EKG l Atrial Fibrillation (A Fib)

guys nurse my dear and welcome to simple nursing comm now before we get today's lecture started please remember to access your free quiz and preview our cool nifty new study guides not here on YouTube click the link right up here at any time during this video all right guys let's begin fireworks in the attics the upstairs of the hearts today we're talking about atrial fibrillation an uncontrolled electrical activity in the atria that causes rapid disorganized twitching of the atrial musculature basically it's just a rapid firing of the atriums causing a pooling and swirling of blood kind of like a hot tub in the atria now this hot tub in the atria means a huge risk for clots basically clots all over the body leading to an mi which is a clot in the heart PE which is clot in the lung si VA a clot in the brain and DVT a clot in the extremities so what's really going on in the body well as you guys know the heart has one main pacemaker and to backup pacemakers in this case our main pacemaker the SA node has lost control as boss pacemaker atria gone wild leading to a revolution of 350 to 600 erratic disorganized beats all over the atria thankfully the AV node blocks most of these erratic beats and protects our precious ventricles using our five steps let's interpret this EKG so step number one the rates is usually over a hundred beats per minute which is a huge indicator for atrial fibrillation step two the rhythm is going to be irregular unorganized uneven basically the space between our are Peaks will not be the same so see right here they're not going to be perfectly spaced out step three the P wave will be none because the atria are not fully contracting step four our PR interval all there's gonna be none guys because the H are not contracting and lastly the QRS will be normal and upright but again not evenly spaced out the atria are not helping squeeze that oxygen-rich blood out to the body meaning we'll have lower cardiac output and basically lower into the body so what are some causes of afib so let's think of our path though here well all of our causes stem from something that makes the heart pump in effectively so major heart surgery like open-heart surgery can cause added stress on the heart during this recovery phase another condition like pulmonary hypertension adds pressure on the heart usually from high blood pressure also stimulants like alcohol can induce something called holiday heart syndrome basically a full episode of atrial fibrillation and even hyperthyroidism can increase your metabolism causing added stimulation to the heart okay so now that we know all of our causes what are some signs and symptoms for atrial fibrillation well all of these various signs and symptoms stem from this low oxygen this low cardiac output and also a possible clot so we'll see classic signs and symptoms like collapsed our cool little acronym to describe all the problems that low oxygen gives our patients and yes guys we did spell it wrong on purpose so the C stands for chest pain o for oxygen saturation that is lower L for lethargy or fatigue a is from anxiety usually caused by lack of oxygen P is for palpitations that described as a racing heart or kind of feels like gallops under the chest S is for shortness of breath or a dis Nia that difficulty breathing a is for elevated heart rate in certain cases so a classic sign of afib is usually tachycardia now sometimes it can be low between 60 to 100 but usually would have an elevated heart rate now D is for dizziness or syncope which is also called fainting or passing out ultimately leading into uncontrolled afib and blood clots all over the body so what are we gonna do about it so nursing interventions and treatments for afib well before we start memorizing things what is the main patient outcome goal well we have three first we want to slow the heart rate and restore that normal electrical conduction in that SA node number two is get an effective organized pump out of those atriums that will eventually number three prevent it's all over the body so how are we going to do this well a B C and D is our acronym so starting with a anticoagulants like warfarin will prevent the clots but caution guys high risk for bleeding with our patients so we're gonna watch our eye on our lab values for a coagulation panel it should be between 2.5 to 3.5 for a therapeutic blood thinning range now again caution educate your patients not to increase or decrease their intake of green leafy vegetables write that down green leafy veggies have vitamin K that blocks warfarin effectiveness so keeping intake the same not increased and not decreased it won't mess with the medications effectiveness B stands for beta blockers which slows down our heart rate C as for cardiac ablation basically want to burn or freeze those atria cells causing the problem D is for digoxin our cardiac glycoside which does two nifty things it increases contractility known as our inotropic drug basically helps those atrial get a deeper contraction and slows the heart rates known as our negative chrono tropic drug so Chronos meeting time so negative time eenz less beats per minute now big caution here never give if the heart rate is less than 60 beats per minute we don't want to slow the heart rate down more than it ready is so that's why we always listen to the apical pulse on the fifth intercostal space right here for one full minute or 60 seconds basically whatever comes first so last nursing precaution we're gonna watch for a digit Aqsa City / 2.0 if your patient complains of seeing green or yellow halos this is a huge toxic tip another one is a low potassium from diuretics like furosemide or hydrochlorothiazide htc it predisposes your patient to be greater risk for digitoxin e e is for electro cardioversion our little baby shock that's 50 to 200 joules of electricity given to reset that SA node that main pacemaker of the heart now it's usually done after t te a transthoracic echocardiogram fee tte which is basically a procedure to roll out clot formation in the atria because think about it guys the last thing we really want to do is shock the patient and spread possible clots all over the body kind of like a party popper now our last test tip cardioversion not to be confused guys with defibrillation which is our supersize shock 200 a 360 joules of electricity now defib is usually only given with our deadly rhythms like v-fib or pulseless v-tach alright guys that wraps up a fib thanks for watching for our full video and new quiz Bank click right up here to access your free trial and please consider subscribing to our YouTube channel last but not least a big thanks to our team of experts helping us make these great videos alright guys see you next time [Music] you

Channel: Simple Nursing

Views: 111,857

Keywords: Atrial Fibrillation, A Fib, AF, EKG interpretation A Fib vs A flutter, EKG, ECG, How to interpret heart rhythms on EKG strips, How to memorize PQRST EKG rhythm, Registered nurse RN, RN, Osmosis, Pharmacology, NCLEX, ATI exit, HESI exit, Kaplan, student nurse, nursing student, simplenursing, simple nursing, electrocardiogram, Dysrhythmias, Rhythems, Cardiac EKG, QRS, waves, electrical activity, dysrhythmias, arrhythmias

Id: eqtiOWRwVwE

Length: 7min 44sec (464 seconds)

Published: Wed Aug 21 2019