• What information would you provide Annie with in relation to her symptoms?
• What treatment options may be available to Annie in order to alleviate her symptoms?

A proposed response to these questions might include:

It is important to ensure that a holistic nursing assessment is carried out in the first instance. Specific questions should also include:

• What are the symptoms that Annie is experiencing? e.g. dizziness, breathlessness, palpitations etc.
• When did the symptoms start?
• If the symptoms are not ongoing, how long did they last and how often do they occur?
• Did anything trigger the symptoms?
• Family and personal past medical history.
• Lifestyle considerations, e.g. smoking, alcohol, drug use.

Following a holistic nursing assessment any information provided should be evidence-based. There are lots of evidence-based support materials available, for example, the ones cited throughout this chapter, which are readily available online and in printed format. The BHF is an excellent source of information. Information produced on a local basis by the NHS Trust is more than likely to be available also.

It is also important that you advise Annie to discuss her symptoms with the practice nurse at her local GP surgery. Annie may also require to have her pulse checked and a 12 lead ECG carried out to determine if she is experiencing AF. If a patient is suspected of experiencing paroxysmal AF, which occurs intermittently, a 24 hour ambulatory ECG monitor or an event recorder ECG can be used to confirm diagnosis. An Echo and bloods will also be taken to determine potassium levels and to eliminate the presence of thyroid issues and anaemia. The majority of these investigations will be carried out at the GP surgery or may require attendance at an outpatient clinic within the hospital setting. Regional practice variations should however be taken into consideration.

It is important that Annie is made aware of the various treatment options, which include: medication, blood tests if taking specific medication, electrotherapy cardioversion and radio frequency ablation. However, you may also wish to ascertain if Annie would like to share this information with her family and friends in order that they can support her during any necessary treatment.