Question

A client with history of atrial fibrillation is admitted to the telemetry unit with sudden onset of shortness of breath. The nurse observes a new irregular heart rhythm and should perform which assessment at this time?

Check for a pulse deficit.
Palpate the apical impulse.
Inspect jugular vein pulse.
Examine for a carotid bruit.

Answer 1

In a case of atrial fibrillation with new onset shortness of breath, the nurse should check for a pulse deficit to assess the efficiency of cardiac output.

Step-by-step explanation:

When a client with a history of atrial fibrillation is admitted to the telemetry unit with sudden onset of shortness of breath and a new irregular heart rhythm, the nurse should check for a pulse deficit. A pulse deficit occurs when there is a difference between the apical pulse rate, as measured directly over the heart, and the peripheral pulse rate, typically measured at the radial artery. By comparing these two rates, healthcare professionals can assess the efficiency of cardiac output and determine if all heartbeats are resulting in effective blood flow or if some contractions are too weak to be detected peripherally, which is often the case in atrial fibrillation.