The nurse is assessing a patient in the emergency room due to chest pain. To determine whether the patient's pain is due to a myocardial infarction, the nurse should note the pain

is unrelieved by nitroglycerin, but is relieved by morphine


• Pain from a myocardial infarction (MI) usually lasts longer than 30 minutes, radiates to the left arm and shoulder, and requires morphine for relief because myocardial tissue has died from hypoxia. The onset of chest pain from an MI can begin with activity or exertion, but does not improve with rest or use of nitroglycerin.

• Incorrect: Anginal pain is usually caused by activity or exertion and is relieved with rest or use of nitroglycerin as perfusion is improved with vasodilation.

• Incorrect: Gnawing or burning pain is usually related to a gastrointestinal (GI) disorder. MI chest pain is usually described as pressure, tightness, or squeezing.

• Incorrect: Nausea and vomiting may accompany a myocardial infarction, but can be present with many other disorders.

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