A 48-year-old male is sitting upright in bed in respiratory distress. He describes an acute onset of difficulty breathing and chest pain during the night that has been worsening for the past 3 hours. He also complains of nausea. Pain is described as a substernal pressure radiating to his left shoulder. Physical examination reveals cool, diaphoretic skin and rales on auscultation bilaterally. Medical history includes two prior myocardial infarctions. Medications include Zestril and metoprolol. HR = 132, BP = 140/100, RR = 25, SaO₂ = 92%. Which of the following is NOT indicated?

Question

Quizplus · Accepted Answer

Adenosine is not indicated in this situation as it is used to treat supraventricular tachycardia, which is not the case for this patient. The patient's symptoms and medical history suggest an acute coronary syndrome, and treatment should focus on relieving pain and improving oxygenation to the myocardium. Enalapril, morphine, and nitroglycerin are appropriate choices for this patient given his history of myocardial infarctions and current symptoms.

A 48-Year-Old Male Is Sitting Upright in Bed in Respiratory