Question: Scenario #2 Mrs. S Is A 72 Year Old Retired School Teacher. She Lives Alone With Her Dog Ginger And Is Very Independent. She Was Shoveling Snow On Monday Morning After The Big Storm. While Shoveling She Developed A Crushing Sensation In Her Chest. This Is Not The First Time She Has Had Chest Pain. Mrs. S Has A History Of Angina, Though She Has Never …

Scenario #2 Mrs. S is a 72 year old retired school teacher. She lives alone with her dog Ginger and is very independent. She was shoveling snow on Monday morning after the big storm. While shoveling she developed a crushing sensation in her chest. This is not the first time she has had chest pain. Mrs. S has a history of angina, though she has never had a heart attack. She takes an aspirin every day at home and keeps nitroglycerin tabs in her pocket “just in case”. Mrs. S took a nitroglycerin tab and an aspirin and drove herself to the hospital. Mrs. S was admitted to the hospital on Monday afternoon with chest pain, rule out myocardial infarction. She has been a patient on cardiology for 4 days now. She has had no chest pain since Monday and has been ruled out for a heart attack. She has a IV of 9NS at keep open and expects to go home in the morning. At 2200, Mrs. S put her call light on. Her nurse Sue, RN, answered the call light. Mrs. S stated that she was having chest pain and rated it a 9/10 on the pain scale. Sue, RN, had the PCA check her vitals and get an EKG. Sue, RN, went to get her a nitroglycerin tab. Mrs. S blood pressure was 90/52. Her EKG shows ST changes. Her HR was 120. Her breathing was labored at 36 and her pulse ox was 85% on room air. Sue gave Mrs. S a nitroglycerin tab sublingually. There was no relief to her chest pain and her blood pressure decreased to 80/52. Sue, RN, placed Mrs. S on oxygen at 2L and her pulse ox improved to 91%. Mrs. S is very anxious and states she feels terrible. Sue, RN, increased her IV fluids to 100cc/hr and called the physician.