Question

A female client receiving IV vasopressin (Pitressin) for esophageal varice rupture reports to the nurse that she feels substernal tightness and pressure across her chest. Which PRN protocol should the nurse initiate? A) Start an IV nitroglycerin infusion. B) Nasogastric lavage with cool saline. C) Increase the vasopressin infusion. D) Prepare for endotracheal intubation.

Answer 1

The nurse should initiate an IV nitroglycerin infusion as the symptoms suggest myocardial ischemia, and nitroglycerin helps to relieve chest pain by relaxing coronary vessel muscles and improving blood flow to the heart.

Step-by-step explanation:

If a female client receiving IV vasopressin for an esophageal varice rupture reports feeling substernal tightness and pressure across her chest, the nurse should initiate Start an IV nitroglycerin infusion. This is because the symptoms described could indicate myocardial ischemia, a serious condition where the heart muscle is not getting enough blood flow and oxygen. In such cases, nitroglycerin is crucial because it is a vasodilator that helps to relieve angina (chest pain) by relaxing the smooth muscle in the tunica media of coronary vessels, which enhances blood flow to the heart muscle. Adding nitroglycerin will not increase the workload on the heart as increasing the vasopressin might, and will address the immediate problem more effectively than nasogastric lavage or endotracheal intubation. So, the correct PRN ( 'as needed') protocol to initiate would be A) Start an IV nitroglycerin infusion.

Answer 2

The nurse should start an IV nitroglycerin infusion as the substernal tightness and pressure reported by a female client on IV vasopressin for esophageal varices rupture can indicate a side effect leading to myocardial ischaemia, which nitroglycerin, as a vasodilator, can help alleviate. Correct option is A.

Step-by-step explanation:

If a female client receiving IV vasopressin (Pitressin) for esophageal varice rupture reports feeling substernal tightness and pressure across her chest, the nurse should initiate the PRN protocol to Start an IV nitroglycerin infusion. Substernal chest pressure can be indicative of myocardial ischaemia or infarction as a side effect of vasopressin, which is a vasoconstrictor.

Nitroglycerin is a known vasodilator that can relieve chest pain associated with myocardial ischaemia. Hence, the correct answer to the given question would be option A) Start an IV nitroglycerin infusion.

Immediate treatments for myocardial infarction (MI) include the administration of oxygen, aspirin, and nitroglycerine sublingually, as well as longer-term treatments like thrombolytic agents, heparin, angioplasty, stents, and bypass surgery. In severe cases, a coronary replacement or cardiac assist device may be employed.