A 68-year-old client is admitted to the ED with a diagnosis…
A 68-year-old client is admitted to the ED with a diagnosis of atrial fibrillation and rapid ventricular response. The ED physician completes the history and physical, and prescribes IV diltiazem to treat the dysrhythmia. Of the choices below select choices that indicate a therapeutic outcome of medication therapy. Choose ALL that apply. Health History Nurses’ Notes Vital Signs Lab Tests A 68-year-old client presents to the ED at 1215 with complaints of “heart fluttering” and shortness of breath that started 2 hours ago. Associated with fatigue and dizziness, worsened by activity. No alleviating factors, symptoms are constant. Denies chest pain, losing consciousness, and difficulty breathing while lying down. Reports past medical history of hypertension, hyperlipidemia, and type 2 DM. Family history is negative for cardiac events. Speaks in short sentences, appears short of breath while talking. Skin is warm, dry, and intact throughout. Rapid, irregular HR, 120–140 BPM on auscultation. Lung sounds clear to auscultation in all fields. No peripheral edema. 1215: Client admitted to ED. Received orders for IV amiodarone. 1230: Admission assessment completed. Amiodarone started. Continuous VS monitoring and cardiac monitor in place. Cardiac monitor shows shortened PR interval, narrowed QRS complex, atrial fibrillation with an irregular rate of 120–140 BPM. 1300: Follow-up VS and assessment completed. Client reports tremors, light sensitivity, lack of appetite with nausea, vomiting × 1 undigested food, no hematemesis. BP 90/56 mm Hg, HR 102 BPM. Cardiac monitor shows prolongation of previously shortened PR interval, widening of previously narrowed QRS complex, atrial fibrillation converted to sinus rhythm. HR regular at 102 BPM. 2+ pitting peripheral edema. 12:15: T = 98.8°F (37.1°C); apical HR = 120–140 BPM and irregular; RR = 22 bpm; BP 128/76 mm Hg; SpO2 = 95% on RA
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