An acute inferior wall MI patient presents with BP 90/60, HR 84, RR 22, clear lungs, SpO2 95%. Which intervention is appropriate?

An acute inferior wall MI patient presents with BP 90/60, HR 84, RR 22, clear lungs, SpO2 95%. Which intervention is appropriate?

• A. Fluid bolus
• B. Nitroglycerin
• C. Diuretic
• D. Oxygen therapy

Answer: (A)

Right ventricular involvement during an inferior-wall MI makes the patient preload-dependent. The goal is to increase venous return to the right ventricle to boost right and then left ventricular filling, which improves cardiac output and blood pressure. A rapid IV fluid bolus does just that, supporting preload and overall perfusion. Nitroglycerin and diuretics would decrease preload and can worsen hypotension in this scenario, so they’re not appropriate. Oxygen therapy is helpful if there’s hypoxemia, but with an SpO2 of 95% on room air it isn’t the priority here. Administering a fluid bolus with careful hemodynamic monitoring is the best intervention.

Right ventricular involvement during an inferior-wall MI makes the patient preload-dependent. The goal is to increase venous return to the right ventricle to boost right and then left ventricular filling, which improves cardiac output and blood pressure. A rapid IV fluid bolus does just that, supporting preload and overall perfusion.

Nitroglycerin and diuretics would decrease preload and can worsen hypotension in this scenario, so they’re not appropriate. Oxygen therapy is helpful if there’s hypoxemia, but with an SpO2 of 95% on room air it isn’t the priority here. Administering a fluid bolus with careful hemodynamic monitoring is the best intervention.