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November 2009, Volume 39 Number 11 , p 72 - 72


  • Susan Simmons Holcomb RN, ARNP-BC, PhD


COMPLAINING OF PALPITATIONS and weakness, Maggie Strunk, 67, is brought to the ED by a neighbor. She's profusely diaphoretic and says her chest hurts and she can't catch her breath. You escort her to a bed and take her vital signs: heart rate, 130 beats/minute and irregularly irregular; BP, 90/40 mm Hg; respirations, 24; and temperature, 105° F (40.6° C) orally. Her lungs are clear on auscultation, and she has no cardiac rub, gallop, or murmur. Her skin is hot and moist, with decreased skin turgor, and you notice a fine, resting tremor of her hands.

What's the situation?

Mrs. Strunk says her ...

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