Reference no: EM133287535

Question - Recall the client Jerry introduced earlier in the chapter. Jerry is now complaining of chest pain that radiates to his arms and unrelenting back pain. He has been to four different health care providers attempting to find an answer to his repeated bouts of chest and back pain. Despite an extensive diagnostic work-up by a cardiologist that reveals no cardiovascular abnormalities or problems, Jerry is convinced that he has angina. He believes it is only a matter of time before he has a major heart attack. Last week, his employer told him his leave of absence has lapsed and he will either have to return to work or lose his job. Rather than face having to work every day, Jerry quits his job and tells his wife that he is afraid to overwork his heart by going to work every day. He refuses to go with her to family gatherings or outings with their friends, stating he will get too tired and start having chest pain.

1. Today, Jerry comes into the emergency department stating, "I know I am having a heart attack. The pain is in my chest, then goes down my arms and back. What do I have to do to get someone to listen to me?"

2. What assessment data should the nurse gather related to the symptoms Jerry is experiencing?

3. Jerry tells the nurse there have recently been a lot of layoffs where he worked and that his department was in the process of reorganization before he quit because of his illness. What underlying feelings may be contributing to his anxiety and somatic symptoms?

4. What secondary gain does he receive from the physical symptoms?