A patient with a possible acute coronary syndrome has ongoing chest discomfort unresponsive to 3 sublingual nitroglycerine tablets. There are no contraindications and 4 mg of morphine sulfate was administered. Shortly, BP falls to 88/60 and the patient complains of increased chest discomfort. You would:
Give normal saline 250 mL to 500 mL fluid bolus
Give nitroglycerin 0.4 mg sublingually
Give an additional 2 mg of morphine sulfate
Start dopamine at 2 ụg/kg per minute and titrate to BP 100 systolic.