What should the nurse do first when a patient reports palpitations and chest pain while on telemetry monitoring?

The most appropriate immediate action when a patient reports palpitations and chest pain while on telemetry monitoring is to assess the patient's vital signs. This assessment will provide critical information regarding the patient’s hemodynamic status, including blood pressure, heart rate, and possibly signs of ischemia or distress. Vital signs can help determine the severity of the situation, guide further interventions, and prioritize subsequent actions.

Telemetry monitoring is in place to track the patient's heart rhythm continuously; however, vital signs are essential for a complete picture of the patient's condition. They can indicate whether the patient is stable or in a critical state, which is crucial for determining the urgency of interventions such as notifying a healthcare provider or administering medication.

While checking the telemetry monitor for alarms is also important, it should be done concurrently with patient assessment rather than as a primary action since the nurse's focus should be on the patient's immediate physiological status. Notifying the healthcare provider and administering medication are necessary steps that may follow after the assessment is complete and the situation is better understood. Therefore, assessing vital signs first allows for a comprehensive understanding of the patient's condition, making it the priority in this scenario.