Assignment: Systemic hypertension.
Your written assignment for this module should be a 2-3 page
paper (not including title page and reference page).
A 78-year old woman is admitted to a Medical unit directly from
her physician’s office for Assessment and management of
congestive heart failure. She has a history of systemic
hypertension.
The initial assessment completed by the RN of the assigned
patient reveals a pulse rate that is rapid and very irregular. The
patient is restless, her skin is pale and cool, she states she is dizzy
when she stands up and she is slightly short of breath and
anxious. Her BP is 106/88. Her ECG monitor pattern shows
uncontrolled atrial fibrillation with a heart rate ranging from 150
-170 beats/min. Her respirations are 20/min and her O2 saturation
is 90%.
Given the findings, what should be the first action of the practical
nurse?
What additional data would the practical nurse collect?
Discuss the potential complications of cardioversion and patient
preparation for an elective cardioversion. Because the length of
time the patient has been in atrial fibrillation is unknown, what
adverse reaction may occur?
Later that evening the patient calls the nurse because she feels
“like something terrible is going to happen.” She reports chest

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