Published
I agree with the others. At least 2L, maybe more depending...
As for the other stuff, if the patient was worked up for chest pain in the ER it should have been initiated there and already included in floor orders unless contraindicated. If the chest pain is a new developement for an admitted patient, then chest pain protocol should be followed, or whatever the policy is at your facility.
I always start O2 before I leave the room to call the MD. I do it in ICU and I did it on the floor.
I usually have the morphine in hand and the MI profile drawn or ready before the MD calls back. Usually we give the morphine. If the pt already has it as a prn I go ahead and give it. That was a floor habit, too.
Often we skip the B-blockers since our pts often are already hypotensive.
I do it with the caveat that any patient who is saturating well with a decent A-a will not really benefit from oxygen. Yet, the chart and QA/QI police think otherwise. Beta blockers as immediate interventions have fallen out of favour and I would be careful about administering any agent that will decrease preload suc has a nitrate until I have a XII lead and V4R assuming inferior wall involvement or hemodynamic concerns.
Blackheartednurse
1,216 Posts
I just have a questions that has been bothered me for a long time..Many nursing books talk about performing basic nursing interventions for a chest pain such as oxygen,beta-blocker,nitro (I guess I'm refering to the angina protocol here) I was wondering if some of the interventions are only specific to an ER such as a beta blocker,oxygen or asprin,I'm slightly confused I guess since when I used to work on a step-down unit when ever we used to get a chest pain patient they just gave nitro but I havent see the oxygen,beta-blocker or aspirin for that matter.I also read in the textbook that oxygen should be given as first line defense.