Pharm Ch 36 Prep U
When a client is prescribed nitroglycerin transdermal spray, what instructions should the nurse provide the client concerning how to administer the spray?
Administer the spray as soon as chest pain develops.
The nurse is providing education to a client who has been prescribed bisoprolol. During teaching, the nurse explains that the drug achieves a therapeutic effect in what way?
Decreasing heart rate
The nurse should instruct the client to take what action if nitroglycerin tablets taken sublingually are not effective in eliminating chest pain?
Go to the emergency department
The client is experiencing an acute onset of angina. The nurse would most likely administer which medication?
Nitrostat
After teaching a client who is using isosorbide dinitrate for treatment of angina, the client demonstrates understanding of the information when he identifies what needs to be avoided? (Select all that apply.)
Sildenafil Tadalafil Vardenafil
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.
Sublingual Transdermal Parenteral
A health care provider has ordered 40 mg of isosorbide dinitrate for a client who reports chest pain. The nurse administers the medication after confirming the absence of what condition?
anemia
The chest pain and pressure a client experiences during an anginal attack is caused by which of the following?
decreased oxygen supply to the heart.
A nurse has an order to apply nitroglycerin topically, twice a day. The nurse's initial action will be to do which?
don a pair of gloves.
A 54-year-old client has been prescribed sublingual nitroglycerin. After the nurse has finished teaching the client about the medication, what statement could the client make to suggest that the client understands proper self-administration?
"I can take up to three tablets at five-minute intervals."
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's angina pectoris is being successfully treated on an outpatient basis with sublingual nitroglycerin. What teaching point should the nurse convey to the client when reporting concern about the headache that follows the use of the medication?
"This is a common adverse effect of nitroglycerin; try taking acetaminophen to treat your headache."
A client is prescribed a transdermal nitroglycerin system. The nurse educates the client on which action?
Apply the new transdermal system at the same time daily.
Following the administration of a scheduled dose of 50-mg atenolol PO, the nurse should prioritize what assessment?
Blood pressure
Prior to the administration of nitroglycerin, the nurse would assess which of the following?
Blood pressure
The client is taking a calcium-channel blocker. What adverse effects might the client experience?
Headache and dizziness
The nurse is caring for a client with angina who is taking a calcium-channel blocker. What adverse effects would the nurse caution this client about?
Headache and dizziness
A 49-year-old client is admitted with uncontrolled chest pain. The client is currently taking nitroglycerin. The health care provider adds nifedipine to the client's regimen. The nurse should observe the client for what adverse effects?
Hypotension
A 62-year-old client is prescribed sublingual nitroglycerin by the health care provider for the treatment of stable angina. The client contacts the office and reports feeling light-headed after taking the medication for an acute episode of chest pain. Based on the nurse's knowledge of nitroglycerin, what is the pathophysiology behind the client having light-headedness?
Nitroglycerin causes relaxation of the arteries and veins, resulting in blood pooling in the extremities and the blood pressure dropping.
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.
A client has been diagnosed with angina and prescribed nitroglycerin. What aspect of the client's health history should prompt the nurse to monitor the client particularly closely after administration of the drug?
Orthostatic hypotension
A client, age 55 years, is started on calcium channel blockers for anginal attacks. The nurse would assess the client for which reaction? Select all that apply.
Peripheral edema Jugular vein distention Breathing difficulty
When teaching a client how to use a transdermal nitroglycerin patch, which instructions would be most important for the nurse to include? Select all that apply.
Remove the old patch before applying the new patch. Leave patch in place for 10 to 12 hours. Apply patch to a dry, hair free area.
