Nokea
The nurse is caring for a client who has chronic angina. Treatment for the condition has been unsuccessful. Which medication does the nurse anticipate will be prescribed?
- A. Atenolol (Tenormin)
- B. Nitroglycerin (Nitrostat)
- C. Sildenafil (Viagra)
- D. Ranolazine (Ranexa)
Correct Answer: D
Rationale: In cases of chronic angina where initial treatment has not been successful, Ranolazine (Ranexa) is often prescribed. This medication helps by reducing the frequency of angina episodes. Atenolol, Nitroglycerin, and Sildenafil are also used in angina management but Ranolazine is more specifically indicated in cases of refractory angina where other treatments have failed.
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A client taking nitroglycerin (Nitrostat) complains of a headache. Which conclusion is most appropriate by the nurse?
- A. A headache indicates a serious allergic reaction to nitroglycerin.
- B. The client will not have a headache if the nitroglycerin is taken with a high-fat meal.
- C. Nitroglycerin does not cause a headache.
- D. The most common side effect of nitroglycerin is a headache.
Correct Answer: D
Rationale: Nitroglycerin is known to cause headaches as a common side effect due to its vasodilatory properties. It dilates blood vessels, which can lead to headaches. While a headache can indicate other serious conditions, the most common association with nitroglycerin use is a headache. It is crucial for the nurse to recognize this side effect and provide appropriate education and support to the client.
The healthcare professional is preparing to administer atenolol (Tenormin) to a client with angina. Which vital sign would cause the healthcare professional to question administering this drug?
- A. Respirations 12 breaths per minute
- B. Pulse 52 beats per minute
- C. Blood pressure 134/72
- D. Oxygen saturation 95%
Correct Answer: B
Rationale: Atenolol is a beta-blocker medication that can lower heart rate. A pulse of 52 beats per minute is relatively low and administering atenolol could further decrease the heart rate, potentially leading to bradycardia. Monitoring the pulse rate and holding the medication if the pulse is below the prescribed parameters is crucial to prevent adverse effects such as bradycardia and hypotension.
Which drug classes are NOT typically used to treat angina?
- A. Calcium channel blockers
- B. Organic nitrates
- C. Alpha blockers
- D. Beta blockers
Correct Answer: C
Rationale: Angina is primarily treated with calcium channel blockers, organic nitrates, and beta blockers. Alpha blockers are not commonly used in the treatment of angina. Calcium channel blockers help dilate blood vessels, decreasing the workload on the heart. Organic nitrates relax and widen blood vessels, improving blood flow and reducing the heart's workload. Beta blockers reduce the heart rate and blood pressure, decreasing the heart's demand for oxygen. Alpha blockers are more commonly used to treat conditions like hypertension and benign prostatic hyperplasia.
Why has an ACE inhibitor been prescribed following an MI?
- A. "This medication will lower your potassium level."
- B. "ACE inhibitors have been found to reduce mortality following MI."
- C. "ACE inhibitors are always prescribed with a beta blocker and calcium channel blocker following an MI."
- D. "This medication will treat your hypotension."
Correct Answer: B
Rationale: Following a myocardial infarction (MI), ACE inhibitors are commonly prescribed due to their proven benefit in reducing mortality and improving outcomes post-MI. These medications help by decreasing the workload of the heart, preventing remodeling of the heart chambers, and improving survival rates. While ACE inhibitors may have effects on potassium levels, the primary reason for their prescription post-MI is their mortality-reducing properties.
Why should the nitrate patch be off for 8 hours per day?
- A. "There is no reason to take the patch off each day."
- B. "The patch can be addictive; leaving it off reduces the addiction."
- C. "You should only leave the patch off for 15 minutes."
- D. "Leaving the patch off for 8 hours per day helps to delay the development of tolerance."
Correct Answer: D
Rationale: Removing the nitrate patch for 8 hours each day is essential to prevent the body from developing tolerance to the medication. By allowing the body to have a drug-free period, the effectiveness of the medication is maintained over time. This practice helps in ensuring that the nitrate patch continues to provide its intended therapeutic effects without diminishing its efficacy. Therefore, it is important for the client to adhere to the prescribed schedule of removing the patch for 8 hours daily to optimize the treatment outcomes.