This report provides a detailed analysis of nursing interventions for Mrs. Fitzgerald, an 84-year-old patient admitted to the emergency department with chest pain. The interventions are prioritized and justified with rationales, considering pathophysiology, pharmacology, and evidence-based practice. Key interventions include performing an ECG to detect myocardial infarction, measuring vital signs to assess the patient's condition, administering oxygen to address hypoxia, performing intravenous cannulation for medication delivery, managing pain with morphine, sending blood for troponin and creatinine kinase tests to assess cardiac damage, constant cardiac monitoring with a defibrillator to prevent cardiac arrest, maintaining a semi-Fowler's position for improved breathing, and administering GTN (IV) if pain persists. Each intervention is thoroughly explained with supporting evidence from relevant literature, emphasizing the importance of timely and effective nursing care in emergency situations. The report highlights the critical role of nursing-focused decision-making in managing patients with acute coronary syndrome.