Atrial Fibrillation Case Study

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Atrial Fibrillation
Symptoms of primary concern: Dizziness, weakness, syncope, shortness of breath, and chest pain.
Implications: Due to the possibility of weakness and syncope the physical therapist needs to proceed with caution when getting the patient up out of bed and during ambulation. The therapist must be aware of signs of stroke because there is an increased risk for developing clots in patients who have atrial fibrillation.

Neuropathy:
Symptoms of primary concern: Lack of sensation in feet and hands; impaired strength in hands.
Implications: The therapist should perform a thorough foot check and sensation testing on this patient because of the neuropathic symptoms. Patient education on proper foot wear and how to perform daily
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This condition may also affect balance so balance testing is indicated.

Diuretics (Atenolol and Lasix): Lasix and Atenolol can both cause dizziness, lightheadedness, fatigue, and nausea. Like most of the drugs she is taking it is possible to have side effects that could cause her to have a syncopic event and requires close monitoring especially the first time you get her out of bed.

Demadex: This drug can cause heart rate to increase, hearing loss, decreased potassium, weakness, muscle cramps, sudden numbness, problems with speech, problems with balance, loss of coordination, swelling in the legs, increased blood sugar, and wheezing. The patient already has some of these side effects and is at risk to develop some of the others do to pre-existing conditions and other medications. So it is important for the physical therapist to be vigilant and pay attention to any precipitating factors should any of these side effects begin, so that proper action can be taken and the correct cause identified. Should hearing be impaired, therapy sessions would be further complicated due to the difficulty the therapist would have with communicating with the patient who already has impaired vision. Tactile cues would become increasingly important in this