Question

Which of the following patients has a contraindication for the administration of nitroglycerin?

A. A 48-year-old woman, who has not taken a previous dose of nitroglycerin, has a blood pressure of 110/60 mmHg, and has chest pain of a ten out of ten
B. A 59-year-old woman, who has taken two previous doses of nitroglycerin five minutes apart, has a blood pressure of 130/85 mmHg, and has chest pain of a seven out of ten
C. A 65-year-old man, who has nitroglycerin prescribed to his wife, has a blood pressure of 120/85 mmHg, and has chest pain of a seven out of ten
D. A 52-year-old man, who has taken one previous dose of nitroglycerin six minutes ago, has a blood pressure of 150/90 mmHg, and has chest pain of a seven out of ten

Answer 1

A 48-year-old woman with a blood pressure of 110/60 mmHg and severe chest pain should not be administered nitroglycerin due to the possibility of exacerbating hypotension.

Step-by-step explanation:

The patient with a contraindication for the administration of nitroglycerin is a 48-year-old woman with a blood pressure of 110/60 mmHg and chest pain of a ten out of ten (option A). Nitroglycerin is a vasodilator used to treat chest pain (angina) and heart conditions, but it can cause hypotension (abnormally low blood pressure). A systolic blood pressure lower than 90 mmHg or a diastolic blood pressure lower than 60 mmHg are general contraindications for the use of nitroglycerin due to the increased risk of causing or exacerbating hypotension. Therefore, it is important to check a patient's blood pressure before administering nitroglycerin. In this scenario, although the patient's blood pressure is not below the typical contraindication threshold, any previous use of nitroglycerin has not been documented, suggesting that her current state might be compromised further with its use, especially given the severity of her chest pain signaling a potential acute coronary event. Immediate medical attention is required.