Questions and Answers
Which is an adverse reaction that may occur when sildenafil (Viagra) and nitrates are taken together?
Which principle does the nurse follow when preparing to administer nitroglycerin to a patient intravenously?
Use an infusion pump to administer nitroglycerin.
Which condition should a patient be assessed for when beginning treatment with enalapril (Vasotec)?
Persistent cough
What is an action of calcium ion antagonists that helps with angina?
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Which statement by the patient indicates a need for further teaching regarding nitroglycerin paste?
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Which instructions will the nurse provide when educating a patient on the use of nitroglycerin translingual spray? (Select all that apply.)
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How can nitrate-induced headaches be treated?
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Study Notes
Sildenafil and Nitrates
- Combining sildenafil (Viagra) with nitrates can lead to a significant drop in blood pressure, potentially fatal.
- Sildenafil enhances the vasodilatory effects of nitrates.
Administering Nitroglycerin
- Use an infusion pump for precise delivery of intravenous nitroglycerin.
- Nitroglycerin should not be mixed with other medications to avoid interactions.
- Special administration sets designed for nitroglycerin are essential due to absorption by standard plastic sets.
- Continuous monitoring of vital signs is required in intensive care settings.
ACE Inhibitors and Persistent Cough
- A patient starting on enalapril (Vasotec) should be assessed for a persistent cough, a common side effect of ACE inhibitors.
- Other symptoms like vertigo, tinnitus, and orthopnea are not associated with enalapril.
Calcium Ion Antagonists
- These drugs work by dilating coronary arteries and peripheral blood vessels, which increases myocardial blood flow and reduces workload.
- Dilation reduces the heart's oxygen demand and improves delivery to the myocardium.
Use of Nitroglycerin Paste
- It is crucial to rotate application sites for nitroglycerin paste to prevent skin irritation.
- Gradually reduce the dose of topical nitroglycerin upon discontinuation over 4 to 6 weeks.
- Implement periodic 8- to 12-hour nitrate-free intervals to avoid tolerance.
Nitroglycerin Translingual Spray
- Avoid using the spray near fire and do not shake the container to maintain drug integrity.
- The spray must not be swallowed or inhaled; proper administration is by spraying under or on the tongue.
Managing Nitrate-induced Headaches
- Acetaminophen can be used to treat nitrate-induced headaches, which can be a mild to severe side effect of nitroglycerin patches.
- Tolerance to headaches often develops after weeks of treatment, and headaches do not necessitate dosage adjustments or cessation of the medication.
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Description
Test your knowledge on pharmacology with these NCLEX-style questions covering chapters 12, 20-28. This quiz focuses on key concepts and adverse reactions important for nursing practice, especially regarding medications like sildenafil and nitrates.
