Question

Please answer these questions ,but please type. 1. What health history information would the nurse assess after the patients pain is gone? 2. What abnormals are present in the patient vitals signs in (first set ?

A 59 year old black female is admitted at midnight with a diagnosis of Chest Pain. She complains of a squeezing type pain across her chest and into her left jaw area. Vital signs are: Blood Pressure-200/110; Pulse-128 beats per minute; Respirations-26 per minute; Temperature-99.8; Saturation of Oxygen-86% on room air, pain level 9/10. During your initial assessment she is rubbing her mid-chest, grimacing and is diaphoretic. The pain has been occurring intermittently throughout the evening and night. Her color is pale except around her lips which are bluish. Cardiac auscultation reveals a rapid regular rhythm and a murmur, no pulse deficit. She has never had this pain before. Lungs sounds are crackles in both bases with clear upper lobes. She is afraid she is going to die. Per standing orders, a nurse administers & administers Nitroglycerine 0.4mg sublingually; applies cardiac electrodes for continuous cardiac monitoring; obtains an electrocardiogram; places a peripheral intravenous catheter with saline lock; positions patient in low Fowlers. On assessment vital signs are Blood Pressure-180/95; Pulse-108 beats per minute: Respirations- 22 per minute; Temperature-99.0; Saturation of Oxygen-90% on 2 liters per minute; Pain level 8/10. She says her chest pain hasn't changed. Heart and lung sounds are unchanged. Color is pale without previous blue changes.

Answer 1

1 Ans. After health history assessment chest pain diagnosed by angina pectoris.

Angina pectoris :- regarded in the chest pain due to ischemia in myocardium ( decrease blood supply to heart) , ischemia to heart cause anerobic respiration to some myocardial muscle leads to lactic acid cause chest pain.

2. First vitals signs assessment increase blood pressure 200/110 mmhg , temperature, respiration, oxygen saturation