Fatigue and Palpitations in a 53-year-old Woman

Essential Immediate Steps 3

The patient comes to the emergency department (ED) 3 days later, despite having been asked to seek immediate medical evaluation. Now when evaluated in the ED, she has an irregular heart rate at 138 beats/min, BP 140/80 mm Hg, and respirations 12/min. She currently has palpitations, light-headedness, and fatigue, but she denies any new symptoms or changes to her medical history. ECG in the ED now confirms persistent atrial fibrillation.

Which of the following steps are essential to do immediately? (You may select more than one option.)