All of the nurse's clients have chest pain and the following additional symptoms. Which of the following is the most concerning and should be the priority?
a. Pain on inspiration
b. Burning and tearing pain that moves down to the abdomen
c. Pain radiates to the left shoulder blade
d. Feels like an elephant is sitting on the chest
b. Burning and tearing pain that moves down to the abdomen
rationale: ALL of these clients are experiencing a potential emergency, but a burning tearing pain that radiates to the abdomen is concerning of an aortic dissection. This can cause fatal deterioration much faster than a myocardial infarction, so it is important to care for this client immediately. Pain on inspiration is indicative of a pulmonary embolism or a myocardial infarction, but neither of these are as emergent as an aortic dissection.
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