The assessment and physical examination of the adult - Essay Example

Patient-oriented, community-based care, with some definitions of primary health care not only including but also requiring the active participation of nurse practitioners and certified nurse midwives This paper includes the holistic approach in patient diagnosed with atrial fibrillation. The assessment and the physical examination play an important role in treating the patient properly. At the end of this paper we will be able to evaluate the importance of such action especially in adult in primary care.

Atrial fibrillation is a supraventricular cardiac rhythm disturbance characterized by uncoordinated, rapid atrial contractions of up to 350 or more impulses per minute. These rapid atrial contractions produce an irregular ventricular response rate that can vary from 130 to 150 or more beats per minute. This chaotic cardiac rhythm affects normal movement of blood through the heart, diminishes cardiac output, and increases the person's risk for thromboembolic stroke as a result of stasis of blood in the atria.

(Seifert, Collins, 2007). Atrial fibrillation was documented as early as 1906, when Cushney and Edmunds studied venous and arterial pulse tracings that demonstrated irregularities of the heartbeat. Using an electrocardiograph machine invented by Einthoven four years earlier, Cushney and Edmunds recorded the first electrocardiogram (ECG) of AF. . Using an electrocardiograph machine invented by Einthoven four years earlier, Cushney and Edmunds recorded the first electrocardiogram (ECG) of AF. The ECG remains the primary diagnostic test for AF.

(Fye, 2006). Clinical Assessment/Physical Examination In assessing the patient it is best to consider the patients medical history to evaluate the abnormality of the patient. In any sick adult, it is best to examine the relevant system followed by all other systems. Atrial fibrillation (AF) usually causes the ventricles to contract faster than normal. When this happens, the ventricles don't have enough time to fill completely with blood to pump to the lungs and body. Physical examinations may include background check of medical records and several questions about what the patient feels.

Patient may have atrial fibrillation if he has the following signs and symptoms:1. A rapid or irregular pulse and irregular heart sounds. 2. Shortness of breath, especially during activity. 3. Fatigue, weakness, and lightheadedness. 4. Sounds in the lungs that may indicate a backup of fluid in the lungs due to heart failure. 5. Swelling in legs, ankles, or feet or in the lower back. 6. Swollen neck veins or a noticeable change in how the blood moves through the blood vessels in the neck. If the above mentioned are indicating that the patient has atrial fibrillation further testing will be done.

Basic ObservationsAll patients should have basic observations taken. These include pulse rate, blood pressure, respiratory rate, temperature and (often) oxygen saturation. To demonstrate a critical understanding of the theories, implications and challenges involved in assessing clients