60. A nursing student asks an RN why clients who have had myocardial infarctions (MIs) should receive medications intravenously rather than intramuscularly. The best response by the RN would be:
60. A nursing student asks an RN why clients who have had myocardial infarctions (MIs) should receive medications intravenously rather than intramuscularly. The best response by the RN would be:
. "A larger dose of medication would be required to bring relief from chest pain."
. "The trauma from more frequent needle sticks would cause stress and increase the serum enzymes."
. "Tissue perfusion is poor and venous return is diminished following an MI, which affects results."
. "Intramuscular injections should be avoided if the client is also receiving an anticoagulant drug post-MI."
Test-Taking Tip
Look for the answer that refers to tissue perfusion after an MI. Remember: tissue perfusion is needed for drug absorption with the IM route.
Content Area: Adult Health, Cardiovascular; Integrated Process: Teaching and Learning; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Pharmacological and Parenteral Therapies/Medication Administration
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Answer 1 is incorrect because increasing the dosage to compensate for the poor perfusion would be unsafe. There would be an increased risk of side effects with a larger dose. Answer 2 is incorrect because these are enzymes that are cardiac specific and that do not increase from other causes of muscle trauma such as injections. Answer 3 is correct because drug effectiveness would be less predictable with the change in perfusion. Answer 4 is incorrect because anticoagulant therapy does not prevent the use of IM injections.