Nursing Application: Antianginals

The nurse is reviewing drug interactions with a male patient who has a prescription for isosorbide dinitrate as treatment for anginal pain. Which substances could result in a drug-drug interaction? Select all that apply.

*A glass of wine *Erectile dysfunction medication *Carvedilol

While obtaining subjective assessment data from a patient with rheumatoid arthritis and angina whose episodes of chest pain have decreased only marginally after three months of treatment with sublingual nitroglycerin, the nurse asks the patient if they are having any difficulty placing the small tablet beneath the tongue. What is the rationale for this question? Select all that apply.

*Assess for physical limitations that may affect medication use *Evaluate the patient's understanding of how and when to take the medication

While assessing a patient with angina with a new prescription for selective beta-1 blocker therapy, the nurse is aware that the presence of which conditions may place this person at risk for complications? Select all that apply.

*Asthma *Diabetes mellitus

A male patient admitted to the emergency department with intermittent chest pain provides a list of prescription medications to the nurse. Concurrent use of which medications has the most immediate implications for the patient's care? Select all that apply.

*sildenafil *captopril

The teaching plan for a client being started on long-acting nitroglycerin includes the drug's mechanism of action. The nurse teaches that this drug relieves chest pain by which action?

Dilating just the coronary arteries

Which assessment data collected by the nurse who is admitting a patient with chest pain suggests that the pain is caused by angina?

The pain is relieved after the patient takes nitroglycerin

While attending a community picnic on a hot day, and older adult with stable angina had an episode of chest pain and took a sublingual nitroglycerine tablet, which relieved the pain. Thirty minutes later, the individual experienced dizziness and hypotension and was brought to the first aid tent for care. After the patient is feeling better and their blood pressure has returned to normal, what information will the nurse provide to help the patient avoid a recurrence?

"Hot weather can increase the effects of your medication. Try to limit your time outside on days like this."

Which statement by the patient reflects the need for additional patient education about the calcium channel blocker diltiazem?

"I can take this drug to stop an attack of angina."

In preparation for discharge, the nurse teaches a patient with chronic stable angina how to use the prescribed short-acting and long-acting nitrates. Which patient statement indicates that the teaching has been effective?

"I will stop what I am doing and sit down before I put the nitroglycerin under my tongue."

A patient is prescribed metoprolol. Which statement by the patient requires the nurse to re-educate the patient on how to take the medication properly?

"If I stop taking this medication, I will let my physician know."

A patient with diabetes, hypertension, and stable angina is being discharged home. The patient will be taking a non-selective beta blocker and insulin per sliding scale. Which statement by the patient demonstrates they require additional education about the side effects of the beta blocker?

"While taking this medication, I will monitor for a fast heart rate because this is an early indication that my blood glucose level is low."

The initial nursing assessment of a patient diagnosed with angina should including questions about which underlying causes? Select all that apply.

*Diabetes mellitus *Tobacco use *High blood pressure

The nurse is preparing to administer a morning dose of atenolol to a patient with hypertension and angina. The nurse withholds the medication and notifies the prescribing health care provider based on which cues discovered during the focused assessment? Select all that apply.

*Swelling in bilateral lower extremities *Dyspnea *Crackles in lung fields

Control of angina is achieved when the 1.____________________ effects and 2._______________ of episodes decreases and the patient's 3.____________________ increased activity occurs.

1. severity 2. frequency 3. tolerance of

Which action is the first priority of care for a client exhibiting signs and symptoms of angina?

Enhancing myocardial oxygenation

A patient with angina has been given a prescription for a calcium channel blocker. The nurse knows that this class of drugs is used to treat which type of angina?

Vasospastic