In AF, the normal regular electrical impulses generated by the sinoatrial node are overwhelmed by disorganized electrical impulses usually originating in the roots of the pulmonary veins, leading to irregular conduction of impulses to the ventricles which generate the heartbeat. AF may occur in episodes lasting from minutes to days ("paroxysmal"), or be permanent in nature. A number of medical conditions increases the risk of AF, particularly mitral stenosis (narrowing of the mitral valve of the heart).
Atrial fibrillation may be treated with medications to either slow the heart rate to a normal range ("rate control") or revert the heart rhythm back to normal ("rhythm control"). Synchronized electrical cardioversion can be used to convert AF to a normal heart rhythm. Surgical and catheter-based therapies may be used to prevent recurrence of AF in certain individuals. People with AF often take anticoagulants such as warfarin to protect them from stroke, depending on the calculated risk. The prevalence of AF in a population increases with age, with 8% of people over 80 having AF. Chronic AF leads to a small increase in the risk of death. A third of all strokes are caused by AF.
Nursing Diagnosis Nursing Care Plan for Atrial Fibrillation:
Decreased Cardiac Output related to alteration in heart rate and rhythmn as evidence by EKG showing Atrial Fibrillation, HR irregular
Nursing Outcomes Nursing Care Plan for Atrial Fibrillation:
Patient with convert back to Normal Sinus Rhythmn within 24 hours.-Pt INR level will remain within 2-3 range.-Pt will verbalize 2 types of programs avaiable to help with medication costs.
Nursing Intervention for Atrial Fibrillation
1. monitor v/s(vital signs)- paying particular attention to heart rate and rhythm. (some patients are chronic for their a-fib) and then there is controlled a-fib and uncontrolled a-fib) making a note of if and when the patient converted to a sinus rhythm based on if the doctor has ordered any drips(ie: cardizem or amio)
2. educate on medications: pt may be placed on amiodarone and asa long term to manage blood consistency.
3. educate on diagnostic tests: EKG, Echo
4. and if placed on coumadin make sure pt knows signs and symptoms of toxicity and to make their appts for lab checks, ie: PT/PTT/INR(coagulations)