Problem:
The patient, Mrs. L.K., a 73-year-old female with a history of COPD, hypertrophic cardiomyopathy, chronic peripheral edema, diastolic heart failure, hyperlipidemia, and rheumatoid arthritis, presented to the Emergency Department (ED) with weakness. This reflection investigates the treatment provided by my preceptor, exploring my agreement or disagreement with the approach. Mrs. L.K. received a comprehensive assessment and treatment plan in the ED, including a liter of NS bolus, diltiazem IV drip, 750mg IV Levaquin, and various diagnostic tests. While the interventions addressed the immediate concerns, particularly the atrial fibrillation with rapid ventricular rate, my reflection will explore the nuances of the treatment and its alignment with evidence-based practices. The journal article titled "Management of Atrial Fibrillation in Patients 75 Years and Older" supports the initiation of diltiazem and metoprolol for rate control. This aligns with Mrs. L.K.'s treatment, and the article further underscores the importance of weighing risks and benefits, especially in elderly patients. The evidence-based guideline on "Acute Kidney