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Dysrhythmia case study

A 78-year old woman is admitted to a Medical unit directly from her physician’s office for evaluation and management of congestive heart failure. She has a history of systemic hypertension.

The initial assessment completed by the RN of the assigned patient reveals a pulse rate that is rapid and very irregular. The patient is restless, her skin is pale and cool, she states she is dizzy when she stands up and she is slightly short of breath and anxious. Her BP is 106/88. Her ECG monitor pattern shows uncontrolled atrial fibrillation with a heart rate ranging from 150 -170 beats/min. Her respirations are 20/min and her O2 saturation is 90%.

Given the findings, what should be the first action of the practical nurse?
What additional data would the practical nurse collect?
Discuss the potential complications of cardioversion and patient preparation for an elective cardioversion. Because the length of time the patient has been in atrial fibrillation is unknown, what adverse reaction may occur?

Sample Solution

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