November 2005, Volume 35 Number 11 , p 88 - 88
ZIEGLER, KIMBERLY RN, MS; QUILLEN, TERRILYNN FOX RN, BS
Assistant Professor of Nursing, Director of Traditional Program, Roberts Wesleyan College, Rochester, N.Y. (ZIEGLER) Faith Community Nurse, Greenwood, Ind. (QUILLEN)
YOU'RE CHARTING at the nurses' station when Raymond Duncan calls for help, saying his wife is having trouble breathing. You hurry to the room and find Alice Duncan, 67, sitting up in bed. Pale, anxious, very short of breath, and coughing, she's leaning over the bedside table with a pillow for support. Her skin is cool and moist. You glance at the cardiac monitor and note that her cardiac rate is 118 with ectopic beats; BP, 102/60; respirations, 32; temperature, 99.1° F (37.3° C); and Spo 2 , 84% on room air.
On chest auscultation, you note an apical rate of 120 and hear an S 3 gallop with a barely perceptible pansystolic murmur. You also hear scattered pulmonary crackles over both lungs. Mrs. Duncan also has distended neck veins.