Question

A nurse in an emergency department is caring for a client who had an anterior myocardial infarction. The client's history reveals she is 1 week postop following an open cholecystectomy. The nurse should recognize that which of the following interventions is contraindicated?

A. Administering nitroglycerin for chest pain
B. Providing pain medication for surgical incision
C. Administering a beta-blocker for blood pressure control
D. Encouraging early ambulation to prevent deep vein thrombosis

Answer 1

Nitroglycerin is contraindicated for the patient who had an anterior myocardial infarction and is postoperative following an open cholecystectomy, as it could critically lower blood pressure given the patient's recent surgery.

Step-by-step explanation:

The intervention that is contraindicated for a patient who had an anterior myocardial infarction and is 1 week postoperative following an open cholecystectomy is administering nitroglycerin for chest pain. This is because nitroglycerin is a potent vasodilator and could potentially lower blood pressure to a critical level, which is particularly risky considering the patient's recent surgery and current unstable condition. Administering nitroglycerin involves careful consideration of a patient's overall health status, including recent surgeries.

Nitroglycerin works by releasing nitric oxide, which relaxes the smooth muscle in the coronary vessel walls, leading to vasodilation. However, in the context of recent surgery, the risk of significant hypotension and its consequences may outweigh the benefits. Other treatments for myocardial infarction, such as administering aspirin to break up clots, may still be appropriate unless contraindicated by other factors such as bleeding risk or allergies.