Question

1.Identify the most important client concerns for Atrial Fibrillation of Atrial Flutter

2. Explain how this dysrhythmia affects perfusion, activity tolerance, and vital signs.

3.You are caring for a patient who has had this rhythm on a chronic basis but is noncompliant with medication. How could you, as the RN, help them maintain compliance with their treatment regimen for this dysrhythmia?

Answer 1

Ans) 1) Atrial flutter and atrial fibrillation (AFib) are both types of arrhythmias. They both occur when there are problems with the electrical signals that make your heart chambers contract. When your heart beats, you’re feeling those chambers contracting.

Atrial flutter and AFib are both caused when the electrical signals occur faster than normal. The biggest difference between the two conditions is in how this electrical activity is organized.

2) Patients with VT may be awake and symptomatic. Common symptoms are dizziness, fatigue, activity intolerance, a "fluttering" in their chest, shortness of breath, and chest pain. They may have syncope from decreased perfusion to the brain, pallor, diaphoresis, hypotension, and dyspnea from diminished perfusion to the lungs. Changes in cerebral perfusion may be manifested by anxiety, agitation, lethargy, or coma. Lethal dysrhythmias such as VF and ventricular asystole usually lead to a full cardiopulmonary arrest. If the patient does not have adequate airway, breathing, or circulation (ABCs), initiate cardiopulmonary resuscitation (CPR) as needed. If the patient is stable, complete a general head-to-toe physical examination. Pay particular attention to the cardiovascular system by inspecting the skin for changes in color, presence of peripheral pulses, or the presence of edema. Auscultate the heart rate and rhythm and note the first and second heart sounds and also any adventitious sounds. Auscultate the blood pressure. Perform a full respiratory assessment and note any adventitious breath sounds or labored breathing.

3) Causes of treatment noncompliance can start with the patient, the physician or the medication, itself. Patient-based causes of noncompliance include forgetfulness; cost and inability to get a prescription filled, picked up or delivered. These include poor doctor-patient relationship and lack of communication.
Improving patient compliance to treatment regimen:
Nine Tips for Improving Medication Adherence
• Educate patients about what to expect.
• Nurture relationships with patients.
• Team up with prescribers.
• Engage the staff.
• Learn about and use available technologies.
• Help patients customize their support tools.
• Schedule appointments.
• Synchronize medications.