CPD practice profile
Atrial fibrillation A CPD article helped Anita Skinner to improve her understanding of the condition and provide effective care
Symptoms and diagnosis
Symptoms often develop quickly and include palpitations, dizziness, angina and breathlessness. Breathlessness, dizziness and angina may develop because the heart becomes less efficient when it beats rapidly. This is because small amounts of blood pumped at a rapid rate are not as useful to the body as larger amounts pumped at the usual slower rate. In addition, diagnosis can often be missed because many individuals with the condition have no symptoms, especially if the heart rate is not particularly rapid. Tests used to confirm diagnosis include an electrocardiogram (ECG) and, if necessary, 24-hour ECG monitoring may be used
ALAMY
Atrial fibrillation (AF) is a supraventricular arrhythmia. AF is common, occurs mostly in older people, and is often associated with cardiovascular conditions. Potentially reversible causes of AF include surgical intervention, acute pulmonary disease, thyroid disease, infection, recreational drug misuse, excessive alcohol intake and autonomic nervous system sensitivity. However, in some cases there is no apparent cause. Patients with AF experience a faster than normal heart rate and an irregular heartbeat of varying strength. There are three different types: paroxysmal AF, which is intermittent and terminates within seven days; persistent AF, which lasts longer than seven days and requires treatment to restore sinus rhythm; and permanent AF, which is long-standing and normal heart rhythm cannot be sustained. if the AF is intermittent. Other investigations, including blood tests and an ultrasound scan of the heart, look for an underlying cause of the AF such as a heart problem or an overactive thyroid gland. Medication is used to slow the heart rate and ease symptoms, and treatment can restore the heart
This practice profile is based on NS658 Richards G (2012) An overview of atrial fibrillation. Nursing Standard. 26, 52, 47-56.
rhythm. The two main strategies for the treatment of AF are control of the ventricular rate and sinus rhythm control. Beta blockers or calcium antagonists are recommended as initial pharmacological agents to control ventricular rate. Rate control is used for patients aged 65 years and above who have coronary heart disease, contraindications to anti-arrhythmic drugs and/or are unsuitable for cardioversion. Rhythm control is achieved via direct current conversion, administration of anti-arrhythmic drugs or ablation. Rhythm control is used for younger patients who are symptomatic, are experiencing their first episode of AF, are experiencing AF secondary to a treatable cause and/or have congestive cardiac failure. Anticoagulation treatment is required to prevent the formation of blood clots, thereby preventing stroke. This is a common complication associated with AF because the irregular blood flow may contribute to the formation of a blood clot. After reading the article, I am able to identify the symptoms of AF, am aware of the complications associated with the condition and understand the need to ensure prompt diagnosis and management of patients with the condition NS Anita Skinner is deputy matron/manager at Lourdes Community Nursing Home in Westgate-on-Sea, Kent
Write your own practice profile You can gain a certificate of learning by reading a Nursing Standard CPD article and writing a practice profile. Turn to page 51 for this week’s article and on page 61 you can find out how to present and submit your practice profile.
Visit the RCN Learning Zone The RCN Learning Zone is a FREE online service to help RCN members with their continuing professional development and professional portfolio management. The RCN Learning Zone can be found at www.rcn.org.uk/members/learningzone.php
60 december 4 :: vol 28 no 14 :: 2013
NURSING STANDARD
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Atrial fibrillation A CPD article helped Anita Skinner to improve her understanding of the condition and provide effective care
Symptoms and diagnosis
Symptoms often develop quickly and include palpitations, dizziness, angina and breathlessness. Breathlessness, dizziness and angina may develop because the heart becomes less efficient when it beats rapidly. This is because small amounts of blood pumped at a rapid rate are not as useful to the body as larger amounts pumped at the usual slower rate. In addition, diagnosis can often be missed because many individuals with the condition have no symptoms, especially if the heart rate is not particularly rapid. Tests used to confirm diagnosis include an electrocardiogram (ECG) and, if necessary, 24-hour ECG monitoring may be used
ALAMY
Atrial fibrillation (AF) is a supraventricular arrhythmia. AF is common, occurs mostly in older people, and is often associated with cardiovascular conditions. Potentially reversible causes of AF include surgical intervention, acute pulmonary disease, thyroid disease, infection, recreational drug misuse, excessive alcohol intake and autonomic nervous system sensitivity. However, in some cases there is no apparent cause. Patients with AF experience a faster than normal heart rate and an irregular heartbeat of varying strength. There are three different types: paroxysmal AF, which is intermittent and terminates within seven days; persistent AF, which lasts longer than seven days and requires treatment to restore sinus rhythm; and permanent AF, which is long-standing and normal heart rhythm cannot be sustained. if the AF is intermittent. Other investigations, including blood tests and an ultrasound scan of the heart, look for an underlying cause of the AF such as a heart problem or an overactive thyroid gland. Medication is used to slow the heart rate and ease symptoms, and treatment can restore the heart
This practice profile is based on NS658 Richards G (2012) An overview of atrial fibrillation. Nursing Standard. 26, 52, 47-56.
rhythm. The two main strategies for the treatment of AF are control of the ventricular rate and sinus rhythm control. Beta blockers or calcium antagonists are recommended as initial pharmacological agents to control ventricular rate. Rate control is used for patients aged 65 years and above who have coronary heart disease, contraindications to anti-arrhythmic drugs and/or are unsuitable for cardioversion. Rhythm control is achieved via direct current conversion, administration of anti-arrhythmic drugs or ablation. Rhythm control is used for younger patients who are symptomatic, are experiencing their first episode of AF, are experiencing AF secondary to a treatable cause and/or have congestive cardiac failure. Anticoagulation treatment is required to prevent the formation of blood clots, thereby preventing stroke. This is a common complication associated with AF because the irregular blood flow may contribute to the formation of a blood clot. After reading the article, I am able to identify the symptoms of AF, am aware of the complications associated with the condition and understand the need to ensure prompt diagnosis and management of patients with the condition NS Anita Skinner is deputy matron/manager at Lourdes Community Nursing Home in Westgate-on-Sea, Kent
Write your own practice profile You can gain a certificate of learning by reading a Nursing Standard CPD article and writing a practice profile. Turn to page 51 for this week’s article and on page 61 you can find out how to present and submit your practice profile.
Visit the RCN Learning Zone The RCN Learning Zone is a FREE online service to help RCN members with their continuing professional development and professional portfolio management. The RCN Learning Zone can be found at www.rcn.org.uk/members/learningzone.php
60 december 4 :: vol 28 no 14 :: 2013
NURSING STANDARD
Downloaded from RCNi.com by ${individualUser.displayName} on Nov 14, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
