Early one morning, 60-year-old Michael Graff began to feel severe anterior crushing chest pain that lasted for 35 minutes. He experienced dizziness, cold sweats, and nausea. Although he considered driving to the local emergency department, his family insisted on calling an ambulance for emergency transport to the hospital. Michael, a general contractor, is a 2-pack-per-day smoker and consumes alcohol (beer) two to three times per week. He has a family history of coronary artery disease, diabetes mellitus, and hyperlipidaemia. It has been at least 10 years since his last physical examination. Upon arrival at the emergency department, he presents with symptoms of anxiety, moderate chest pain, and cold extremities. Auscultation of the thorax revealed tachycardia and clear lung fields. Blood pressure was slightly above normal at 156/90 mmHg. He had no neck venous distention. His white blood cell count was 7,600/mm 3, hematocrit 43.8%, platelets 256,000/mm 3, creatine phosphokinase (CPK) 87 international units/L, and troponin-I <4.1>
1. Michael and his family ask you to explain what is occurring with his heart. How would you describe the pathophysiology of Michael’s condition to them?
2. Discuss the reason Michael is receiving nitroglycerin.
3. What adverse effects should the nurse monitor with patients receiving IV nitroglycerin?
4. How do nitroglycerin infusions differ from other IV infusions?