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Terms in this set (22)Which instruction should be included in the discharge teaching for a patient with a transdermal nitroglycerin (Nitro-Dur) patch? "Apply the patch to a hairless, nonirritated area of the chest, upper arm, back or shoulder." 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." Preload is determined by the amount of blood in the ventricle just before contraction. Which statement by the patient demonstrates a need for further education regarding nitroglycerin (Nitrostat) sublingual tablets? "I can take up to four tablets at 5-minute intervals for chest pain." Patients are taught to take up to three sublingual tablets 5 minutes apart. According to current guidelines, if the chest pain or discomfort is not relieved in 5 minutes, after one dose, the patient (or family member) must call 911 immediately. The patient can take one more tablet while awaiting emergency care and a third tablet 5 minutes later, but no more than three tablets total. Patients should always sit or lie down before taking this medication. Calcium channel blockers reduce myocardial oxygen demand by decreasing afterload. How would the nurse explain afterload to the patient? It is the force against which the heart must pump. Afterload is the force (systemic vascular resistance) against which the heart must exert itself when delivering blood to the body. Which dosage form of nitroglycerin has the longest duration of action? Transdermal patch The transdermal patch has an 8- to 12-hour duration of action compared with 3 minutes to 6 hours for the other dosage forms of nitroglycerin. To prevent the development of tolerance to nitroglycerin (Nitro-Bid) 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. Before administering isosorbide mononitrate (Imdur) sustained-release tablet to a patient, what is the priority nursing intervention? Obtain a blood pressure reading. Mononitrate is a vasodilator and thus can cause hypotension. It is important to assess blood pressure before administering. The patient asks the nurse, "How should sublingual nitroglycerin be stored when I travel?" What is the nurse's best response? "It's best to keep it in its original container away from heat and light." Although sublingual nitroglycerin needs to be kept in a cool, dry place, it should not be placed in an ice chest, where it could freeze. It should not be kept in the glove compartment of a car and needs to be kept away from heat, not in a clear plastic bag. The nurse is teaching treatment of acute chest pain for a patient prescribed nitroglycerin (Nitrostat) sublingual tablets. Which instructions should the nurse include? Sit or lie down before taking medication. Nitroglycerin is a vasodilator and can cause orthostatic hypotension, resulting in dizziness. It should be kept in a readily accessible location for immediate use should chest pain occur. Three tablets may be taken 5 minutes apart. It should be placed under the tongue and allowed to dissolve. The nurse is providing discharge teaching for a patient with a new prescription for nitroglycerin (Nitrostat) sublingual tablets. Which statement by the patient indicates an understanding of the nurse's discharge instructions about this medication? "I will keep my nitroglycerin tablets in their original glass container." The sublingual dosage form of nitroglycerin needs to be kept in its original amber-colored glass container with metal lid to avoid loss of potency from exposure to heat, light, moisture, and cotton filler. It should be replaced every 3 to 6 months in order to maintain potency. Potency of the sublingual nitroglycerin is noted if there is burning or stinging when the medication is placed under the tongue; if the medication does not burn, then the drug has lost its potency, and a new prescription must be obtained. Headaches associated with nitrates last approximately 20 minutes (with sublingual forms) and may be managed with acetaminophen. A patient who is taking nitroglycerin (Nitrostat) sublingual tablets is complaining of flushing and headaches. What is the nurse's best response? "These are the most common adverse effects of nitroglycerin. They should subside with continued use of nitroglycerin." Headache, flushing of the face, dizziness, and fainting are the most common adverse effects of nitroglycerin and the headache generally subsides after the start of therapy. When applying nitroglycerin (Nitro-Bid) ointment, the nurse should perform which action? Apply the ointment to a nonhairy part of the upper torso. A patient receiving IV nitroglycerin at 20 mcg/min 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 nurse's best action? Decrease the IV nitroglycerin by 10 mcg/min. Nitroglycerin, as a vasodilator, causes a decrease in blood pressure. Because it is short-acting, decreasing the infusion rate will allow the blood pressure to rise. The patient should be monitored every 10 minutes while changing the rate of the IV nitroglycerin infusion. It is MOST important for the nurse to instruct a patient prescribed nitroglycerin to avoid which substance? Erectile dysfunction drugs Concurrent administration of nitrate drugs and erectile dysfunction drugs such as sildenafil citrate (Viagra), tadalafil (Cialis), and vardenafil (Levitra) can cause an additive hypotensive effect. When caring for a patient with angina pectoris, the nurse would question a prescription for a noncardioselective beta blocker in a patient with which preexisting condition? Bronchial asthma Noncardioselective beta blockers should be used with caution in patients with bronchial asthma, because any level of blockade of beta2-receptors can promote bronchoconstriction. The nurse understands that a patient receiving nitroglycerin should be monitored for which common adverse effects associated with this medication? Flushing, dizziness, hypotension & headache For a patient receiving IV nitroglycerin (Tridil), what are the priority nursing interventions? Check heart rate, monitor blood pressure, & assess for worsening chest pain IV nitroglycerin can cause sudden and severe hypotension, worsening of chest pain, and significant changes in heart rate (less than 60 beats/min or greater than 100 beats/min). Angina pectoris chest pain that occurs when the heart's supply of blood carrying oxygen is insufficient to meet the demands of the heart Atherosclerosis a common form of arteriosclerosis involving deposits of fatty, cholesterol-containing material (plaques) within arterial walls Coronary arteries arteries that deliver oxygen to the heart muscle Ischemia damaged cells/tissue as the result of inadequate oxygen supply Myocardial infarction necrosis of the myocardium following interruption of blood supply; it is almost always caused by atherosclerosis of the coronary arteries & is commonly called a heart attack Sets with similar termsPHARM- EVOLVE CH 2317 terms moriah_montano NCLEX REVIEW Q&A Ch 42 Pharmacology16 terms Tee_Bee1991 Pharm Ch. 23 - Antianginal Drugs17 terms Yogesh_Sethi Pharm Ch. 23 - Antianginal Drugs17 terms HaleyJill Sets found in the same folderDiabetic Drugs61 terms delvonica_price 3101 Ex 3 Ch 25 Practice Quiz39 terms ATK1120 Pharm Exam II - Respiratory Questions16 terms lyra_flores Chapter 24 Heart Failure Drugs, Lilley, (Evolve)11 terms michelle_m_dutton Other sets by this creatorDiabetes12 terms Doogin21 Ch. 617 terms Doogin21 Maternity final exam78 terms Doogin21 CH. 61 urinary function16 terms Doogin21 Other Quizlet setsJurisprudence part II170 terms tom_hansen20 A-Level Geography, Coasts - EQ241 terms RichardMe123 PSYCHIATRIC MH-NURSING EXAM 3: DISORDERS OF CHILDH…50 terms jbertin Regeneration and Repair23 terms bsmills88 Related questionsQUESTION What are the ways to dilate veins? 6 answers QUESTION What is true regarding a hemothorax? 5 answers QUESTION You are caring for a 47-year-old male patient with classical chest pain suggestive of a myocardial infarction. 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What 3 instructions should be given to a patient taking transdermal nitroglycerine?Choose a spot on your upper body or upper arms to apply your patch. Do not apply the patch to your arms below the elbows, to your legs below the knees, or to skin folds. Apply the patch to clean, dry, hairless skin that is not irritated, scarred, burned, broken, or calloused. Choose a different area each day.
When should you take nitroglycerin sublingual?Adults—1 tablet placed under the tongue or between the cheek and gum at the first sign of an angina attack. 1 tablet may be used every 5 minutes as needed, for up to 15 minutes. Do not take more than 3 tablets in 15 minutes. To prevent angina from exercise or stress, use 1 tablet 5 to 10 minutes before the activity.
What are the contraindications of nitroglycerin sublingual?The contraindications of nitroglycerine therapy include:. Allergic reactions to nitroglycerin are extremely rare, but reports do exist. ... . Known history of increased intracranial pressure, severe anemia, right-sided myocardial infarction, or hypersensitivity to nitroglycerin are contraindications to nitroglycerin therapy.. |
Which instruction regarding sublingual nitroglycerin would the nurse provide to the patient?
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