In which individuals should caution be taken when administering isosorbide dinitrate?

Caution should be taken when administering isosorbide dinitrate to all of the mentioned individuals due to the drug's vasodilatory effects, which can lead to significant drops in blood pressure.

In a dehydrated middle-aged adult, the risk of hypotension is elevated as dehydration can already compromise blood volume and blood pressure stability. Administering a vasodilator like isosorbide dinitrate may exacerbate these issues, leading to dizziness, fainting, or other complications related to low blood pressure.

For an older adult with chest pain, there may be multiple considerations. Older adults often have changes in their cardiovascular system that can impact how medications are metabolized and how their body responds to them. Additionally, they are often more vulnerable to adverse effects from medications due to coexisting conditions or polypharmacy, which makes it important to proceed with caution.

In the case of an individual with right ventricular involvement, particularly in scenarios such as acute coronary syndromes or pulmonary embolism, isosorbide dinitrate can lead to a decrease in preload. This decrease in preload can hinder the right ventricle's already compromised ability to pump effectively, potentially causing further hemodynamic instability.

Thus, due to the potential for adverse effects