Primary Diagnosis: Atrial Fibrillation with Rapid ventricular Response

Status/Condition : Hemodynamically stable

Code Status: Full code

Allergies: NKA

Admit to Unit: Telemetry Unit

Activity Level: Ambulate with assistance if necessary, Bedrest with Bathroom privileges, Fall risk in place

Diet: 2 Gram Sodium Diet, Low fat

IV Fluids: Sodium Chloride 0.9 % solution 1000 ml – IV continuous, Order rate: 50 ml/h, Administer over 20 hours

· Critical Drips: None at this time will reevaluate after initial dose of Beta Bloker is given

Respiratory: Nasal Cannula 2L to maintain SPO2 above 93 %

· Medications : Metoprolol tartrate 2,5 mg IV bolus administer over 2 min once, for Atrial Fibribilation with Rapid ventricular response – re evaluate for possible initiation of Metoprolol Oral as initial treatment.

Nursing Orders : Vital Signs every 4 hours, Pulse Oximetry continuous, Weigh patient once upon admission, Educate for Cardiac Disease, Cardiac Arrythmias PRN, Intake and Output every shift, Assess IV site every shift, Cardiac monitoring in telemetry floor for 24 hours and re- assess, Consent for treatment as needed, notify provider if there is any change in cardiac rhythm, bleeding precautions.

Follow-Up Lab Tests: 12 lead EKG, THS, CBC. CMP, PT , PTT

· Diagnostic testing : TEE, ECHO Doppler

Consults: Cardiologist consult for New Onset of Atrial fibrillation with Rapid ventricular response

Patient Education and Health Promotion: Educate patient in regards Cardiac disease, diet , medication compliance and proper specialist follow up.

Discharge Planning and Required Follow-Up Care: Plan to discharge home with primary care and cardiologist follow up within one week.

References (minimum of three timely references that prove this plan follows current standards of care):