How should a nurse initially manage a patient in atrial fibrillation?

Managing a patient in atrial fibrillation often begins with strategies aimed at preventing thromboembolic events, such as stroke. Administering Heparin is crucial because it acts as an anticoagulant to prevent blood clots from forming in the atria, where stagnant blood can lead to clot development. Atrial fibrillation increases the risk for thrombus formation, particularly in the left atrial appendage, thus making immediate anticoagulation a priority in acute management.

While other interventions like cardioverting or administering beta-blockers are also relevant in the overall management of atrial fibrillation, they are generally used to manage heart rate or rhythm rather than to address the immediate risk of clot formation. Warfarin, while an important long-term anticoagulant for patients with recurrent atrial fibrillation, is not typically administered acutely as it takes time to achieve effective anticoagulation levels.

Therefore, starting with Heparin reflects best practice in acute situations, aiming to minimize the risk of complications while other management strategies are evaluated.