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NEW QUESTION: 1
To appropriately monitor therapy and client progress, the nurse should be aware that increased myocardial work and O2 demand will occur with which of the following?
A. Positive inotropic therapy
B. Afterload reduction therapy
C. Increase in balance of myocardial O2 supply and demand
D. Negative chronotropic therapy
Answer: A
Explanation:
(A)
Inotropic therapy will increase contractility, which will increase myocardial O2 demand.
(B)
Decreased heart rate to the point of bradycardia will increase coronary artery filling time. This should be used cautiously because tachycardia may be a compensatory mechanism to increase cardiac output. (C) The goal in the care of the MI client with angina is to maintain a balance between myocardial O2 supply and demand. (D) Decrease in systemic vascular resistance by drug therapy, such as IV nitroglycerin or nitroprusside, or intra-aortic balloon pump therapy, would decrease myocardial work and O2 demand.

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