CHAPTER 1 Cardiovascular System^53
NURSING INTERVENTION
- Monitor breathing because changes in respiratory status can signal that a clot
has dislodged and moved to the lung. - Monitor labs because the patient is receiving anticoagulants. Monitor for
therapeutic effect. - Apply warm moist compresses over affected area because it enhances blood
flow to area. - Explain to the patient:
- Report signs of bleeding—anticoagulant may be too much.
- Report signs of clotting—pain in affected area, shortness of breath—
patient may have underlying clotting disorder. - Move about frequently when allowed—discourages chances of develop-
ing another clot. - Don’t cross legs—avoid constriction of lower extremity vessels.
- Don’t use oral contraceptives—increases risk of clot formation.
- Support hose.
- Elevate affected area.
Atrial Fibrillation
WHAT WENT WRONG?
Uncoordinated firing of electrical impulses in the wall of the atria (upper chambers
of the heart) causes the heart to quiver instead of beating regularly, resulting in inef-
fective contractions. This is usually due to an abnormality in the electrical system of
the heart. Blood is ineffectively pumped to the ventricles (lower chambers of the
heart) and may result in not enough blood being pumped throughout the body.
Usually the heart beats rapidly; however, this is not always the case. Atrial fibrilla-
tion (also called AF or “a fib”) is the most common chronic arrhythmia and is not
life-threatening on its own, but increases the patient’s risk for blood clots and strokes.
PROGNOSIS
The arrhythmia usually goes away once the cause of atrial fibrillation is identi-
fied and treated. If left untreated or if it returns, there is a risk of stroke and other
complications.
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