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(Solved): Nigel Small is a 52-year-old construction worker who was admitted to the ward with complaints of a s ...



Nigel Small is a 52-year-old construction worker who was admitted to the ward with complaints of a sudden onset of crushing chest pain, radiating from his jaw to neck and left arm. He rated the pain as 10/10 on the pain scale, lasting approximately 2 minutes. He also complained of shortness of breath, fatigue, nausea, palpitation and light-headedness. Nursing history reveals that Mr. Small complained of a syncopal event a few weeks ago, and since then, has been experiencing occasional abdominal discomfort that he associated with gas and hunger pain, due to work demand and poor eating habits. Mr. Small explained that he works as a construction worker during the day and has a part-time job as a night security officer. He has a history of hypertension and hyperlipidemia and admits that he is too busy to take his hypertension medication. He last visited his family doctor in 2022. He is the primary bread winner, and father of two teenagers, with responsibility for the care of his elderly parents, who reside with him. He does not smoke and drinks alcohol occasionally and admits that he has no time for exercise! Physical ExaminationHeight: 179.8 cm (59)Weight: 130 kgs (286.6 lbs.)Temperature: 36.5C (97.8 F)Pulse: 52 bpmBlood Pressure: 198/110 mmHgRespiration: 22 p/min, SaO2 94% on room air.Skin cool, clammy, capillary refill time greater than 3 seconds and nail bed pallor. Bilateral 3+ pitting lower extremity edema. SOB persists and chest pain is now 8/10 on pain scale and he is anxious, sitting upright in bed. Diagnostic Data:Chest X-ray: possible CardiomegalyTroponin 1: 1.78 ng/ml (elevated)CK-MB 13% (markedly elevated)Twelve-lead (12-Lead) electrocardiogram (ECG): ST-elevation in Lead II, Inferior Wall M.I. 1. Identify a risk factor and formulate a teaching care plan.2. Identify one priority need and develop a nursing care plan.



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