"candyn;6660937" hello cardiac nurses,
i am a new grad and i have questions about chest pain.
for patients that have recurring chest pain, when is the time that you call and report to doctor to get ekg and nitro order? do you call every single time when they say chest pain?
for example: a patient that came with chest pain and had a work up done to rule out mi. with patient's previous admission, he had chest pain too. another patient has constant chest pain after coded and bunch of cpr. what i was told is it is normal for patient to have chest pain after cpr and code before basically patient suffers from ischemia.
thank you for responses
" end quote
this is where those critical thinking skills come into play. each situation is different. every patient with a cardiac history when first admitted and c/o chest pain should have a 12 lead done and the md called for further orders. if the pain is recurring depending on the orders you would get a 12 lead, give nitro, start o2, give pain rx, and labs according to the orders. you would call each time until instructed otherwise be the md.
a patient that has coded and received cpr would have chest pain but also obviously has cardiac issues. as you get to know the patient you will try to get them to discern which pain is their cardiac pain. pain after cpr/non cardiac pain will increase with palpation, movement, deep breath, usually will not radiate, and can be reproduced.
for chest pain....... i always tell my patients that their heart is not a part of any democracy....they are guilty until proven innocent....it's safer for them that way.