Chapter 46: Antianginal Agents

A nurse is giving discharge instructions to a client receiving nitroglycerin for angina. The nurse recognizes the client needs additional information when the client makes what statement?

"I will take a pill every 15 minutes until the pain subsides."

A 52-year-old client who experienced a myocardial infarction has an order for discharge. Part of the discharge teaching includes prior administration of nitroglycerin for chest pain. Which statement by the client indicates understanding of the teaching provided?

"I will take three nitroglycerin tablets 5 minutes apart, and if I do not have any relief I will seek emergency care immediately."

A client is diagnosed with erectile dysfunction. He asks what effect sildenafil (Viagra) has because he is taking nitroglycerin for chest pain. What is the best explanation for why nitrates are contraindicated with sildenafil?

"The combination can cause a severe decrease in blood pressure."

A client is diagnosed with angina pectoris. What would the nurse include when explaining this condition to the client?

"The heart muscle isn't getting enough oxygen."

The nurse is caring for a male client with a history of hypertension and Prinzmetal angina who is currently taking amlodipine 10 mg orally every day, and minoxidil 25 mg orally twice a day. The client stated that he is concerned about a recent enlargement of his breasts. What is the best therapeutic response to the client's concern?

"The increase in breast size is an adverse effect of minoxidil, and I will notify your primary care provider so other options may be explored."

A client prescribed nitroglycerin reports to the nurse that he is having headaches. How should the nurse best respond?

"You may experience headaches as an adverse reaction to nitroglycerin."

Anti-anginal drugs are used in the treatment of cardiac disease for what purposes? (Select all that apply.)

1. relieve the pain of acute anginal attacks 2. prevent angina attacks 3. treatment of chronic stable angina pectoris

What should the nurse tell the client about storage of oral nitroglycerin products? (Select all that apply.)

1. store oral nitroglycerin away from light exposure 2. Store oral nitroglycerin with the container lid tightly sealed. 3. Store oral nitroglycerin in the original container.

A nurse is preparing to administer a prescribed nitrate to a client with angina. The nurse understands that nitrates are available in which dosage forms? Select all that apply.

1. sublingual 2. transdermal 3. parenteral

A 62-year-old man is admitted to the hospital with a diagnosis of chest pain. He has an order for 0.3 mg of sublingual nitroglycerin prn for chest pain. Which action should the nurse do first when he reports chest pain?

Administer a tablet under the tongue and repeat the action in 5 and 10 minutes if the pain has not subsided.

The nurse is providing education to a client who has been prescribed nitroglycerin transdermal spray. What instruction should the nurse provide the client concerning how to administer the spray?

Administer the spray as soon as chest pain develops.

A client with asthma has been prescribed a beta-blocker for management of angina. For what adverse reaction should the nurse observe?

Bronchospasm

The 47-year-old client is experiencing chest pain and has taken three sublingual nitroglycerin tablets, but the pain remains. What should the client do next?

Call 911.

Ms. Quinn is admitted to the surgical intensive care unit after open heart surgery. The health care provider prescribes IV nitroglycerin, according to a hospital protocol for titration of the drug. Which factor would be most important when determining increases or decreases in the dose?

Current blood pressure

A client with angina is prescribed atenolol. Following absorption of the drug, the nurse should monitor the client for what desired effect?

Decreased heart rate

A client is diagnosed with atherosclerosis. What would the nurse say is the most likely cause of his angina?

Decreased oxygenation to the myocardium

Beta-adrenergic blocking agents decrease the oxygen demands of the heart by what mechanism?

Decreasing the heart rate, allowing for longer filling time and increased blood to the heart

The client is taking a calcium-channel blocker. What adverse effects might the client experience?

Headache and dizziness

A client with diabetes is prescribed propranolol. For what should the client be assessed?

Hypoglycemia

A patient receiving amlodipine for angina reports dizziness. Which intervention should the nurse implement to help alleviate the condition?

Instruct the patient to lie down.

A group of students are reviewing the various antianginal agents. The students demonstrate a need for additional review when they identify what as a beta blocker?

Isosorbide

A health care provider has prescribed sublingual nitroglycerin and the nitroglycerin patch for a client. When the nurse explains the medications to the client, what advantage of the patch might the nurse mention?

It has a longer duration of action than sublingual tablets.

A patient arrives at the community health care center reporting chest pain and is diagnosed with angina pectoris. Which drug is administered for treating angina?

Nicardipine

A client with a history of angina has sustained a mild head injury in a motor vehicle accident. When the client reports chest pain, what explanation should the nurse provide to support the decision not to treat the angina-related pain with nitroglycerin tablets?

Nitroglycerin will increase intracranial pressure.

The client is experiencing an acute onset of angina. The nurse would most likely administer which medication?

Nitrostat

A patient is being discharged after being treated with nitroglycerin for angina. Which instructions should the nurse include in the teaching plan for the patient?

Recap the container tightly after taking the capsules.

The nurse provides client education on how to use translingual nitroglycerin. The client has an angina attack. The client uses the drug. At which step during the client usage would the nurse intervene?

Shakes the canister gently before using.

An older adult client whose medical history includes angina experiences a sudden onset of chest pain. This client would most likely administer a dose of nitroglycerin by what route?

Transmucosal spray

The physician is considering prescribing a beta blocker for a patient who is experiencing angina. For which condition should the patient be assessed before the physician orders the medication? a. COPD b. Diabetes c. asthma d. all of the above

all of the above

Following the administration of a scheduled dose of 50-mg atenolol PO, the nurse should prioritize what assessment?

blood pressure

When caring for a patient with angina, the nurse instructs the patient to place the nitroglycerin tablet between the cheek and the gums. Which route of administration is the nurse referring to?

buccal

After teaching a group of students about angina, the instructor determines that the teaching was successful when the students describe stable angina as:

chest pain that is relieved by rest

The nurse is performing a history for a black client that is concerned about developing coronary artery disease since it "runs in the family." What risk factor, that is modifiable, does the nurse identify when taking the history?

obese 40% over total body weight

A patient is using propranolol for treatment of angina. The nurse understands that this drug is administered by which route?

oral