NSG 202 Application Activity Perfusion - Atrial Fibrillation

AA#3 WI 2021
Please read criteria for each section of the rubric:
 Please read criteria for each section of the rubric
 Answers must be organized and must be typed.
 Answers cannot be in narrative form and must be in your own words.
 Answers must have a cited source (e.g. Ignatavicius et al, pg. 432)
 Points will be deducted for not following the rubric directions.
 Attach the rubric to the top of your application activity when you turn it in.

Total Points Awarded Points
Criteria Available with Comments
1. Identify the clinical significance (complication) 2 points 2
of atrial fibrillation.
 List two complications
 You must give a rationale for each. (SLO 6.2)

2. Explain the purpose of why the orders for THIS 3 points 3
client include Heparin, Cardizem, and
Digoxin. (SLO 3.1, 6.2)
 You must list the purpose for each one of the
3 meds to get full credit.
 The purpose has to be specific to the
treatment of a-fib.
3. List two nursing responsibilities for each of 6 points 6
the medications being Heparin, Cardizem, and
Digoxin.
(SLO 1.1., 3.1, 3.2, 5.1, 6.2, 7.1)
4. Why is THIS client on both heparin and warfarin 1 point 1
at the same time? You must give rationale for
your answer. (SLO 1.1)
5. How many mL per hour will you set your 1 point 1
infusion pump for the start of the heparin
infusion? (SLO 6.1)
 Refer to the primary provider order for
heparin dosing.
 Use rounding rules for credit.
6. What lab requires monitoring while the heparin 1 point 1
infusion is in progress? (SLO 1.1, 6.2)

7. The nurse initiated the heparin protocol at 6am. 1 point 1
When should you recheck the lab that you
indicated in the previous question? (SLO 1.1,6.2)

Attach the rubric to the top of your application activity TOTAL: 15 /15




Nursing 202
Application Activity

1

, AA#3 WI 2021
Concept: Perfusion
Exemplar: Atrial-Fibrillation
Resources: Ignatavicius, Workman, & Rebar (9th edition) and Giddens (2nd ed), Lilley pharm text,
Mosby’s Nursing Drug Reference and Potter et al

 Utilize the information from the client in the case study to answer the rubric questions
 You must follow the rubric directions to get full credit; points will be deducted.
 Please put your name on the rubric

You must include a reference(s) for the source you used for your answer. Example: Ignatavicius et al,
page 123. This is to avoid potential plagiarism and to make sure you understand the information. You
must put answers in your own words. You cannot simply cut and paste. The answer cannot be in
narrative form.


Case Study: Atrial Fibrillation
Client Profile: Mr. Smith is an 85-year-old African American Male admitted to the monitored care unit
for a diagnosis of Atrial Fibrillation with a rapid ventricular rate (A-Fib with RVR). He has a history of
Coronary Artery Disease (CAD), Heart failure, Hyperlipidemia, Diabetes Mellitus type II.
Admission Data:
Subjective data:
 Complains of heart palpitations and chest pain and difficulty in breathing
Objective Data:
 BP 110/68 manual
 HR 156 beats per minute, irregular
 Respiratory rate at 32 breaths per minute and labored
 Breath sounds reveal crackles scattered in bases of lungs bilaterally in anterior and posterior
chest
Labs:
 Troponin negative (NO MI)
 BNP 99 ng/dL
 ABGs: Ph 7.38, PaO2 78.6mmhg, PaCo2 44.8mmhg, Hco3 26, SaO2 96
 aPTT at 0600 today is 52 seconds
 Electrolytes Na+ 138 mEq/L, K+ 4.0 mEq/L, Ca++ 9 mg/L creatinine 0.85




2