Atrial Fibrillation

By Lisa Lemenger RN

What is atrial fibrillation? Atrial fibrillation is the two atria of the heart quivering instead of beating effectively. Because the blood isn’t pumped out of the atria effectively, it may pool and form clots (American Heart Association, 2011). Visualized on an EKG rhythm strip, it is an irregular, narrow complex rhythm with no discernable P-waves.
What’s the worst that can happen that can happen with atrial fibrillation? The worst is a blood clot breaking free and lodging in the brain causing a cerebral vascular accident (CVA). While some patients may recover from a CVA with few deficits, the sooner the treatment the better, others suffer deficits that range from motor activity to speech and other senses. Whatever the effect, it is detrimental to a person’s well-being.
Although not all patients with atrial fibrillation experience blood clots and CVA’s, symptoms they may experience include palpitations, shortness of breath, dizziness, chest pain, and syncope. Although none of these cause harm on their own, they cause discomfort and may lead to other illness or injuries.
Treatment for atrial fibrillation ranges from treating underlying causes, such as a thyroid condition, to prescribed medications. Anticoagulant therapy, such as Coumadin, is used to prevent blood clots. Beta blockers and calcium channel blockers are used to slow the heart rate (American Heart Association, 2010).
If medications do not control heart rates, a procedure called radiofrequency catheter ablation can be performed. Multiple catheters are inserted through bilateral veins in the groin, up through the right atrium, and into the left atrium through a transeptal puncture. The pulmonary vein is burned to cause a scar around it to eliminate the abnormal electrical signals sent by the atrial node (Johnson, Jadick, & Knippers, 2011).
Patient education provided by the nurse should include signs and symptoms; when to seek medical attention; medication information; and education regarding any underlying causes or associated chronic illnesses. Equipped with education and encouragement by the nurse, the patient should be able to follow a medication regimen and control his atrial fibrillation, minimizing symptoms and the risk of blood clots.

References
American Heart Association. (2011). Atrial Fibrillation. Retrieved February 23, 2011, from
American Heart Association: http://www.americanheart.org/presenter.jhtml?
Identifier=4451

American Heart Association. (2010, August 11). Treating Atrial Fibrillation. Retrieved February 23,
2011, from American Heart Association: http://www.heart.org/STROKEORG/LifeAfter
Stoke/HealthyLivingAfterStroke/UnderstandingRiskyConditions/Treating-Atrial-
Fibrillation_UCM_310778_Article.jsp

Johnson, T.W., Jadick, E.A., & Knippers, L. (2011). Atrial Fibrillation Ablation. American Journal of
Nursing, 58-61.

Note: This blog post reflects the work of Lisa Lemenger RN with minor editing by Shirley Comer RN and was completed as a class assignment. The content of this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.

Colorectal Cancer

By Margaret Duffy-Chodl RN

Colorectal cancer is found in the colon or the rectum that develops slowly over a period of 10 to 15 years. The cancer usually develops from polyps in the inner lining of the colon or rectum. These polyps can either be benign or malignant. When the polyps are malignant, they invade the wall of the colon or rectum and grow into the blood or lymph vessels which metastasize to other parts of the body. Most colorectal cancers are adenocarcinomas which account for 95% of this type of cancer (ACS).
Diagnosis of colorectal cancer is usually made in the advanced stages of the disease. The diagnosis is made through a biopsy of the tissue in the colon or rectum. The major symptoms of this cancer are a change in bowel habits, rectal bleeding or black tarry stools, abdominal pain, fatigue, or weight loss. It is very important to have colorectal screenings after age 50 to detect this treatable disease. The screenings to detect this disease are flexible sigmoidoscopy, colonoscopy, double-contrast barium enema, CT colonoscopy, or a fecal occult blood test (ACS).
The symptoms can be effectively addressed by having the recommended screenings starting at age 50 and knowing the risk factors. The one major risk factor is age, most colorectal cancers are diagnosis after the age of 50. Other risk factors are history of polyps, inflammatory bowel disease, and family history of colorectal cancer, inherited gene defects, and racial & ethnic background. African Americans and Jews of Eastern European descent have the highest rate of colorectal cancer (ACS).
The prognosis is based upon when the diagnosis is made. Since the symptoms are vague, diagnosis is normally made in advance stages of the disease. This is why screening for this disease is so important and knowing the risk factors (ACS).
The recommended prevention of this disease is to maintain a healthy weight, be physically active, eat a healthy diet with fruits and vegetables, and limit the amount of alcoholic beverages. This along with knowing risk factors and screenings for the disease after age 50 helps with early diagnosis (ACS).

References

American Cancer Society. (2011) Colorectal Cancer Early Detection. Retrieved from http://www.cancer.org/Cancer/ColonandRectum


Note: This blog post reflects the work of Margaret Duffy-Chodl RN with minor editing by Shirley Comer RN and was completed as a class assignment. The content of this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.