Nokea
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.
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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.
A client is prescribed verapamil. The nurse would alert the client to the possibility of which of the following as most common? Select all that apply.
- A. Constipation
- B. Tachycardia
- C. Tachypnea
- D. Hypotension
- E. Headache
Correct Answer: A,E
Rationale: The most common adverse reactions associated with verapamil are constipation and headache. Hypotension is associated with nitrate therapy. Tachycardia and tachypnea are not associated with verapamil.
A client is prescribed verapamil as treatment for his angina. Which of the following would the nurse include in the teaching plan for this client? Select all that apply.
- A. Caplets may be opened and sprinkled on food.
- B. Drug should be administered without regard to meals.
- C. Tablet coverings can be expelled in the stool.
- D. Caplets should be swallowed whole.
- E. Drug should be administered with a meal.
Correct Answer: A,C,E
Rationale: Verapamil frequently causes GI upset and should be administered with a meal. Caplets may be opened and sprinkled on food or mixed in liquids for clients who have difficulty swallowing. Sometimes the tablet coverings are expelled in the stool.
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.
In which of the following situations would a nurse withhold the antianginal medication and contact the physician? Select all that apply.
- A. Heart rate above 50 bpm
- B. Heart rate below 50 bpm
- C. Systolic blood pressure below 90 mm Hg
- D. Diastolic blood pressure below 90 mm Hg
- E. Respiratory rate below 20 breaths per minute
Correct Answer: B,C
Rationale: A nurse would withhold the antianginal medication and contact the physician if a client's heart rate was below 50 bpm or systolic blood pressure drops below 90 mm Hg.