SUBJECTIVE: The patient is a 85-year-old Hispanic male who himself to our office and is complaining of chest pain discomfort since last evening. He lives alone and is a widower. He has a past history of an episode of asystole and 6 years ago was resuscitated by the paramedics doing cpr. OBJECTIVE: Temperature 98.8F, respiratory rate 30, blood pressure 150/100. The heart rate is irregular with runs of atrial fibrillation. The patient is alert and oriented, but in some distress. ASSESSMENT: Atrial fibrillation and hypertension. PLAN: An ambulance was called, and the patient was sent to the Emergency Department. Family notified. QUESTIONS What is the definition of atrial fibrillation? Which vital sign reading led to a diagnosis of hypertension?

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Health Assessment