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A client is being discharged after being treated with nitroglycerin for an acute anginal attack. Which of the following instructions should the nurse provide the client regarding the administration of nitroglycerin ointment?
- A. Apply a thick layer of the ointment.
- B. Rub the ointment onto the skin.
- C. Use an applicator for applying the ointment.
- D. Apply on the same site during every application.
Correct Answer: C
Rationale: The nurse should instruct the client to use an applicator for applying the nitroglycerin ointment. The ointment should not come in contact with the skin of the person applying it, as it gets easily absorbed. The nurse should instruct the client to apply a thin layer of the ointment on the skin using an applicator.
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Prior to administering an antianginal drug, the nurse should assess which of the following? Select all that apply.
- A. Pain
- B. Physical appearance
- C. Lung sounds
- D. Heart sounds
- E. Vital signs
Correct Answer: A,B,C,E
Rationale: Before administering an antianginal agent, the nurse would assess the client's pain, history of medication allergies and disease processes, physical appearance, and lungs for adventitious sounds and obtain a baseline electrocardiogram and vital signs.
After teaching a client about how to use translingual nitroglycerin spray, the nurse determines that the teaching was successful when the client states which of the following? Select all that apply.
- A. I need to shake the canister before use.
- B. I will place one to two metered doses under my tongue at the start of an attack.
- C. I'm not to use this form to prevent an attack.
- D. I should not exceed three metered doses in 15 minutes.
- E. I can spray the drug onto or under the tongue.
Correct Answer: B,D,E
Rationale: Nitroglycerin translingual spray can be used prophylactically 5 to 10 minutes prior to engaging in activities that precipitate an anginal attack. The client should not shake the canister before use. At the onset of an anginal attack, the client should spray one or two metered doses onto or under the tongue and not exceed three metered doses within 15 minutes. The client should clean the canister as directed on the package.
When applying nitroglycerin ointment, which of the following would be appropriate? Select all that apply.
- A. Wear plastic disposable gloves.
- B. Apply entire tube of ointment to client's skin.
- C. Use the same application site each time ointment is applied.
- D. Cleanse the area of skin before application
- E. Use the upper arms and legs for application
Correct Answer: A,D,E
Rationale: The nurse should wear plastic gloves while administering ointment and use application paper to measure and apply ointment to the client's chest, abdomen, or upper arms and legs. The application site should be rotated and cleansed with each application.
A nurse instructs a client who is taking oral nitrates to store the drug in which manner? Select all that apply.
- A. In its original container
- B. With the container lid tightly sealed
- C. With other medications in the container
- D. In a plastic pill box so doses are not missed
- E. Away from light exposure
Correct Answer: A,B,E
Rationale: The proper storage of oral nitroglycerin includes keeping tablets and capsules in their original container, never mixing oral nitroglycerin with other drugs in a container, never storing oral nitroglycerin in a plastic container, keeping the drug away from light, and always replacing the container tightly and as soon as the drug is removed.
A client is receiving treatment for angina with a vasodilator. The nurse instructs the client to notify his primary health care provider about which of the following?
- A. Weight loss of 2 lb in a week
- B. Swelling of the extremities
- C. Episodes of dyspnea
- D. Heart rate increased by about 10 bpm
- E. Fainting
Correct Answer: B,C,E
Rationale: The primary health care provider should be notified if the client experiences a heart rate of 20 bpm or more above the normal rate, rapid weight gain of 5 lb or more; unusual swelling of the extremities, face, or abdomen, dyspnea; angina; severe indigestion; or fainting.