A patient presents with chest pain, elevated jugular venous pressure, cyanosis, a right ventricular heave, and sinus tachycardia on electrocardiogram. He has been bedridden for the past week following surgery. Vital signs are as follows: blood pressure, 100/60 mm Hg; respiratory rate, 40 breaths/min; heart rate,115 beats/min; and oxygen saturation, 80% on room air. The patient remains persistently hypotensive. What should be done first?

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The Cardiac Medicine Certification (CMC) exam is designed for certified nurses currently practicing in areas such as CCU, combined ICU/CCU, medical ICU, telemetry, progressive care, heart failure clinics/home care, interventional cardiology, cardiac catheterization labs and/or electrophysiology units. Exam content: Since all eligible candidates must hold a clinical nursing specialty certification, the 90-item subspecialty exams concentrate solely on the Synergy Model component of Clinical Judgment. Although components such as patient teaching and collaboration are very important in providing... Show more

A patient presents with chest pain, elevated jugular venous pressure, cyanosis, a right ventricular heave, and sinus tachycardia on electrocardiogram. He has been bedridden for the past week following surgery. Vital signs are as follows: blood pressure, 100/60 mm Hg; respiratory rate, 40 breaths/min; heart rate,115 beats/min; and oxygen saturation, 80% on room air. The patient remains persistently hypotensive. What should be done first?