After receiving change-of-shift report about the following four patients, which patient should the nurse assess first?After receiving change-of-shift report about the following four patients, which patient should the nurse assess first?
a. 39-year-old with pericarditis who is complaining of sharp, stabbing chest pain
b. 56-year-old with variant angina who is to receive a dose of nifedipine (Procardia)
c. 65-year-old who had a myocardial infarction (MI) 4 days ago and is anxious about the planned discharge
d. 59-year-old with unstable angina who has just returned to the unit after having a percutaneous coronary intervention (PCI)
ANS: D
This patient is at risk for bleeding from the arterial access site for the PCI, so the nurse should assess the patient's blood pressure, pulse, and the access site immediately. The other patients should also be assessed as quickly as possible, but assessment of this patient has the highest priority.
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