Question

A 56 y/o male patient presents with CHF and respiratory distress. You have placed the patient on CPAP. His vital signs are P 120, R 30, BP 190/108. Medical Command has authorized the use of nitroglycerin paste. What is the correct dosing range for this patient

Answer 1

The dosing for nitroglycerin paste must be tailored to the patient's condition, with a starting range of 0.5 to 2 inches of paste. The patient's blood pressure and heart rate should be closely monitored to avoid hypotension and evaluate the therapeutic response.

Step-by-step explanation:

The correct dosing range for nitroglycerin paste for a 56-year-old male patient with congestive heart failure (CHF) and respiratory distress would depend on the specific instructions given by Medical Command and the standard dosing guidelines. Usually, for acute CHF management, nitroglycerin paste might be started at 0.5 to 2 inches (measured on the dosing paper) and could be increased as tolerated, considering the patient's blood pressure and symptoms.

However, the patient's high blood pressure (BP 190/108) and tachycardia (P 120) indicate a significant cardiovascular stress, and nitroglycerin may help by reducing preload and afterload, thereby improving cardiac output and reducing pulmonary congestion. It is vital always to consider the patient's current medications, potential contraindications, and to closely monitor the patient's response to the nitroglycerin paste, adjusting the dose as necessary.