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September 2008, Volume 38 Number 9 - Supplement: ED Insider , p 12 - 13


  • Elaine E. Steinke, ARNP, PHD
  • Karen S. Hayes, ARNP, BC, ACNP, PHD


Jeff Seaton, 54, arrives in your ED with irregular tachycardia that began about 90 minutes ago. He says he's had brief episodes of palpitations over the last couple weeks, but no sustained tachycardia until now. He feels weak, sweaty, anxious, and uncomfortable, but says he isn't nauseated. You take his vital signs: BP, 100/62 mm Hg; pulse, 152; respirations, 18; temperature, 100° F (37.8° C). In the last few weeks, he's lost 7 pounds (3.18 kg) and had increased appetite, heat intolerance, and muscle cramping, which he attributes to working in the yard.

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