You are caring for a 48-year-old patient with acute onset pulmonary edema secondary to an acute myocardial infarction. He has rales (crackles) in both lung fields and wheezes in the bronchial regions. His blood pressure is 160/90 mmHg, his pulse is 112, and his ventilations are 32. Which of the following medications is indicated FIRST, and why?
A) Nitroglycerin (Nitrostat) to vasodilate the coronary vessels to maximize myocardial oxygen supply
B) Furosemide (Lasix) to achieve a diuresis and remove a portion of fluids from the intravascular space
C) Nitroglycerin (Nitrostat) to reduce preload and afterload to redistribute fluids to the periphery
D) Morphine sulfate to decrease anxiety and reduce afterload

Question

Quizplus · Accepted Answer

Nitroglycerin (Nitrostat) is indicated first in this scenario to reduce preload and afterload, which helps in redistributing fluids away from the congested pulmonary circulation, thereby alleviating symptoms of pulmonary edema. This action not only helps in managing the symptoms of acute pulmonary edema but also benefits the heart by reducing the work it has to do, which is crucial following an acute myocardial infarction.

You Are Caring for a 48-Year-Old Patient with Acute Onset