Chapter 8

Cues that confirm the need for inpatient medical treatment include severe chest pain, elevated blood pressure, tachycardia, tachypnea, low oxygen saturation, and shortness of breath.

Based on the cues and provider’s orders, it can be inferred that the patient is experiencing a myocardial infarction, or heart attack. The patient has a history of coronary artery disease, which is another sign that she may be having a heart attack. The admitting provider is likely going to treat the patient’s symptoms as if they were a myocardial infarction until it is ruled out because if not treated in a timely manner, severe heart damage may occur.

The patient is likely going to the cardiac unit because they are exhibiting signs/symptoms of myocardial infarction. The patient may end up in the cardiac catheterization lab eventually, but for the moment, the patient is reporting improvement in symptoms and is stable. If the patient were to become unstable at any point, it is likely that they would be transferred to the intensive care unit.

The emergency room nurse should include the reason for the patient seeking care, pertinent symptoms, and any interventions performed. In this case, the nurse would include that the patient presented for 7/10 chest pain with shortness of breath and interventions included a 12-lead ECG, blood work, supplemental oxygen administration, and administration of IV nitroglycerin. The nurse will want to report any pertinent details about those interventions such as what dosage of nitroglycerin is currently infusing, how much oxygen has been applied, and results of the lab tests. The nurse should end the report with any relevant provider orders that have not been addressed yet and let the nurse know what the next steps in the plan of care are.

The emergency room nurse should ensure that the cardiology nurse has been provided with an adequate report and is ready to receive the patient. The nurse should make sure that all of the patient’s belongings are transferred with the patient to their new room. If the patient wishes for family to be notified of the transfer, the nurse should initiate making those phone calls. Additionally, the nurse should assess the patient’s mobility status to determine the most appropriate method of physical transfer to the new unit.

The patient will report comfort during and after the physical transfer to the new unit and room. Additionally, the patient will report that all personal belongings are present in the new room and that their family members have been made aware of the transfer. Lastly, the nurse will ensure the patient is left in a safe position (e.g., bed low and locked, fall alarm on) before leaving the unit.