Pharm Chapter 23

Which instruction would be included in the discharge teaching for a patient with a transdermal nitroglycerin patch? "Make sure to rub a lotion or cream on the skin before putting on a new patch." "Apply the patch to a hairless, nonirritated area of the chest, upper arm, back or shoulder." "If you get chest pain, apply a second patch next to the first patch." "If you get a headache, remove the patch for 4 hours and then reapply."

"Apply the patch to a hairless, nonirritated area of the chest, upper arm, back or shoulder."

Which statement by the patient demonstrates a need for further education regarding nitroglycerin sublingual tablets? "I can take up to four tablets at 5-minute intervals for chest pain." "If I get a headache, I should keep taking my nitroglycerin and use Tylenol to relieve my headache." "I should change positions slowly to avoid getting dizzy from the drug's effect on my blood pressure." "I should keep my nitroglycerin in a cool, dry place."

"I can take up to four tablets at 5-minute intervals for chest pain."

The nurse is providing discharge teaching for a patient with a new prescription for nitroglycerin sublingual tablets. Which statement by the patient indicates an understanding of the nurse's discharge instructions about this medication? "I will need to refill my prescription when I feel burning under my tongue." "I will keep my nitroglycerin tablets in their original glass container." "My nitroglycerin tablets are not affected by cold or heat." "I can take some aspirin if I get a headache related to nitroglycerin."

"I will keep my nitroglycerin tablets in their original glass container."

The patient states to the nurse, "My friend said nitroglycerin relieves angina pain by reducing preload. What is preload?" Which statement by the nurse explains preload to this patient? "It is the blood return to the heart." "It is dilation of arteries and veins throughout the body." "It is the oxygen demand of the heart." "It is the pressure against which the heart must pump."

"It is the blood return to the heart."

The patient asks the nurse, "What is the best way to store sublingual nitroglycerin when I travel?" What is the appropriate response by the nurse? "It's best to keep it in its original container away from heat and light." "You can protect it from heat by placing the bottle in an ice chest." "Keep it in the glove compartment of your car to prevent exposure to heat." "You can put a few tablets in a resealable bag and carry it in your pocket."

"It's best to keep it in its original container away from heat and light."

A patient who is taking nitroglycerin sublingual tablets is complaining of flushing and headaches. What is the nurse's best response? "Stop taking the nitroglycerin because you are experiencing an allergic reaction to the medication." "Put a cold wet washcloth or use an icepack on your forehead and lie down in a quiet place." "Immediately notify your health care provider because these symptoms are not related to the sublingual nitroglycerin." "These are the most common adverse effects of nitroglycerin. They should subside with continued use of nitroglycerin."

"These are the most common adverse effects of nitroglycerin. They should subside with continued use of nitroglycerin."

To prevent the development of tolerance to nitroglycerin transdermal patch, the nurse instructs the patient to perform which action? Apply the nitroglycerin patch in the morning and remove it at night for 8 hours. Use the nitroglycerin patch for acute episodes of angina only. Apply a new nitroglycerin patch every other day. Switch to sublingual nitroglycerin when the systolic blood pressure is greater than 140 mm Hg.

Apply the nitroglycerin patch in the morning and remove it at night for 8 hours.

When applying nitroglycerin ointment, the nurse would perform which action? Use the fingers to spread the ointment evenly over a 3-inch area. Massage and then gently rub the ointment into the skin. Apply a thick layer of ointment on the nitroglycerin paper. Apply the ointment to a nonhairy part of the upper torso.

Apply the ointment to a nonhairy part of the upper torso.

When caring for a patient with angina pectoris, the nurse would question a prescription for a noncardioselective beta blocker in a patient with which pre-existing condition? Bronchial asthma Atrial fibrillation Myocardial infarction Hypertension

Bronchial asthma

A patient receiving IV nitroglycerin at 20 mcg/min and now complains of dizziness. Nursing assessment reveals a blood pressure of 85/40 mm Hg, heart rate of 110 beats/min, and respiratory rate of 16 breaths/min. What is the priority nursing action? Notify the health care provider. Assess the patient's lung sounds. Decrease the IV nitroglycerin by 10 mcg/min. Recheck the patient's vital signs in 1 hour.

Decrease the IV nitroglycerin by 10 mcg/min.

It is most important for the nurse to instruct a patient prescribed nitroglycerin to avoid which substance? Grapefruit juice Antacids Potassium-sparing diuretics Erectile dysfunction drugs

Erectile dysfunction drugs

The nurse understands that a patient receiving nitroglycerin would be monitored for which common adverse effects associated with this medication? (Select all that apply.) Blurred vision Flushing Dizziness Headache Hypotension

Flushing Dizziness Headache Hypotension

Calcium channel blockers reduce myocardial oxygen demand by decreasing afterload. How would the nurse explain afterload to the patient? It is the total volume of blood in the heart. It is the contractility of the heart muscle. It is the force against which the heart must pump. It is the pressure within the four chambers of the heart.

It is the force against which the heart must pump.

For a patient receiving IV nitroglycerin, what are the priority nursing interventions? (Select all that apply.) Monitor blood pressure. Assess for worsening chest pain. Measure intake and output. Measure intake and output. Check the heart rate.

Monitor blood pressure. Assess for worsening chest pain. Check the heart rate.

Before administering isosorbide mononitrate sustained-release tablet to a patient, what is the priority nursing intervention? Obtain a blood pressure reading. Advise the patient that Tylenol is used to treat headache. Emphasize that the patient should swallow the tablet whole. Remind the patient to take the tablet before meals.

Obtain a blood pressure reading.

The nurse is teaching treatment of acute chest pain for a patient prescribed nitroglycerin sublingual tablets. Which instructions would the nurse include? Chew or swallow the tablet for the quickest effect. Keep the tablets locked in a safe place until you need them. Sit or lie down before taking medication. Take five tablets every 3 minutes for chest pain.

Sit or lie down before taking medication.

Which method of administration of nitroglycerin has the longest duration of action? Intravenous (IV) infusion Immediate-release tablet Sublingual tablet Transdermal patch

Transdermal patch