When nitrates are administered early to the acute MI client, the effect is:
A. Hypotension
B. Bradycardia
C. Reduced mortality
D. Reduced morbidity
Correct Answer: C. Reduced mortality
Research has shown that when nitrates are administered early to the acute MI client, the effect is reduced mortality, infarct size, infarct extension, and related complications.
Option A: Hypotension will result from nitrate administration, but it is not the reason for prescribing the drug. PDE inhibitors and nitrates both cause vasodilation, and concomitant use may cause severe hypotension. Poor right ventricular contractility causes the patients to be pre-load sensitive, and nitrates may cause severe hypotension.
Option B: Tachycardia rather than bradycardia is more likely to occur with nitrate administration. However, if the patient is on diuretic therapy or has low systolic blood pressure, blood pressure, and heart rate requires monitoring. Other medications may be used in conjunction with nitrates to treat reflexive mechanisms. Beta-blockers can be used with nitrates to prevent reflex tachycardia.
Option D: The morbidity is already present because the client has pain. Due to high prevalence and high rates of readmission compared to other chronic medical diseases, coronary heart disease in patients must receive treatment with significant interprofessional communication for not only symptomatic improvement but also mortality reduction.