Term
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Definition
| can be triggered from AMI, pulmonary embolism, or pericarditis; can be neurogenic and triggered by heightened vagal or adrenergic tone is susceptible pts. |
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Term
| What is recurrent paroxysmal AF? |
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Definition
| Two or more episodes of AF that resolve spontaneously |
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Term
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Definition
| Sustained >7days; can occur as a first episode of AF or after recurrent paroxysmal episodes; can also describe AF> 1 year's duration in which cardioversion has failed or hasn't been attempted. |
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Term
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Definition
| Also called chronic AF; occurs when sinus rhythm can't be sustained after cardioversion or when the decision is made to let AF continue without efforts to restore normal sinus rhythm. |
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Term
| AF is irregular and rapid; it prevents atria from completely emptying leading to what three things? |
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Definition
| blood stasis, thrombus formation, and thromboembolism |
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Term
| What are the 5 complications of AF? |
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Definition
| Stroke, Cardiomyopathy, HF, hemodynamic compromise, and death |
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Term
| The risk for complications with AF is reduced when what occurs? |
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Definition
1. early treatment-within 48 hours of start of AF
2. Adherence to treatment plan |
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Term
| What are the signs and symptoms of AF? |
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Definition
| irregularly-irregular cardiac rhythm, ventricular rate may be >100 bpm; palpitations, fatigue, SOB, decreased exercise tolerance. |
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Term
| What are the S/S of hemodynamic compromise? |
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Definition
| hypotension, diaphoresis, chest pain, pulmonary edema, neurologic deficits, usually rate related not rhythm related, improves once heart rate is controlled, pt may also be asymptomatic. |
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Term
| What are 3 management goals for a pt with AF? |
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Definition
| Control ventricular rate, prevent thromboembolism, and reestablish NSR if possible. |
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Term
| What factors affect treatment of AF? |
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Definition
| Length of time in AF, S/S, previous episodes of AF, and Medical history. |
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Term
| What drugs are given to control the ventricular rate for a pt in AF? |
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Definition
| Beta Blockers, CCB, and Digoxin may be used. |
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Term
| What is given to prevent thromboembolisms in AF? |
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Definition
IV Heparin (acute anticoagulation)
Coumadin (PO) want the INR to be 2-3 (maintenece anticoagulation) |
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Term
If spontaneous cardioversion is used about 50% of all pts with AF will convert to NSR within ___ to ____ hrs.
Less likely if AF duration is greater than ___days. |
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Definition
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Term
Electrical Cardioversion may be used in AF <___hours; the pt is hemodynamically unstable, or there are serious s/s related to AF.
This may be short lived and long term antiarrhythmic drug and long term anticoagulation is needed. |
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Definition
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Term
| What are the complications associated with electrical cardioversion? |
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Definition
| bradycardia, ventricular tachycardia, and skin burns |
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Term
| If a pt has been in asymptomatic AF >48 hours what criteria needs to be met before cardioversion can be performed? |
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Definition
| anticoagulation for 3 weeks OR transesophageal echocardiogram to rule out mural thrombus. |
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Term
| To do pharmacologic cardioversion what 2 medications are given? |
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Definition
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Term
| What are the adverse effects of Amiodarone? |
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Definition
| dysrhythmias, damage to the liver, thyroid, and lungs |
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Term
| An adverse effect of Ibultilide can put a pt in this type of dysrhythmia? |
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Definition
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Term
| What are some nursing considerations for AF? |
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Definition
| monitor vs and cardiopulmonary status; institute continuous cardiac monitoring, have emergency equipment and drugs readily available, monitor for S/S of bleeding; and report daily labs including INR to the doctor. |
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Term
| Who is catheter ablation with radiofrequency energy generally used for? |
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Definition
| Those with symptomatic AF who haven't responded to drug therapy or cardioversion; those that can't tolerate drug therapy; generally the younger population. |
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Term
| What are some nursing considerations when a pt has catheter ablation with radiofrequency energy? |
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Definition
| Nuerovascular checks, monitor for bleeding, pain management, and neurological assessment. |
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Term
| What pt teaching can you do for a pt with AF? |
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Definition
| Teach pt about tests, procedures, and drugs; the common S/S of AF; S/S to report to his or her HCP; the Importance of INR, and S/S of bleeding to look for and to report. |
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