A 71 year old female is admitted at midnight with a diagnosis of Chest Pain. You are the RN on the tele floor. She complains of a squeezing type pain across her chest and into her left jaw area. Vital signs are: Blood Pressure-200/***; Pulse-*** beats per minute; Respirations-*** per minute; Temperature-***; Saturation of Oxygen-**% on room air; pain level */10. During your initial assessment she is rubbing her mid-chest, grimacing and is diaphoretic. The pain has been occurring intermittently throughout the evening and night. Her color is pale except around her lips which are bluish. Cardiac auscultation reveals