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A client has been prescribed diltiazem (Cardizem) and asks the nurse what type of drug this is. Which response by the nurse is most appropriate?
- A. "A beta blocker."
- B. "A sodium channel blocker."
- C. "An alpha blocker."
- D. "A calcium channel blocker."
Correct Answer: D
Rationale: Diltiazem (Cardizem) belongs to the class of drugs known as calcium channel blockers. These medications work by blocking calcium from entering the muscle cells of the heart and blood vessels, leading to relaxation of the blood vessels and reduced workload on the heart. This helps in lowering blood pressure and improving blood flow. It is crucial for the nurse to provide accurate information to the client about the type of drug prescribed to ensure understanding and compliance with the treatment plan.
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The client with angina is being discharged to home. The nurse is instructing the client on dietary changes. What should be included in this teaching?
- A. Decrease salt and fat intake and limit alcohol intake.
- B. There are no dietary restrictions for a person diagnosed with angina.
- C. Limit smoking and increase protein and sugar intake.
- D. Increase fruits, vegetables, and foods high in cholesterol.
Correct Answer: A
Rationale: The correct answer is to decrease salt and fat intake and limit alcohol intake. These dietary changes can help manage angina by reducing the workload on the heart and preventing further plaque buildup in the arteries. Choices B, C, and D are incorrect as dietary restrictions for angina typically involve reducing salt, fat, and alcohol intake, rather than increasing sugar or cholesterol intake.
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.
The client makes which statement about lifestyle changes to reduce the development and progression of coronary artery disease that indicates the need for further teaching?
- A. "I will check my weight regularly for any gain or loss."
- B. "I'll make sure to take my high blood pressure medications."
- C. "I am attending a smoking cessation class."
- D. "As long as I exercise, stress at my job will not bother me."
Correct Answer: D
Rationale: The client stating, 'As long as I exercise, stress at my job will not bother me,' indicates a misunderstanding of the relationship between exercise and stress management. It is important to clarify that while exercise can help reduce stress, it may not eliminate all stressors, especially those related to work. Further teaching is needed to ensure the client understands the multifactorial approach required to address stress and its impact on coronary artery disease.
When a client is discharged with nitroglycerin (Nitrostat), what should the nurse include in client education?
- A. "Your chest pain should go away with one tablet."
- B. "If your chest pain doesn't go away after three tablets, call 911; you might be having a heart attack."
- C. "If your chest pain doesn't go away with one tablet, you can repeat the dose as many times as you need to."
- D. "Be sure to call 911 before you take any tablets."
Correct Answer: B
Rationale: The correct answer instructs the client on the appropriate use of nitroglycerin. Nitroglycerin is used to relieve chest pain or angina. If the chest pain does not subside after taking one tablet, the client should take a maximum of three tablets at 5-minute intervals. If the pain persists after three tablets, it could indicate a heart attack, and emergency medical help should be sought. This education is crucial to ensure the client knows when to seek immediate medical attention.
A client has been prescribed a calcium channel blocker for angina. The nurse knows this medication should NOT be used with caution in combination with which drug classes?
- A. NSAIDs
- B. Cardiac glycosides
- C. Beta blockers
- D. None of the above
Correct Answer: C
Rationale: Calcium channel blockers and beta blockers should be used with caution together because they can both suppress heart function, potentially leading to bradycardia, heart block, or heart failure. NSAIDs and cardiac glycosides do not have significant interactions with calcium channel blockers in the same way, so they are not typically a cause for concern when combined.