What should be administered to a patient in severe CHF with an SBP > 160 mmHg?

In cases of severe congestive heart failure (CHF) where the patient's systolic blood pressure (SBP) is greater than 160 mmHg, the administration of push dose nitroglycerin is appropriate and effective. Nitroglycerin acts as a vasodilator, which helps to decrease the workload on the heart by reducing both preload and afterload. This can alleviate symptoms associated with CHF, such as shortness of breath, without causing further elevation in blood pressure, especially when the patient already presents with an SBP that is considered high.

By carefully managing the high blood pressure through the use of nitroglycerin, you can help alleviate the pulmonary congestion and improve overall cardiac output. The goal is to stabilize the patient’s condition while monitoring their response to the medication. Nitroglycerin is particularly suitable in this scenario because it can be administered in a controlled manner and allows for quick adjustments based on the patient's response.

The other treatments listed are not suitable for a patient in this specific situation. The administration of aspirin tends to be more beneficial in cases involving acute coronary syndromes rather than CHF management. Push dose epinephrine and norepinephrine are typically used to address hypotension or cardiogenic shock and would not be appropriate in a