A 48 year old man has presented with a 2 hour history of crushing chest pain, his BP is 140/90, pulse is 88, respirations are 18, and oxygen saturation is 99 %. He is calm and in no distress. Which of the following orders by the physician would be expected first.Morphine 10mg IV, oxygen 2 lit/min, Aspirin 162mg, Nitroglycerine 1/150 SLAspirin 162mg, 12 lead EKG, IV access, Nitroglycerine 1/150 slHeparin, Tenecteplase (TNKase), oxygen, aspirin12 lead EKG, cardiac enzymes, morphine 4mg IV, heparin drip 800u/hr.
Question
A 48 year old man has presented with a 2 hour history of crushing chest pain, his BP is 140/90, pulse is 88, respirations are 18, and oxygen saturation is 99 %. He is calm and in no distress. Which of the following orders by the physician would be expected first.Morphine 10mg IV, oxygen 2 lit/min, Aspirin 162mg, Nitroglycerine 1/150 SLAspirin 162mg, 12 lead EKG, IV access, Nitroglycerine 1/150 slHeparin, Tenecteplase (TNKase), oxygen, aspirin12 lead EKG, cardiac enzymes, morphine 4mg IV, heparin drip 800u/hr.
Solution
The first order by the physician would likely be "Aspirin 162mg, 12 lead EKG, IV access, Nitroglycerine 1/150 sl". This is because the patient's symptoms suggest a possible myocardial infarction (heart attack), and these interventions are aimed at reducing the workload of the heart, preventing further clot formation, and assessing the extent of the possible heart damage. Aspirin is an antiplatelet agent that helps prevent further clot formation. A 12 lead EKG can help identify if a heart attack is occurring. IV access is important for administering further medications and treatments. Nitroglycerine can help reduce the workload of the heart by dilating the blood vessels.
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