CH 23

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created 2 years ago by unicyclebro99
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updated 2 years ago by unicyclebro99
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1

Before deciding whether the patient receives a diuretic, what are you looking for in your assessment of the patient?

  • baseline vital signs
  • drug history and health history (especially look for erectile dysfunction medications)
  • pain-level, quality , precipitating factors
2

What would the nurse's plan include when using nitroglycerin?

  • patient will be free from chest pain after administration of nitroglycerin
3

What nursing interventions would the nurse use to minimize adverse effects when administering nitroglycerin?

  • Nitroglycerin SL can be administered for 3 doses, 5 minutes apart. you would give the first dose, if pain does not COMPLETELY go away, you would administer a second dose after 5 minutes, then a third dose after 5 minutes if pain still unrelieved
  • monitor vital signs because hypotension is common with nitrates: systolic blood pressure below 90 mm Hg can be an indicator there is a problem and the healthcare provider should be notified before any other dose is administered
4

What nursing interventions would the nurse use to minimize adverse effects when administering nitroglycerin? pt 2

  • position patients sitting or lying when taking nitroglycerin for angina. It helps reduce the workload of the heart and it helps prevent orthostatic hypotension. Should remain seated or lying for 30 minutes after last dose taken.
  • monitor response to nitro throughout the treatment (after each dose)
  • offer a sip of water before giving SL nitro. Dry mouth can decrease absorption. Place the tablet under their tongue and let it dissolve. Tingling sensation normally occurs and shows the medication is effective.
5

What nursing interventions would the nurse use to minimize adverse effects when administering nitroglycerin? pt 3

  • wear gloves when applying transdermal nitroglycerin (ointment or TD patch) or you might have orthostatic hypotension because you were exposed to NTG
6

What would the nurse ensure the patient understands when administering nitroglycerin?

  • teach patient to take SL nitro if chest pain occurs, call MD if pain does not go away after 2nd dose. Do not drive to the hospital, call 911
  • teach patient to lie down with phone and take dose of nitro (helps prevent fainting)
  • teach patient about storage of NTG-original dark container, room temperature, away from the light and keep dry
7

What would the nurse ensure the patient understands when administering nitroglycerin?

  • once bottle is opened, the pills last only about 3-6 months before they expire. Teach patient that if they do not feel the "tingling sensation under their tongue, it could mean the medication is no longer effective.
  • teach to apply TD patch as prescribed (Healthcare provider may want the patient to remove the patch over night and apply new patch in the morning)- remember patch rules- rotate sites , remove old patch , cleanse old site
8

what is the purpose of antianginal drug therapy?

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9

The nurse will teach a patient who will be taking nitroglycerin (Nitrostat) about which common adverse effect of this drug?

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10

The nurse is reviewing dosage forms of nitroglycerin (Nitrostat). This drug can be given by which routes?

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11

For a patient using transdermal nitroglycerin patches, the nurse knows that the prescriber will order which procedure for preventing tolerance?

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12

Patients who are taking beta-blockers for angina need to be taught which information?

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13

A patient with coronary artery spasms will be most effectively treated with which type of antianginal medication?

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14

During his morning walk, a man begins to experience chest pain. He sits down and takes one nitroglycerin sublingual tablet. After 5 minutes, the chest pain is worsening. What action would be the priority in this situation?

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15

A patient has a new prescription for transdermal nitroglycerin patches. The nurse teaches the patient that these patches are most appropriately used for which reason?

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16

A nurse with adequate knowledge about the administration of intravenous nitroglycerin will recognize that which statement is correct?

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17

Which statement by the patient reflects the need for additional patient education about the calcium channel blocker diltiazem (Cardizem)?

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18

A 68-year-old man has bee taking the nitrate isosorbide dinitrate (Isordil) for 2 years for angina. He recently has been experiencing erectile dysfunction and wants a prescription for sildenafil (Viagra). Which response would the nurse most likely hear from the prescriber?

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19

The nurse is reviewing drug interactions with a male patient who has a prescription for isosorbide dinitrate (Isordil) as treatment for angina symptoms. Which substances listed below could potentially result in a drug interaction? (select all that apply)

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