Chat with us, powered by LiveChat A 59-year-old black female presents to the Emergen - Writedi

A 59-year-old black female presents to the Emergen

A 59-year-old black female presents to the Emergency Department with complaints of Chest Pain. She complains of a squeezing type pain across her chest and into her left jaw area and down her left arm. She is also complaining of epigastric pain. The pain has been occurring intermittently throughout the evening and night. She states, “she has never felt this type of pain before and is afraid she is going to die.” Vital signs are: • Blood Pressure-196/106 • Pulse-110 beats per minute • Respirations- 26 per minute • Temperature-99.8 • Oxygen Saturation-86% on room air • Pain level 9/10 During your initial assessment she is rubbing her mid-chest, grimacing and is diaphoretic. Her color is pale except around her lips which are bluish. Cardiac auscultation reveals a rapid regular rhythm. Lungs sounds reveal crackles in lower lobes. Per standing orders Nitroglycerine 0.4mg sublingually is administered. Cardiac monitoring is initiated. An electrocardiogram is obtained. An 18-gauge saline lock is placed in left arm. Patient is positioned in low Fowlers. After following the initial orders, she states her chest pain hasn’t changed. Heart and lung sounds are unchanged. Color is pale without previous blue changes. Question 1 After following the initial orders and initial assessment, what other priority cares and assessments would the nurse need to complete? What labs would be important to her care and diagnosis and why? Question 2 What is the significance of the crackles in the patient’s lungs? Is this right or left sided heart failure? What is causing this to occur? Question 3 What is the significance of administering Nitroglycerine and what is the correct way to administer it? What side effects will the nurse have to assess for and manage? What important information is needed if administering this medication to a male. Question 4 How can the concept of fluids and electrolytes tie into this case study and why? What nursing diagnosis can be used for both concept of perfusion and fluids & electrolytes?

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