Nokea
A client is being discharged after being treated with nitroglycerin for angina. Which of the following instructions should the nurse include in the teaching plan for the client?
- A. Store the nitroglycerin capsules in a plastic container.
- B. Place the nitroglycerin capsules along with other tablets.
- C. Recap the container tightly after taking out the capsules.
- D. Do not store nitroglycerin in a dark container.
Correct Answer: C
Rationale: The nurse should instruct the client to recap the container tightly after taking out the nitroglycerin capsule. This is to ensure that the potency of nitroglycerin is not lost on exposure to air. Nitroglycerin should be stored in a dark container and protected from direct light exposure.
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A nurse is preparing to administer nitroglycerin intravenously. Which of the following would be important for the nurse to keep in mind? Select all that apply.
- A. Using glass bottles
- B. Using non-polyvinyl chloride (PVC) infusion sets
- C. Administering the drug as an IV bolus
- D. Diluting the drug with normal saline
- E. Using a gravity flow rate of infusion
Correct Answer: A,B,D
Rationale: When administering IV nitroglycerin, the nurse should dilute it with normal saline or 5% dextrose in water, administer the drug by continuous infusion using an infusion pump for accuracy, and use glass IV bottles and non-PVC infusion sets. The dose is regulated based on client response.
When instructing the client on how to use the prescribed nitroglycerin ointment, the nurse would tell the client to use which of the following to determine the amount?
- A. A teaspoon
- B. Length of a finger
- C. Paper applicator
- D. The size of the previous dose
Correct Answer: C
Rationale: The topical ointment is supplied with a paper applicator to determine the amount of drug to be used. No other method is appropriate.
The nurse assesses for which of the following in a client receiving a calcium channel blocker? Select all that apply.
- A. Crackles
- B. Bradycardia
- C. Wheezing
- D. Dyspnea
- E. Peripheral edema
Correct Answer: A,D,E
Rationale: A client receiving a calcium channel blocker should be monitored for signs of heart failure (dyspnea, weight gain, peripheral edema, abnormal lung sounds such as crackles or rales, and jugular vein distention). The physician should be notified immediately if any of these signs develop.
A nurse is teaching a client who is prescribed nitrate therapy about adverse reactions. When discussing headaches associated with nitrates, which of the following would the nurse include? Select all that apply.
- A. Headaches should decrease with continued therapy.
- B. Headaches may be relieved with the use of aspirin or acetaminophen.
- C. Headaches should be avoided by altering the dosage schedule.
- D. Headaches are a serious adverse reaction and should be reported immediately.
- E. Headaches may be a marker of the drug's effectiveness.
Correct Answer: A,B,E
Rationale: Headaches are a common adverse reaction of nitrates but should decrease with continued therapy. Headaches should be reported if they become severe or persist. Headaches may be a marker of the nitrate's effectiveness, and clients should not alter the dosing schedule to avoid headaches. Headaches may be treated with acetaminophen or aspirin.
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.