A patient is admitted to the telemetry unit. Which nursing assessment has the highest priority for further investigation?
1. The patient complains of intermittent chest pain during mild exercise.
2. The patient has a history of urinary retention.
3. The patient complains of fatigue and dyspnea after walking up several flights of stairs.
4. The patient's father has a history of smoking.
1
Rationale 1: A history of intermittent chest pain during mild exercise signals the highest need for further investigation into the patient's cardiovascular status.
Rationale 2: The past history of urinary retention may be of concern if the patient will be receiving medications that could cause urinary retention or if surgery is planned, but should not be a high priority initially.
Rationale 3: This complaint may need further investigation, but it also may not be significant, depending on how many flights of stairs the patient climbs and whether chest pain or discomfort develops.
Rationale 4: The father's history of smoking is relevant based on secondhand smoke exposure but is not the priority assessment.
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