The patient with palpitations and sharp chest pain that is worse with inspiration than expiration is brought to the emergency department (ED). Upon auscultation of heart sounds, the nurse notes a scratching noise, like leather rubbing together. Breath sounds are clear and equal bilaterally. Complete blood count is notable for leukocytosis; cardiac enzymes are within normal limits. The nurse prepares the patient for which treatment?

The patient is brought to the emergency department after sudden onset slurring of the words, confusion, and right-sided weakness that started 3 hours ago. Aspirin was given by emergency response. He has a history of diabetes mellitus, hypertension, and hyperlipidemia for which he is compliant with therapy. He smokes 2 packs of cigarettes per day. Upon assessment, the patient’s temperature is 37.4°C, heart rate is 118 bpm, and blood pressure is 204/118 mmHg.  A stat computed tomography (CT) scan shows an area of hyperechogenicity on the left side of the brain. The nurse prepares to provide which medication?  

The patient receiving a rapid infusion of Lactated Ringer’s solution for dehydration calls out to report difficulty breathing and a racing heart. Upon assessment, the nurse notes decreased level of consciousness and severe hypotension. Which assessment does the nurse make first?