Scenario:Chester is a 63 year old man of African descent who is an accountant.  He arrives to the em

Scenario:Chester is a 63 year old man of African descent who is an accountant.  He arrives to the emergency department for evaluation of chest pain that was a sudden onset while getting out of his vehicle. It was associated with dizziness and difficulty breathing. Chester tells you that he knows what it is as his father died of a heart attack when he was 59 years of age and now it’s my turn. His wife takes you aside and tells you that he had been treated for hypertension, high cholesterol levels, and diet controlled diabetes but that he has refused medication for the past year.  He eats what he wants and does not get much exercise during the school year.  According to his wife, Helen he is 23 kg overweight.  She also tells you the he quit smoking couple of months ago.  Upon your objective assessment you note the following:Heart rate = 104Respiratory rate = 22BP = 172/102SPO2 = 95% on room airNo visible pulsations, heaves, or lifts evident with the precordiumPain = 10/10No cyanosis is observed, and an apical impulse is palpable at the 5th intercostal spaceHis skin is cool and moist, and his clothes are damp from perspirationHe feels nauseated but had not vomitedShortness of breath noted with tachypneaDescribes the pain he experienced as intenseCurrently he is unable to find a position of comfort due to pain1.  When you auscultate his chest you note that S1 and S2 are present.  Describe the difference between the two sounds, and the best location to hear them. (2.5 marks each portion = 5 marks)2. When assessing pain in chest pain presentation for Chester, what are descriptor words of concern used for describing chest pain/discomfort? What would the differential diagnoses that you would be most concerned with? (4)3. What are some ethnic considerations to keep in mind in Chester’s case? (1)4. Chester is exhibiting shortness of breath with some crackles in the lower bases. What additional blood test would be ordered for Chester to differentiate between a non-cardiac cause and cardiac cause such as ventricular dysfunction?  (1) Health Science Science Nursing NURSING CNC110 Share QuestionEmailCopy link Comments (0)

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