Question

Patient History:

A 33 year old black male comes to the ER via Medics with a 1 hour history of left chest pain 7/10. The pain is unrelieved by Nitro. The patient has a history of hypertension but otherwise sates he is healthy (smokes ½ pack cigarettes per day) with no medical problems. Monitor shows NSR with 6 PVC’s per minute. He denies drug & alcohol use.

BP 200/110    HR. 118    RR. 26   O₂ Sat 98%   Temp: 100.4 F Pupils PERL @ 5 mm

What category would you give this patient & Why? (5 Tier Triage System)

Where would you place him after triage is completed & why? (waiting room, monitored bed, non-monitored bed)

What do you anticipate doing for him once she is in a bed/room? (tests, any nursing actions)

What do you think his medical problem is?

Answer 1

We will categorize patient in ESI LEVEL 1 because patient require immediate inervention as vital signs are exceeded, chest pain score is 7.

The patient will be placed in MONITORED BED for further evaluation and assessment, regular monitoring of BP and HR is must .

TEST AND NURSING INTERVENTION REQUIRED:

ECG, ECHO ,cardiac stress test, serum electrolytes, blood test for troponin and angiogram.

Regular vitals should be checked, IV fluids, cold spongingcan be given.

Analgesics, Beta blocker, ACE inhibitors, aspirin,antiplatelet can be provided as per physician order.

Advice to stop smoking.

MEDICAL PROBLEM:

From observation it is concluded that the patient may suffer from CORONARY HEART DISEASE, MYOCARDIAL INFARCTION.