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Questions and Answers
A client with angina is prescribed sublingual nitroglycerin. What instruction should the nurse provide regarding its administration?
A client with angina is prescribed sublingual nitroglycerin. What instruction should the nurse provide regarding its administration?
- Swallow the tablet whole with a glass of water.
- Chew the tablet for faster absorption.
- Place the tablet under the tongue and let it dissolve. (correct)
- Crush the tablet and inhale it.
A client is using transdermal nitroglycerin patches. Which instruction is most important for the nurse to emphasize?
A client is using transdermal nitroglycerin patches. Which instruction is most important for the nurse to emphasize?
- Apply the patch to a hairless area and rotate sites daily. (correct)
- Apply heat to the patch to enhance medication delivery.
- Apply the patch to the same site each day to ensure consistent absorption.
- Cut the patch in half if a lower dose is needed.
A client reports a headache after taking sublingual nitroglycerin. What is the nurse's best action?
A client reports a headache after taking sublingual nitroglycerin. What is the nurse's best action?
- Explain that headache is a common side effect and usually diminishes with time. (correct)
- Hold the next dose of nitroglycerin and notify the physician.
- Administer a beta-blocker to counteract the headache.
- Administer an opioid analgesic for pain relief.
A client is prescribed IV nitroglycerin for unstable angina. Which nursing intervention is most critical during administration?
A client is prescribed IV nitroglycerin for unstable angina. Which nursing intervention is most critical during administration?
A client taking nitroglycerin reports experiencing dizziness upon standing. What should the nurse advise the client to do?
A client taking nitroglycerin reports experiencing dizziness upon standing. What should the nurse advise the client to do?
What is the most important instruction to give a client regarding the storage of nitroglycerin tablets?
What is the most important instruction to give a client regarding the storage of nitroglycerin tablets?
A client is prescribed nitroglycerin for angina. Which medication, if taken concurrently, is contraindicated due to the risk of severe hypotension?
A client is prescribed nitroglycerin for angina. Which medication, if taken concurrently, is contraindicated due to the risk of severe hypotension?
A client using transdermal nitroglycerin patches asks why they need to remove the patch each night. What is the best rationale for the nurse to provide?
A client using transdermal nitroglycerin patches asks why they need to remove the patch each night. What is the best rationale for the nurse to provide?
A client with angina takes one sublingual nitroglycerin tablet but still experiences chest pain after 5 minutes. What is the next appropriate action?
A client with angina takes one sublingual nitroglycerin tablet but still experiences chest pain after 5 minutes. What is the next appropriate action?
A nurse is teaching a client about nitroglycerin. Which statement by the client indicates a need for further teaching?
A nurse is teaching a client about nitroglycerin. Which statement by the client indicates a need for further teaching?
A client is using nitroglycerin for angina. What activity should the nurse advise the client to avoid due to its vasodilating effects?
A client is using nitroglycerin for angina. What activity should the nurse advise the client to avoid due to its vasodilating effects?
A client taking nitroglycerin sublingually reports a burning sensation with the medication. What is the nurse's appropriate response?
A client taking nitroglycerin sublingually reports a burning sensation with the medication. What is the nurse's appropriate response?
A client is prescribed nitroglycerin for long-term angina prevention. Which route of administration is most suitable for this purpose?
A client is prescribed nitroglycerin for long-term angina prevention. Which route of administration is most suitable for this purpose?
A client on nitroglycerin therapy experiences reflex tachycardia. Which physiological mechanism is responsible for this side effect?
A client on nitroglycerin therapy experiences reflex tachycardia. Which physiological mechanism is responsible for this side effect?
When should a client who is experiencing chest pain call emergency services after taking sublingual nitroglycerin?
When should a client who is experiencing chest pain call emergency services after taking sublingual nitroglycerin?
A nurse is assessing a client who has been using nitroglycerin patches for several months. What finding suggests the client may have developed nitrate tolerance?
A nurse is assessing a client who has been using nitroglycerin patches for several months. What finding suggests the client may have developed nitrate tolerance?
A client is prescribed nitroglycerin ointment. What is the correct procedure for applying this medication?
A client is prescribed nitroglycerin ointment. What is the correct procedure for applying this medication?
Alcohol consumption can potentiate the effects of Nitroglycerin, what effect would this have on the patient?
Alcohol consumption can potentiate the effects of Nitroglycerin, what effect would this have on the patient?
Which of the following conditions is a contraindication for nitroglycerin administration?
Which of the following conditions is a contraindication for nitroglycerin administration?
A patient is scheduled to have sexual activity and asks when they can take sildenafil after taking Nitroglycerin. What is the most appropriate response?
A patient is scheduled to have sexual activity and asks when they can take sildenafil after taking Nitroglycerin. What is the most appropriate response?
The patient has already administered 3 nitroglycerin tablets and still reports chest pain. After calling 911, what needs to occur while waiting for Emergency Medical Services (EMS)?
The patient has already administered 3 nitroglycerin tablets and still reports chest pain. After calling 911, what needs to occur while waiting for Emergency Medical Services (EMS)?
A nurse is teaching a client with angina how to use nitroglycerin sublingual tablets. Which of the following instructions should be included?
A nurse is teaching a client with angina how to use nitroglycerin sublingual tablets. Which of the following instructions should be included?
A client is prescribed nitroglycerin transdermal patches. The nurse should instruct the client to:
A client is prescribed nitroglycerin transdermal patches. The nurse should instruct the client to:
A client reports a headache after taking sublingual nitroglycerin. The nurse should:
A client reports a headache after taking sublingual nitroglycerin. The nurse should:
A client is receiving IV nitroglycerin for unstable angina. The nurse should monitor for:
A client is receiving IV nitroglycerin for unstable angina. The nurse should monitor for:
When teaching a client about nitroglycerin, the nurse emphasizes the importance of:
When teaching a client about nitroglycerin, the nurse emphasizes the importance of:
Which medication is contraindicated with nitroglycerin due to the risk of severe hypotension?
Which medication is contraindicated with nitroglycerin due to the risk of severe hypotension?
A client using nitroglycerin patches asks why they need to remove the patch each night. The nurse's best response is:
A client using nitroglycerin patches asks why they need to remove the patch each night. The nurse's best response is:
If a client takes one sublingual nitroglycerin tablet and still has chest pain after 5 minutes, they should:
If a client takes one sublingual nitroglycerin tablet and still has chest pain after 5 minutes, they should:
A client states, "I can take nitroglycerin with my erectile dysfunction medication if I have chest pain." The nurse should:
A client states, "I can take nitroglycerin with my erectile dysfunction medication if I have chest pain." The nurse should:
Which activity should a client taking nitroglycerin avoid due to its vasodilating effects?
Which activity should a client taking nitroglycerin avoid due to its vasodilating effects?
A client taking nitroglycerin sublingually reports a burning sensation with the medication. The nurse should respond:
A client taking nitroglycerin sublingually reports a burning sensation with the medication. The nurse should respond:
Which nitroglycerin administration route is most appropriate for long-term angina prevention?
Which nitroglycerin administration route is most appropriate for long-term angina prevention?
A client on nitroglycerin therapy experiences reflex tachycardia. This occurs due to:
A client on nitroglycerin therapy experiences reflex tachycardia. This occurs due to:
After administering three nitroglycerin tablets with persistent chest pain, the client should:
After administering three nitroglycerin tablets with persistent chest pain, the client should:
A nurse assessing a client on long-term nitroglycerin patch therapy finds persistent chest pain. This indicates:
A nurse assessing a client on long-term nitroglycerin patch therapy finds persistent chest pain. This indicates:
When applying nitroglycerin ointment, the correct procedure involves:
When applying nitroglycerin ointment, the correct procedure involves:
Flashcards
Nitroglycerin
Nitroglycerin
Medication to treat angina by dilating blood vessels, reducing heart workload.
Nitroglycerin Administration Routes
Nitroglycerin Administration Routes
Under the tongue, through the skin (patch), or IV.
Sublingual Nitroglycerin Instructions
Sublingual Nitroglycerin Instructions
Place under the tongue until dissolved. Don't swallow or chew.
Transdermal NTG Patch Application
Transdermal NTG Patch Application
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IV Nitroglycerin Administration
IV Nitroglycerin Administration
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Sublingual Nitroglycerin Dosage
Sublingual Nitroglycerin Dosage
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Transdermal NTG Patch Strengths
Transdermal NTG Patch Strengths
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IV Nitroglycerin Dosage Adjustment
IV Nitroglycerin Dosage Adjustment
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Sublingual NTG - No Relief
Sublingual NTG - No Relief
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Nitroglycerin Common Side Effects
Nitroglycerin Common Side Effects
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Orthostatic Hypotension
Orthostatic Hypotension
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Reflex Tachycardia
Reflex Tachycardia
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Nitroglycerin Tolerance
Nitroglycerin Tolerance
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Nitroglycerin Contraindication
Nitroglycerin Contraindication
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Drugs Contraindicated with NTG
Drugs Contraindicated with NTG
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Nitroglycerin Other Contraindications
Nitroglycerin Other Contraindications
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Antihypertensives & Nitroglycerin
Antihypertensives & Nitroglycerin
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Alcohol & Nitroglycerin
Alcohol & Nitroglycerin
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Aspirin/NSAIDs & Nitroglycerin
Aspirin/NSAIDs & Nitroglycerin
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Pre-Administration Assessment
Pre-Administration Assessment
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Post-Administration Monitoring
Post-Administration Monitoring
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Nitroglycerin Patient Education
Nitroglycerin Patient Education
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Activities to Avoid with NTG
Activities to Avoid with NTG
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When to Contact Provider
When to Contact Provider
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Nitroglycerin Storage
Nitroglycerin Storage
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Nitroglycerin Replacement
Nitroglycerin Replacement
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Position When Taking NTG
Position When Taking NTG
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Transdermal Patch Removal
Transdermal Patch Removal
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Home Monitoring
Home Monitoring
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Signs of Nitrate Tolerance
Signs of Nitrate Tolerance
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How Nitroglycerin Relieves Angina
How Nitroglycerin Relieves Angina
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Steps to Take During Chest Pain
Steps to Take During Chest Pain
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Timing of NTG Doses
Timing of NTG Doses
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Common Side Effects of Nitroglycerin
Common Side Effects of Nitroglycerin
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How to Store NTG Tablets
How to Store NTG Tablets
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How Often to Replace NTG
How Often to Replace NTG
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ED Drugs to Avoid with NTG
ED Drugs to Avoid with NTG
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Alcohol Interaction with NTG
Alcohol Interaction with NTG
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NTG Patch Applications
NTG Patch Applications
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All Medications with NTG
All Medications with NTG
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Study Notes
- Nitroglycerin treats angina by dilating blood vessels, reducing the heart's workload.
Administration
- Nitroglycerin can be administered sublingually, transdermally, or intravenously.
- Sublingual tablets provide immediate angina relief.
- Transdermal patches are for long-term angina prevention.
- IV nitroglycerin treats severe, unstable angina or controls blood pressure.
- Sublingual nitroglycerin: place the tablet under the tongue and allow it to dissolve completely, without swallowing or chewing.
- Transdermal patches: apply to a hairless skin area, rotating sites daily to prevent irritation.
- IV nitroglycerin requires a dedicated IV line and infusion pump, with close blood pressure monitoring due to the risk of rapid drops.
Dosage
- Sublingual nitroglycerin is typically 0.4 mg, repeated every 5 minutes for up to three doses.
- Transdermal nitroglycerin patches range from 0.2 mg/hr to 0.8 mg/hr.
- IV nitroglycerin dosage is based on individual response and blood pressure.
- If chest pain persists after the first sublingual nitroglycerin dose, call emergency services.
Side Effects
- Common side effects: headache, dizziness, lightheadedness, and flushing.
- Orthostatic hypotension is a significant side effect, especially with the first dose, change positions slowly to minimize this.
- Reflex tachycardia can occur in response to hypotension.
- Tolerance to nitroglycerin's effects can develop with long-term use.
Contraindications
- Contraindicated in clients with hypersensitivity to nitrates.
- Avoid use with phosphodiesterase-5 (PDE5) inhibitors (e.g., sildenafil, tadalafil, vardenafil) due to the risk of severe hypotension.
- Also contraindicated in clients with severe anemia, head trauma, or increased intracranial pressure.
Interactions
- Concurrent use with antihypertensive medications (e.g., beta-blockers, calcium channel blockers) can increase hypotension risk.
- Alcohol can potentiate nitroglycerin's hypotensive effects.
- Aspirin and other NSAIDs may reduce nitroglycerin's effectiveness.
Nursing Considerations
- Before administering nitroglycerin, assess blood pressure and heart rate.
- Monitor for chest pain relief after administration.
- Educate about proper use, storage, and disposal.
- Avoid activities causing vasodilation, such as hot showers or saunas.
- Report any persistent or severe side effects to the healthcare provider.
- Store tablets in the original container, away from light and moisture.
- Check the expiration date, replace the supply every six months.
- Sit or lie down when taking nitroglycerin to prevent falls.
- Remove transdermal patches each night for 10-12 hours to prevent tolerance.
- Teach how to take pulse and blood pressure at home, and when to seek medical attention.
- Assess for signs of nitrate tolerance.
Patient Education
- Nitroglycerin relieves chest pain (angina) by widening blood vessels.
- If chest pain occurs, stop activity and sit or lie down. Place one tablet under the tongue and let it dissolve.
- If pain doesn't improve within 5 minutes, take a second tablet. If it still doesn't improve 5 minutes after the second tablet, take a third tablet and call 911 immediately. Do not exceed three tablets within 15 minutes.
- Common side effects: headache, dizziness, and flushing, sit or lie down when taking nitroglycerin to avoid falls.
- Store tablets in a cool, dry place, in the original container.
- Replace tablets every 6 months due to potency loss.
- Avoid taking nitroglycerin with erectile dysfunction medications (sildenafil, tadalafil, or vardenafil) due to hypotension risk.
- Avoid alcohol while taking nitroglycerin, as it can increase dizziness and low blood pressure.
- For patches, apply one patch daily to a hairless skin, rotate the application site daily and remove the patch each night for 10-12 hours to prevent tolerance.
- Inform your doctor about all medications, including over-the-counter drugs and herbal supplements.
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