Nitrates and Nitrites (isosorbide dinitrate, nitroglycerin)

An individual taking three doses of isosorbide dinitrate asks the health professional why this medication is taken once every six hours, rather than in the morning, with lunch, and before going to bed like another medication they take. What is the best response by the health professional?

"A nitrate free period allows your cells to be responsive to the medication."

After the nurse has finished teaching a patient about the use of sublingual nitroglycerin, which patient statement indicates that the teaching has been effective?

"I will call an ambulance if I still have pain after taking 3 nitroglycerin 5 minutes apart."

Which statement provides subjective data that the recently prescribed isosorbide dinitrate is having the desired therapeutic effect on the individual speaking? Select all that apply.

*"Last night I realized I had not taken any sublingual nitroglycerin through the day, instead of the 2-3 times I'd been averaging." *"I was able to walk around the block twice last night with my partner. First time in years we've done that."

In which individuals should caution be used when administering isosorbide dinitrate? Select all that apply.

*An older adult experiencing chest pain for the first time *A middle-aged adult who is dehydrated *An individual having a heart attack involving the right ventricular muscle

Select the routes by which nitroglycerin may be administered.

*Intravenous *Sublingual tablet *Transdermal patch *Oral *Translingual spray *Ointment

By what route can isosorbide dinitrate be administered? select all that apply.

*Sublingual *Oral

Scheduling a 1._______________ nitrate free period allows plasma and tissue nitrate levels to 2.______________, allowing cells to recover to a responsive state when the next dose is administered. These nitrate free periods are used to offset 3._____________ that can develop with long-term continuous administration of nitrates.

1. daily 2. fall 3. tolerance

What precautions does the nurse take to protect themselves when preparing and administering nitroglycerin ointment?

Apply gloves

The nurse prepares discharge teaching for a client receiving isosorbide dinitrate for treatment of angina. What information to lower potential side effects of the medication will the nurse include?

Avoid alcohol consumption

A nurse is monitoring a patient with angina for therapeutic effects of a rapid-acting nitrate given for chest pain. Which assessment finding indicates that the medication has been effective?

Client stating that pain is 0 out of 10

When teaching an individual with angina to administer translingual nitroglycerin, which information regarding safety should be included?

Direct the spray carefully

In addition to angina, for what condition is isosorbide dinitrate indicated? Select all that apply

Heart failure

Use the drop down menus to fill in the missing information related to the pharmacokinetics of NITROGLYCERIN.

Onset: 2-3 Duration: 0.5-1 hr

Use the drop down menus to fill in the missing information related to the pharmacokinetics of ISOSORBIDE DINITRATE.

Onset: 30 Duration: 12

An individual with a history of angina takes sublingual nitroglycerine to relieve chest pain ranked 6/10. Five minutes later, the chest pain is 4/10. What action should be taken next?

The person should take another sublingual nitroglycerine tablet

The nurse cautions the client receiving isosorbide dinitrate for treatment of angina that long-term use can lead to the development of which condition?

Tolerance