(^54) Medical-Surgical Nursing Demystified
HALLMARK SIGNS AND SYMPTOMS
- Asymptomatic
- Irregular pulse
- Feeling faint (near syncope)
- Palpitations
- Lightheadedness
- Dyspnea
INTERPRETING TEST RESULTS
- Electrocardiogram will show irregularities characteristic of the disease:
- QRS complexes are of irregular duration and structure.
- PR interval barely noticeable.
- Erratic, low-voltage, or absent P-waves.
- Echocardiogram to look for structural abnormalities.
- Thyroid function tests as hyperthyroidism can lead to atrial fibrillation.
TREATMENT
Treatment is directed towards restoring the regular heart rate and rhythm. If the
atrial fibrillation is less than 72 hours old, chemical or electrocardioversion is
endeavored. Electrocardioversion, or shocking the heart, often restores normal
sinus rhythm. If greater than 72 hours, anticoagulation is begun as the risk of
thromboembolism is great.- Administer antiarrhythmics once patient stabilizes—these medications may
be effective in restoring a regular rhythm and also for in long-term therapy:- amiodarone
- digoxin
- diltiazem
- verapamil
- Unstable patient: Synchronized cardioversion is a treatment that involves an
electrical shock delivered to the heart, which is synchronized with the R- or
S-wave of the EKG, in an attempt to restore coordinated firing of electrical
impulses.