M. D. is a 45-year-old male who arrived at the emergency room with his wife following symptoms of dizziness, dyspnea, and palpitations. “I thought I was having a heart attack!” The client has been experiencing episodic palpitations over the past two months both at rest and with activity, with no accompanying chest pain. “I just thought it was due to all the stress I am under at work.” He has also had an unintentional weight loss of 10 lbs. over the past two months and put that down to his irregular eating habits due to work, ever though “I am hungry all the time.” He did state that it “feels sometimes like food is getting stuck in my throat,” and planned to see his primary care provider about that in a few weeks. His wife had mentioned that he has “been on edge” with his moods, but she too thought it was due to the current stress at work. Vital Signs: BP 98/70 (supine), HR 130-170 bpm irregular, Respiration 20, Temp. 98.8 deg F. On assessment, skin is very warm, soft, moist, and intact with normal color and turgor. Hair is velvety, fine, and sparse on crown of head. No
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