The severity of the patient’s symptoms, the practice setting of the nurse, and the purpose of the assessment are factors that need to be considered when determining the frequency and extent of nursing assessment required. The assessment of the acutely ill cardiac patient will be different from that of a patient with stable or chronic cardiac conditions. For example, the assessment per formed by an emergency department nurse caring for a patient who is experiencing an acute myocardial infarction (MI) must be very focused and must be performed rapidly. The nurse must as-sess the patient for complications associated with the MI, screen the patient for contraindications to coronary artery reperfusion strategies including thrombolytic therapy or primary percuta-neous transluminal coronary angioplasty (PTCA), and evaluate the patient’s response to medical and nursing interventions. For this patient, the health history, physical assessment, and important nursing interventions (eg, cardiac monitoring, administration of intravenous medications) are performed simultaneously.
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