During pretesting for an elective surgery, it is discovered that the o

During pretesting for an elective surgery, it is discovered that the older adult client has atrial fi-brillation. The nurse knows that this is a common dysrhythmia in older people and can cause:

1. Fatigue, a fluttering in the chest, or shortness of breath if the ventricular response is rapid
2. Acute loss of pulse and respiration
3. Severe hypotension and loss of pulse and consciousness
4. Dizziness, syncope, or chest pain

ANSWER

ANS: 1
There is a loss of the atrial kick (portion of the cardiac output squeezed in the ventricles with a coordinated atrial contraction), pooling of blood in the atria, and development of microemboli. The client often complains of fatigue, a fluttering in the chest, or shortness of breath if the ven-tricular response is rapid. It is a commonly occurring dysrhythmia in the aging and older adult. Acute loss of pulse and respiration is indicative of ventricular fibrillation. Immediate defibrilla-tion is needed after assessment of ABCs of CPR. Ventricular tachycardia results in decreased cardiac output due to decreased ventricular filling time and often leads to severe hypotension and loss of pulse and consciousness. Sinus bradycardia may present signs and symptoms of re-duced cardiac output such as dizziness, syncope, or presence of chest pain.