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Original Question

62-year-old woman has been feeling heart palpitations and shortness of breath for a few weeks. To date, she has not sought treatment. Today, her husband noticed that she was having slurred speech and difficulty walking, so he brought her to the Emergency Department. Nursing assessment reveals the following: radial pulse too rapid to count, apical pulse 160 beats per minute and irregular BP 168/98, RR 24, and oral temp 99.4°F (37.4°C), SpO2 was 95% on room air. EKG shows atrial fibrillation with rapid ventricular response of 164. Skin is warm, flushed, and dry. Reports a headache, and falls asleep during the interview, with a decreased level of Reports a headache, and falls asleep during the interview, with a decreased level of consciousness. Lower legs have 1+ edema bilaterally. States her last bowel movement was 2 days ago. 1. Identify priority assessment findings that require immediate follow-up by the nurse. 2. Explain how atrial fibrillation has contributed to the patient’s current condition. 3. What nursing actions do you expect the nurse to perform? Include medical orders and medication administration? 4. What are the expected outcomes from the nursing actions listed in question 3?

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