AFib Nurse Protocol
Support AFib patients — rate/symptom checks, anticoagulation adherence, and stroke/bleeding red flags.
Learning Objectives
- 1.Monitor AFib symptoms and rate control.
- 2.Reinforce anticoagulation adherence and recognize stroke/bleeding red flags.
- 3.Escalate AFib emergencies appropriately.
Purpose
In AFib, two things keep patients safe: controlling the rate/symptoms and preventing stroke with anticoagulation. The nurse reinforces both and catches emergencies.
What to ask / monitor
- •Palpitations, racing heart, fatigue, exercise tolerance.
- •Heart rate (home device) — very fast or very slow?
- •Taking the anticoagulant as prescribed? Any bleeding?
- •Lightheadedness, chest pain, shortness of breath?
- •Stroke warning signs awareness.
Stroke red flags (FAST)
- •Face droop, Arm weakness, Speech difficulty → Time to call 911. Any sudden one-sided weakness, numbness, vision or speech change.
Escalate — stroke
AFib raises stroke risk. Any FAST sign → call 911 immediately. Time is brain.
Other red flags
- •Rapid heart rate with chest pain, severe dyspnea, or near-fainting.
- •Major bleeding on anticoagulation, or head injury/fall.
- •Very slow heart rate with symptoms.
Escalate
Symptomatic rapid AFib, major bleeding, or head injury on anticoagulation → 911/ED and notify the provider.
Meds/labs that matter
- •Anticoagulant (warfarin → INR; DOAC → renal dosing) for stroke prevention.
- •Rate-control meds (beta-blocker, etc.).
- •Never advise stopping anticoagulation without the provider.
What to send the provider
- •Symptoms, heart rate, anticoagulation adherence/bleeding, associated chest pain/dyspnea, urgency read.
Patient education script
- •"Your blood thinner prevents strokes — take it every day and don’t stop without calling us."
- •"Learn the stroke signs: face droop, arm weakness, speech trouble — call 911 right away."
Spanish phrase
Your blood thinner prevents strokes — do not stop it without calling us.
Su anticoagulante previene derrames — no lo deje de tomar sin llamarnos.
soo an-tee-koh-ah-goo-LAN-teh preh-VYEH-neh deh-RRAH-mes — noh loh DEH-heh deh toh-MAR seen yah-MAR-nos
Mini case
An AFib patient’s spouse calls: the patient suddenly has a facial droop and slurred speech that started 20 minutes ago.
What now?
Show answer
FAST-positive stroke signs in an AFib patient — call 911 immediately ("time is brain"), note the time of onset, and notify the provider. Do not schedule a visit or wait.
Checklist
- Assessed symptoms, rate, and anticoagulation adherence.
- Taught and screened FAST stroke signs.
- Escalated symptomatic rapid AFib, bleeding, or stroke signs.
- Reinforced not stopping anticoagulation.