Читать книгу Understanding Anatomy and Physiology in Nursing - John Knight - Страница 137

Atrial fibrillation (AF) is an arrhythmia that becomes increasingly common with advancing age. During AF the atria will be contracting rapidly and in an uncoordinated manner, which can result in poor ventricular filling. AF is often asymptomatic when at rest since 70 per cent of ventricular filling occurs passively; however, Gerald has been experiencing symptoms of breathlessness during exercise (when gardening and walking upstairs). It is during exercise that the full filling of the ventricles becomes increasingly important.

With AF the final 30 per cent of ventricular filling may not occur and as a result the cardiac output (CO) may fall, leading to the breathlessness Gerald is experiencing. AF can cause turbulent blood flow in the atria, increasing the risk of thrombosis. It is almost certainly a mobile clot (embolus) that has caused the stroke which Gerald has just suffered. Although Gerald has not recently been compliant in taking his medication, as a nurse it is vital to reinforce how essential apixiban is to managing his AF since it is this medication that will reduce the chances of clots forming and further strokes occurring.