SKINNY Reasoning

Part I: Recognizing RELEVANT Clinical Data

History of Present Problem:

JoAnn Smith is a 68-year-old woman who presents to the emergency department (ED) after having three days of

progressive weakness. She denies chest pain, but admits to shortness of breath (SOB) that increases with activity. She also

has epigastric pain with nausea that has been intermittent for 20-30 minutes over the last three days. She reports that her

epigastric pain has gotten worse and is now radiating into her neck. Her husband called 9-1-1 and she was transported to

the hospital by emergency medical services (EMS).

Personal/Social History:

JoAnn is a recently retired math teacher who continues to substitute teach part-time. She is physically active and lives

independently with her spouse in her own home. She has smoked 1 pack per day the past 40 years. JoAnn appears anxious

and immediately asks repeatedly for her husband upon arrival.

What data from the histories are RELEVANT and must be interpreted as clinically significant by the nurse?

(Reduction of Risk Potential)