Don't Miss a Beat: Proper Assessment of Chest Pain
When assessing a patient who is complaining of left-sided chest pain, it can be a rather stressful and scary situation because as a nurse, one knows that minutes count and that it can be a life or death situation. The key elements when a patient presents in this manner is to remain calm and to stay focused. The first question one should ask is "Does this pain have other signs and symptoms?" such as shortness of breath, nausea, or diaphoresis? If the patient does, the nurse will want to alleviate the patient by applying 2 liters of oxygen via a nasal cannula. Next, the nurse should ask should relate specifically to the pain itself. "Does it radiate down the arm, back or up the neck?" "What does the pain feel like?" "Is it a crushing pain or burning pain?" "Does it come and go, or is it constant?" "Severe, immobilizing chest pain not relieved by rest, position change
is the hallmark sign of a Myocardial Infarction (heart attack)" (Lewis, Heitkemper 2005). This patient has a history of Gastroesophogealregurgitation Disease (GERD), and it is therefore important to simultaneously rule out indigestion. Inquire when his last meal was, and what it contained. Medications, therefore, become the next focal point. It is important to know; what cardiac medications the patient is currently taking, has the patient taken an antacid recently, does the patient have an Aspirin available to take at this time? If the patient has Aspirin available to take, it would be ideal to administer the medication. "Aspirin is a platelet, interrupting platelet aggregation at the site of plaque rupture. Patients who receive aspirin have a 15% higher mortality than those who do not" (Nursing 2006). Another medication to consider, if the patient has available to them would be Nitroglycerin; a nitrate that dilates veins making it easier for the blood to pump through. Also, if pain is significant, it would be ideal to administer a...
References: American Heart Association (2007). "Risk Factors and Coronary Heart Disease". Information
retrieved on May 5, 2007, from, http://www.americanheart.org/presenter.jhtml?identifier=4726
Lackey, S. (2006). Suppressing the Scourge of AMI. Information retrieved on May 5, 2007,
Lewis, Heitkemper, Dirksen (2005). Medical-surgical Nursing: Assessment and Management of
Clinical Problems, Pg 818 table 33-12, Pg 828 p10.
Pope, Barbara (2006). "What 's Causing Your Patient 's Chest Pain?" Information retrieved on,
May 7, 2007, from http://web.ebscohost.com/ehost/pdf?vid=11&hid=120&sid=e509b87b-094e-4ab2- 8a77-89f0f748d698%40sessionmgr106
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