You are on med surg. Your patient is a 58 year old man who i…
You are on med surg. Your patient is a 58 year old man who is one day post knee replacement. He has been non-compliant with knee exercises and movement stating “too much pain”. Height: 5’10” (178 cm) Weight: 210 lbs (95 kg) Medical History: Hypertension, Type 2 Diabetes Mellitus, Hyperlipidemia, Smoking (1 pack/day for 30 years), Family history of cardiovascular disease. Allegies: Cephalexin Medications: Metformin 500 mg BID, Lisinopril 20 mg daily, Atorvastatin 40 mg daily, Aspirin 82 mg daily, Lovenox 40mg daily, Nitro 0.4mg SL PRN for chest pain. The patient pushes the call bell and when you enter he states “my chest hurts”. He appears anxious, pale, and diaphoretic. Blood Pressure; 160/95 Heart Rate: 110 beats per minute, regular Respiratory Rate: 22 breaths per minute Oxygen Saturation: 94% on room air Temperature: 98.6°F (37°C) The RAT arrives and begins to treat the patient. The 12 lead ECG shows a pattern of a left ventricular MI. A cardiac alert is called. The first nitro decreases the patient’s chest pain from a 7/10 to a 6/10. Which assessment MUST you perform prior to giving the next dose of nitro?
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