Question

A 76 y/o female patient presents with a chief complaint of difficulty breathing and a history of IDDM, HTN, CVA, CHF, previous MI, and dementia. She has course crackles in the bases with expiratory wheezing. Her vitals are P 96 weak and regular, BP of 168/92, R 22 and labored. Her skin is diaphoretic and pale. You have administered a single nitroglycerin table. What is the subsequent dose of nitroglycerin?

Answer 1

The subsequent dose of nitroglycerin for a 76 y/o female patient should be based on her response and vitals after the first dose, with a typical protocol allowing for a dose every 5 minutes, up to three doses. Monitoring her response — particularly blood pressure and relief of symptoms — is essential before administering further doses.

Step-by-step explanation:

The subsequent dose of nitroglycerin for a 76 y/o female patient with a difficult breathing condition, IDDM, HTN, CVA, CHF, previous MI, and dementia depends on her response to the first dose and current vital signs. Nitroglycerin is typically used to manage chest pain (angina) by improving blood flow to the heart. After administering a single dose and assessing the patient's response — considering the BP of 168/92, R 22 and labored, presence of crackles and wheezing, and diaphoretic and pale skin — a healthcare provider should monitor for signs of symptomatic improvement or hypotension before considering additional doses.

Supplementary nitroglycerin can be administered every 5 minutes for a maximum of three doses, but caution is necessary, especially in elderly patients and those with low blood pressure or volume depletion. Continual monitoring of blood pressure, heart rate, respiratory rate, and relief of symptoms is crucial. If the patient's symptoms do not improve or her condition worsens, further medical intervention is required immediately.