV node to send electrical impulses4.3.3. MAZE procedure4.3.3.1. incisions made on atria4.3.3.1.1. Scar tissue forms4.3.4. Cardioversion4.3.4.1. return to NSR is successful4.3.4.2. starting dose 100 to 120 Joules
- Diagnosis
5.1. Cardiac monitoring
5.1.1. Holter monitor5.1.2. portable event monitor
5.2. EKG
5.3. Electrophysiologist/cardiologist consult
- Complications
6.1. Heart failure
6.1.1. with prolonged lack of rhythm/rate control
6.2. Clot6.2.1. MI6.2.2. Stroke