What further nursing assessments need to be performed for Mr. Salazar? 2. What interventions do you anticipate being ordered by the provider? Upon further assessment, the patient has no jugular vein distention (JVD), and no edema. His heart sounds are normal S1 and S2 present and lungs are clear with scattered wheezes on auscultation. His vital signs were as follows: BP 140/90 mmHg SpO2 90% on Room Air HR 92 bpm and regular Ht 173 cm RR 32 bpm Wt 104 kg Temp 36.9°C His 12-lead EKG report reads: “Normal sinus rhythm (NSR) with frequent premature ventricular contractions (PVCs) and three- to four-beat runs of ventricular tachycardia (VT)”. ST-segment elevation in leads I, aVL, and V2 through V6 (3-4mm). ST-segment depression in leads III and aVF.” Cardiac enzymes were drawn, results are still pending. A chest x-ray was ordered as well. The provider orders the following: Aspirin 324 mg PO once, Nitroglycerin 0.4 mg SL q5min for up to 3 doses, Morphine 4 mg IVP PRN unrelieved chest pain, Oxygen to keep SpO2>92%. 1. What intervention should you, as the nurse, perform right away? Why?
Please answer each question to the best of your ability. Clear, concise answers with full sentences are expected. Please use APA 6th edition for all references
Mr. Salazar, a 57-year old male, presents to the Emergency Department (ED) with chest pain. He reports that the pain started about an hour after dinner, while he was working. He describes the pain as a “crushing pressure” located maternally and radiating down his left arm and to his back. He rates the pain a 4/10. On assessment, Mr. Salazar is diaphoretic and pale and complains of shortness of breath (SOB).
1. What further nursing assessments need to be performed for Mr. Salazar?
2. What interventions do you anticipate being ordered by the provider?
Upon further assessment, the patient has no jugular vein distention (JVD), and no edema. His heart sounds are normal S1 and S2 present and lungs are clear with scattered wheezes on auscultation. His vital signs were as follows:
BP 140/90 mmHg SpO2 90% on Room Air
HR 92 bpm and regular Ht 173 cm
RR 32 bpm Wt 104 kg
Temp 36.9°C
His 12-lead EKG report reads: “Normal sinus rhythm (NSR) with frequent premature ventricular contractions (PVCs) and three- to four-beat runs of ventricular tachycardia (VT)”. ST-segment elevation in leads I, aVL, and V2 through V6 (3-4mm). ST-segment depression in leads III and aVF.”
Cardiac enzymes were drawn, results are still pending. A chest x-ray was ordered as well.
The provider orders the following: Aspirin 324 mg PO once, Nitroglycerin 0.4 mg SL q5min for up to 3 doses, Morphine 4 mg IVP PRN unrelieved chest pain, Oxygen to keep SpO2>92%.
1. What intervention should you, as the nurse, perform right away? Why?
2. What medication should be the first one administered to this patient? Why? How often?
3- What is the significance of the ST-segment changes on Mr. Salazar's 12-lead EKG?
Mr. Salazar’s chest pain was unrelieved after three (3) doses of sublingual nitroglycerin (NTG). Morphine 5 mg intravenous push (IVP) was administered, as well as 324 mg chewable baby aspirin. His pain was still unrelieved at this point
Mr. Salazar’s cardiac enzyme results were as follows:
CK 254 U/L
CK-MB 10%
Troponin I 3.5 ng/mL
1- Based on the results of Mr. Salazar's labs and his response to medications, what is the next intervention you anticipate? Wh
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