In transporting a 76-year-old morbidly obese female with chest pain and dyspnea, which action should you ensure?

• A. place her personal items where she can see them.
• B. place her in full Fowler's position.
• C. increase the amount of aspirin that you administer.
• D. do not restrict her breathing.

Answer: (D)

The key idea is keeping the patient’s breathing unimpeded. In an elderly, morbidly obese patient with chest pain and dyspnea, respiratory reserve is limited and any restriction of chest wall movement or breathing effort can quickly worsen ventilation. Therefore, you should ensure nothing tight or constrictive is restricting her breathing, and position and support her in a way that maximizes ease of breathing while you assess and manage symptoms.

This means avoiding anything that compresses the chest or abdomen or restricts diaphragmatic excursion, and being ready to provide oxygen and monitor respiratory status as needed. The other options don’t directly address the immediate threat to ventilation: personal items being visible doesn’t impact breathing, full Fowler’s position isn’t necessary to the point of protecting her airway and may not be essential for her comfort or oxygenation, and increasing aspirin beyond standard dosing isn’t indicated without specific cues or protocols.