Final answer:
Immediate treatment for the patient should focus on improving oxygenation through methods like oxygen delivery via a non-rebreather mask or BVM with 100% oxygen, considering nitroglycerin after stabilization, and if breathing permits, using a nasal cannula. Positioning can help, but hypoxemia and hemodynamic stability are the priorities.
Step-by-step explanation:
The immediate treatment for the 61-year-old female patient who woke up with chest discomfort and shortness of breath should prioritize improving her oxygenation and stabilizing her vital signs. Given her SpO2 of 89%, which is below the normal range, her elevated heart rate of 128 bpm, and low blood pressure reading at 92/58, she is likely experiencing a form of respiratory distress that could be critical. Treatment options include:
Administering oxygen via a non-rebreather mask or ventilatory assistance using a BVM with 100% oxygen attached to increase her oxygen saturation.
Considering the administration of nitroglycerin only after addressing and stabilizing her oxygenation and ensuring it does not conflict with other underlying conditions.
Oxygen via a nasal cannula at 4-6 lpm can be considered as a less invasive method if her breathing is adequate and her oxygen levels can be improved via this method.
Placing her in a position that facilitates breathing, such as the left lateral recumbent position, may provide comfort and improve circulation; however, the priority should be addressing her hypoxemia and hemodynamic stability first.
Each of these options must be considered in context of the patient's specific clinical presentation and in accordance with local protocols and the guidance of medical control or a supervising physician.