Question

you are working as a nirse in tha ED when a 42 years old female comes in complaining of chest diacomfort

71 year of С.К who isan inability to lie dowthcommunity. of accesona Acute Cardiac Unfolding Case Study Concept: Perfusion You are working as a nurse in the ED when a 42 year old female comes in complaining of chest discomfort. Although she states that she has been experiencing this discomfort on & off" for a couple of weeks, today it is much worse. She says that today she has also been anxious, fatigued and nauseated. Other than that she is vague about her symptoms and hesitant to get into a hospital gown. When you question her about her pain, she is very timid and appears afraid to answer your questions. When she finally agrees to change into a gown, you notice that she has bruises, in various stages of healing across her anterior chest wall. You ask her how she got the bruises...she states she is clumsy and always running into the shelf in her pantry". Her husband is in the room, appears frustrated and tells you that he thinks that she is just complaining of pain to get attention. What do you think could be the cause of her chest discomfort? As the nurse, what are your priorities with this patient? What do you want to make sure happens and is documented? Explain what diagnostic testing you think the MD will order, as well as the

Answer 1

Q. No. 1. Answer :

I can think cause for her chest discomfort is bruises, in various stages healing across her anterior chest wall.

This bruises may caused by either blunt trauma or injury ect.

And also she is having on and off pain since a couple of weeks, so we need to confirm whether she is using any Aspirin or blood thinner medications, these are also caused for bruising, so it may leads to chest discomfort.

Or collect history for any infections and any other heart related problems.

Q. No. 2. Answer :

Nursing priorities :

* provide comfortable position like semifowlers with the support of pillows.

* check the vital signs to know the altered values.

* check the oxygen saturation levels, if it is below 90 % administer the oxygen 2 lit per minute with nasal prongs.

* take ECG, to find abnormalities.

* administer diuretics if any fluid overload.

* administer analgesics to reduce pain.

* administer anxiolytics,.

* provide adequate rest.

* prepare patient for 2 d echo.

What ever the readings has been find through all interventions should be recorded and reported.

Q. No. 3. Answer :

Diagnostic testings :

* Electrocardiogram

* chest X Ray

* 2 d echo

* cholesterol levels

* blood investigations ect.