Heart Failure & Valvular Diseases Q 2 - Gyan Darpan : Learning Portal
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Thursday, 28 April 2022

Heart Failure & Valvular Diseases Q 2

What is the first intervention for a client experiencing MI?
     A. Administer morphine
     B. Administer oxygen
     C. Administer sublingual nitroglycerin
     D. Obtain an ECG

Correct Answer: B. Administer oxygen

Administering supplemental oxygen to the client is the first priority of care. The myocardium is deprived of oxygen during an infarction, so additional oxygen is administered to assist in oxygenation and prevent further damage. Supplemental oxygen is indicated in patients with hypoxemia (SaO2 <90% or PaO2 <60mm Hg).

Option A: The chest pain due to myocardial infarction is associated with sympathetic arousal, which causes vasoconstriction and increased workload for the ischemic heart. Intravenous opioids (e.g., morphine) are the analgesics most commonly used for pain relief (Class IIa).
Option C: Nitro is also used to treat MI, but they’re more commonly administered after the oxygen. Intravenous nitrates are more effective than sublingual nitrates with regard to symptom relief and regression of ST depression (NSTEMI). The dose is titrated upward until symptoms are relieved, blood pressure is normalized in hypertensive patients, or side effects such as a headache and hypotension are noted.
Option D: An ECG is the most common diagnostic tool used to evaluate MI. The resting 12 lead ECG is the first-line diagnostic tool for the diagnosis of acute coronary syndrome (ACS). It should be obtained within 10 minutes of the patient’s arrival in the emergency department. Acute MI is often associated with dynamic changes in the ECG waveform.

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