46

The nurse is caring for a male client with a history of hypertension and Prinzmetal's 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 <b>best</b> 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 is experiencing chest pain and self-administers nitroglycerine sublingually. When should the client expect to notice relief of the chest pain?

1-3 minutes

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.

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

Bronchospasm

Beta-blockers have what advantage over nitrates in the management of angina?

Clients do not develop tolerance to beta-blockers.

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

Headache and dizziness

The health care provider prescribes calcium channel blockers for a client who is diagnosed with angina pectoris. What is the action of calcium channel blockers?

Improve blood supply to the myocardium

Which would a nurse identify as a nitrate?

Isosorbide

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.

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

Nitrostat Nitrostat is administered for acute relief of angina. Nitro-Dur is used to prevent angina. Procardia and Norvasc are indicated for chronic angina.

The nurse is aware that the use of ranolazine is contraindicated in clients who have what condition?

QT-interval prolongation

Frequent episodes of exercise-related chest pain have caused a 79-year-old woman to use her prescribed nitroglycerin spray several times in recent weeks. This patient's age will have what effect on her use of nitroglycerin?

The woman will be more susceptible to hypotension than a younger patient.

A client reports substernal chest pain that radiates to the neck. The pain lasts 5 minutes and then subsides with relaxation. What is the most likely cause of the chest pain?

angina pectoris Classic angina pain related to angina pectoris is substernal chest pain that can radiate to the jaw. Chest pain that lasts longer than 5 minutes is not associated with angina but is associated with myocardial infarction. Hypertension is usually a condition in which the client is pain free. Intermittent claudication is not associated with chest pain.