A young adult patient comes to the emergency department with ...

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A young adult patient comes to the emergency department with severe chest pain and agitation. Which action should the nurse take first?
 
  a. Give naloxone (Narcan) IV.
  b. Ask about any use of stimulant drugs.
  c. Assess orientation to person, place, and time.
  d. Check blood pressure, pulse, and respirations.

Question 2

A patient who has inhaled cocaine is admitted to the emergency department with palpitations and shortness of breath. What should the nurse do first?
 
  a. Obtain a 12-lead echocardiogram (ECG).
  b. Start oxygen at 4 L/minute.
  c. Draw blood for drug screening.
  d. Infuse normal saline at 100 mL/hr.

[chem1s3]

Answer to Question 1

ANS: D
The patient has symptoms consistent with the use of cocaine or amphetamines and is at risk for fatal tachydysrhythmias or complications of hypertension such as stroke or myocardial infarction. The nurse also will ask about drug use and assess orientation, but these are not the priority actions. Naloxone may be given if the patient develops symptoms of central nervous system (CNS) depression, but this patient's current symptoms indicate stimulant use.

Answer to Question 2

ANS: B
The priority here is to ensure that oxygenation is adequate. The other orders also should be accomplished as soon as possible but are not the first priority.

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TYSM

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