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    Afib NCP

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    Gen Rodriguez
    The patient presented with decreased cardiac output related to altered myocardial contractility as evidenced by tachycardia, dyspnea, crackles, and elevated blood pressure. The plan was for the short term goal of demonstrating adequate cardiac output through normal vital signs, capillary refill, and urine output. Long term, the goal was to convert the patient back to normal sinus rhythm. Interventions included assessing heart and lung sounds, monitoring vital signs, pulses, and urine output, administering supplemental oxygen, antiarrhythmic and antihypertensive drugs, and providing a quiet environment.

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    Afib NCP

    Uploaded by

    Gen Rodriguez
    3K views3 pages
    The patient presented with decreased cardiac output related to altered myocardial contractility as evidenced by tachycardia, dyspnea, crackles, and elevated blood pressure. The plan was for the short term goal of demonstrating adequate cardiac output through normal vital signs, capillary refill, and urine output. Long term, the goal was to convert the patient back to normal sinus rhythm. Interventions included assessing heart and lung sounds, monitoring vital signs, pulses, and urine output, administering supplemental oxygen, antiarrhythmic and antihypertensive drugs, and providing a quiet environment.

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    atrial fibrillation

    Original Title

    AFIB.NCP

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    The patient presented with decreased cardiac output related to altered myocardial contractility as evidenced by tachycardia, dyspnea, crackles, and elevated blood pressure. The plan was for the short term goal of demonstrating adequate cardiac output through normal vital signs, capillary refill, and urine output. Long term, the goal was to convert the patient back to normal sinus rhythm. Interventions included assessing heart and lung sounds, monitoring vital signs, pulses, and urine output, administering supplemental oxygen, antiarrhythmic and antihypertensive drugs, and providing a quiet environment.

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    © All Rights Reserved
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    3K views3 pages

    Afib NCP

    Uploaded by

    Gen Rodriguez
    The patient presented with decreased cardiac output related to altered myocardial contractility as evidenced by tachycardia, dyspnea, crackles, and elevated blood pressure. The plan was for the short term goal of demonstrating adequate cardiac output through normal vital signs, capillary refill, and urine output. Long term, the goal was to convert the patient back to normal sinus rhythm. Interventions included assessing heart and lung sounds, monitoring vital signs, pulses, and urine output, administering supplemental oxygen, antiarrhythmic and antihypertensive drugs, and providing a quiet environment.

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    ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVAUATION

    Assess for abnormal heart Shallow, rapid respirations are characteristics


    SUBJECTIVE: and lung sounds. of decreased cardiac output. Crackles indicate Short term:
    “Sobrang bilis ng Decreased Cardiac Short term: Patient fluid buildup secondary to impaired left Goal partially
    tibok ng puso ko, as Output related to will demonstrate ventricular emptying. met, patient
    verbalized by the altered myocardial adequate cardiac S1 and S2 may be weak because of diminished demonstrated
    patient.” contractility output as evidenced pumping action. Gallop rhythms are common signs of
    by vital signs within (S3and S4), produced as blood flows into adequate
    normal range, noncompliant chambers. Murmurs may reflect cardiac output
    OBJECTIVE: regular pulse rate, valvular incompetence. as evidenced by
    good capillary refill, Check for peripheral normal pulse
     Nausea and normal urine pulses, including capillary Decreased cardiac output may be reflected in rate, good
     Weakness output. refill. diminished peripheral pulses. Weak pulses are capillary refill,
     Tachycardia present in reduced stroke volume and cardiac absence of
    180 bpm Long term: Patient output. Capillary refill is sometimes slow or pallor, and urine
     Dyspnea 26 will convert back to absent. output of 700
    cpm Normal Sinus Rhythm In early, moderate, or chronic HF, BP may be ml of urine in 8
     (+) Crackles as evidenced by Monitor BP. elevated because of increased SVR. In hours.
     BP 190/100 normal ECG result advanced HF, the body may no longer be able RR: 26
    to compensate, and PR: 95
    profound hypotension may occur BP: 140/90

    Pallor is indicative of diminished peripheral


    Inspect skin for pallor. perfusion secondary to inadequate cardiac
    output.

    Monitor urine output Kidneys respond to reduced cardiac output by


    retaining water and sodium. Oliguria is a
    classic sign of decreased renal perfusion.

    Review patient’s EKG. EKG can reveal previous MI, or evidence of left
    ventricular hypertrophy, indicating aortic
    stenosis or chronic systemic hypertension.
    Check symptoms for
    chest pain. Low cardiac output can further decrease
    myocardial perfusion, resulting in chest pain.
    Note changes in
    sensorium:
    lethargy, confusion, May indicate inadequate cerebral perfusion
    disorientation, anxiety, secondary to decreased cardiac output.
    and depression.

    Administer supplemental
    oxygen as indicated.
    Increases available oxygen for myocardial
    Give anti-arrhythmic drug uptake to combat effects of hypoxia.
    as prescribed
    Amiodarone is a primarily a class III
    antiarrhythmic. Like other antiarrhythmic
    drugs of this class, it works primarily by
    blocking potassium rectifier currents that are
    responsible for repolarization of the heart
    Give anti-hypertensive during phase 3 of the cardiac action potential.
    drug as ordered
    It works by relaxing blood vessels so blood can
    flow more easily and helps prevent strokes
    Monitor bowel function. and heart attacks.
    Provide stool softeners as
    ordered. Tell patient to Straining when defecating that results in the
    avoid straining when Valsalva maneuver can lead to dysrhythmia,
    defecating. decreased cardiac function, and sometimes
    death.
    Provide quiet
    environment: explain
    therapeutic management, Psychological rest helps reduce emotional
    help patient avoid stress, which can produce vasoconstriction,
    stressful elevating BP and increasing heart rate.
    situations, listen and
    respond to expressions of
    feelings.

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