Chapter 46: Agents for Treating Heart Failure
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 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 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."
Nitrate efficacy in lowering systolic blood pressure contraindicates when what contraindication exists? Select all that apply.
-severe anemia -phosphodiesterase enzyme type 5 inhibitor -cerebral hemorrhage
A client is to take diltiazem (Cardizem) 360 mg/d PO in four divided doses. How many mg will the client take per dose?
90 mg
Following the administration of a scheduled dose of 50-mg atenolol PO, the nurse should prioritize what assessment?
Blood pressure
A client with a long-standing diagnosis of asthma is prescribed a beta-blocker for the treatment of angina. The nurse should consequently prioritize assessment for what health problem?
Bronchospasm
An asthmatic client on a beta blocker should be observed for which adverse reaction?
Bronchospasm
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
When describing the possible adverse effects associated with nitroglycerin, what would the nurse include?
Dizziness
The nurse is teaching a client with angina who is prescribed sublingual tablets. The nurse would instruct the client to use a tablet at which frequency when experiencing an acute attack?
Every 5 minutes
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 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
For relief of acute angina and for prophylaxis before events that cause acute angina, what is the primary drug of choice?
Nitroglycerin
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 patient is using propranolol for treatment of angina. The nurse understands that this drug is administered by which route?
Oral
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 client with a history of angina has been prescribed IV atenolol. When monitoring this client's health status, the nurse should recognize that there is a need to titrate the client's dose of atenolol with the goal of achieving what outcome?
heart rate of 50 to 60 beats/min
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
What effect, if any, would extensive facial and oral trauma have on a client's sublingual nitroglycerin therapy prescribed to manage the angina?
route changed to transdermal
