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Case Study CA is a 57 year old female who presents in ER complaining of crushing chest pain radiating to her left jaw. CA is clutching her chest and grimacing as she arrives in the ER, she is pale, diaphoretic and her lips appear to have a bluish tint. On assessment cardiac auscultation reveals a rapid regular rhythm with a murmur, and lung sounds are clear in the upper lobes and crackles are heard in the lower lobes. Patient states her pain is 9/10, she is anxious, states she is scared of dying as she has never experienced pain like this before. Vital signs on initial assessment: Vital signs after treatment: B/P 118/108 B/P 178/98 HR 130 HR 107 RR 27 RR 22 Temp 99.9 Temp 98. 9 02 Sat 86% on room air 02 Sat 92% Patient is placed on cardiac monitor. MD orders 02 3L/min, EKG, Labwork, Nitroglycerin 0.4mg sublingually and Aspirin 81mg X 3 tablets by mouth chewed. 1. What type of pain is this patient experiencing? 2. Name other areas where chest pain often radiates? 3. How does chest pain presentation differ in men and women? 4. What labs should be drawn to determine if the pain is of cardiac origin? 5. If cardiac damage is present, what lab results would you expect to find? 6. Why was nitroglycerin ordered for this patient? 7. What side effects from nitroglycerin will the nurse assess and manage? 8. How many doses of nitroglycerin can be given, how often is it given? 9. What is rationale for aspirin order? 10. The patient has lung crackles, what does this indicate?
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