A client presents to the emergency department reporting severe, crushing chest pain. The client's oxygen saturation is 88% on room air. The healthcare provider prescribes supplemental oxygen, chewable aspirin, sublingual nitroglycerin, and intravenous morphine. Arrange these interventions in the correct sequence of administration from first to last.
- 1Administer supplemental oxygen via nasal cannula.
- 2Administer chewable aspirin.
- 3Administer a sublingual nitroglycerin tablet.
- 4Administer intravenous morphine.
Answer
The correct sequence of interventions is to first administer oxygen, followed by aspirin, then nitroglycerin, and finally morphine.
In the management of an acute myocardial infarction, the priority is to maximize myocardial oxygenation and minimize workload. Since the client is hypoxic (SpO2 88%), providing supplemental oxygen is the immediate first step. Aspirin is administered next to inhibit platelet aggregation and prevent the thrombus from enlarging. Nitroglycerin follows to dilate coronary arteries and increase blood flow to the ischemic area. Finally, if the pain is not relieved by nitroglycerin, intravenous morphine is administered to provide pain relief and decrease preload and afterload.
Step-by-Step Solution
Key Concept
Prioritization of clinical interventions during an acute myocardial infarction to maximize myocardial oxygen supply and minimize cardiac workload.