Reference no: EM133607600

Question: This is your report from Triage Nurse Nancy: Generic L. Patient is an elderly gentleman just brought in to the ER via ambulance from the local nursing home. The pajamas he is wearing are very damp and he has sweat running down his face. He is complaiiy of heavy pressure in the middle of his chest. VS show pulse 130, respiratory rate 24, BP 155/86. After placing oxygen 2L by nasal cannula on the patient I called to have an EKG done STAT per protocols. Fill out your Focused Assessment, here is what you observed: • When you auscultate heart sounds you hear lub, dub plus a third sound just before lub which makes you wonder if the patient is having a myocardial infarction (MI). Bilateral radial pulses are very strong, pedal pulses could not be felt but are loudly heard using a Doppler • Edema is noted to bilateral lower legs and pressing with a finger leaves a 6mm deep dent which lasts more than a minute • The nailbeds on his thumbs blanch and refill within 5 seconds when released. The nailbeds on the great toes have a bluish cast to them and do not blanch with pressure • Overall he is very pale, almost grey with no skin lesions or open areas noted. Discussing the focused assessment. What will be in the note of the patient's chart describing what you think each of these findings mean.