Afib

Afib

1. Nursing priority

   • Risk for falls due to dizziness and weakness
     • Implement fall risk precautions i.e gait belt, foot wear, bed alarms etc. Goal 7 promotes patient safety and infomed conset
   • Risk for bleeding due to anticoagulant therapy.
     • Promote adherence to anticoagulant therapy for example with blister packets for meds. Monitor s/s of bleeding. Goal 14 of NPGs requires hospitals to have safe medication management
   • Risk for clotting due to irregular HR and blood pooling.
     • Encourage ambulation and use of incentive spirometry. Implement compression stocking

2. Patho (Ignatavicius)

   • Atrial fibrosis and loss of muscle
     • HTN, Hyperlipemia, H(x) of smoking
       • palpitations, dizziness, fatigue, irregular HR
         • Decreased Cardiac output
       • Rapid impulses

3. D(x) tools

   • ECG and echocardiogram
   • Expected additional Test: Ambulatory ECG. Rationale: patient reported intermittent symptoms (Kumar.)

4. S/S

   • palpitations, dizziness, fatigue, irregular heart rate and occasional shortness of breath

5. Interventions

   • Continous cardiac monitorring
   • Educate patient about diet and exercise
   • Assessing VS, LOC and any new symptoms

6. Meds

   • Eliquis (Vallerand & Sanoski, 2026)
     • Therapeutic Class: anticoagulant
       • Pharm class: Factor xa inhibator
     • Side effects: Bleeding
     • Therapeutic goal: prevent thromboembolic events
     • Nurse considerations:.
       • Antidote is andexanet alfa. If switching from warfarin, patient must have INR of <2.0. MOnitor for bleeding
   • Metoprolol (Vallerand & Sanoski, 2026)
     • Therapeutic goal: decrease BP, HR and frequency of angina attacks
     • Therapeutic class: antianginals and antihypertensives
       • Pharm class: Beta blockers
     • Common side effects: ED, weakness, fatigue
     • Life threatening side effects: Bradycardia, HF ,PE
     • Nurse Considerations: Monitor Apical HR for a minute and hold if <50. Monitor B/P and HR. Monitor Is and Os. Educate patient to report any wheezing. VS