Research has shown that culture is a differentiating factor in

For each of the following cases, identify one or two likely conditions based on the data. Most importantly, include your rationales as to why you chose that disorder. Lastly, discuss any additional interventions needed to confirm the diagnosis. M.R. is a 56-year-old general contractor who is admitted to your telemetry unit directly from his internist’s office with a diagnosis of chest pain. On report, you are informed that he has an intermittent 2-month history of chest tightness with substernal burning that radiates through to the mid-back intermittently, in a stabbing fashion. Symptoms occur after a large meal; with heavy lifting at the construction site; and in the middle of the night when he awakens from sleep with coughing, shortness of breath, and a foul, bitter taste in his mouth. Recently, he has developed nausea, without emesis, that is worse in the morning or after skipping meals. He complains of “heartburn” three or four times a day. When this happens, he takes a couple of Rolaids or Tums. He keeps a bottle at home, at the office, and in his truck. Vital signs (VS) at his physician’s office were 130/80 lying, 120/72 standing, 100, 20, 98.6° F (37° C), SpO2 94% on room air. A 12-lead ECG showed normal sinus rhythm. Breathing is unlabored. M.R. has smoked one pack of cigarettes a day for the past 35 years, drinks two or three beers on most nights, and has noticed a 20-pound weight gain over the past 10 years. He feels “so tired and old now.” M.R. has dark circles und

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