Nokea
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.
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When caring for a client with angina, the nurse instructs the client to place the nitroglycerin tablet between the cheek and the gums. Which form of nitroglycerin is the nurse administering?
- A. Sublingual
- B. Transdermal
- C. Buccal
- D. Translingual
Correct Answer: C
Rationale: The nurse is referring to the buccal route of administration. When administering buccal nitroglycerin, the nurse should instruct the client to place the tablet between the cheek and gums or the lips and gums above the incisors. The nurse should instruct the client to allow the tablet to dissolve and not to chew the tablet. Nitrates can also be given by the sublingual, transdermal, and translingual routes mentioned.
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.
After teaching a group of nursing students about antianginal drugs, the instructor determines that the teaching was successful when the students identify which of the following as a calcium channel blocker?
- A. Minoxidil
- B. Hydralazine
- C. Isosorbide
- D. Nifedipine
Correct Answer: D
Rationale: Nifedipine is a calcium channel blocker used to treat angina. Minoxidil and hydralazine are peripheral vasodilators. Isosorbide is a nitrate.
When discussing the use of antianginal drugs for the treatment of cardiac disease, a nurse would expect to include which of the following? Select all that apply.
- A. Relief of pain of acute anginal attacks
- B. Reduction in serum triglyceride levels
- C. Prevention of anginal attacks
- D. Elevation of high-density lipoproteins (HDLs)
- E. Treatment of chronic stable angina pectoris
Correct Answer: A,C,E
Rationale: Antianginal drugs are used to relieve the pain of acute anginal attacks, prevent anginal attacks, and treat chronic stable angina pectoris. Antianginals have no effect on HDLs or triglycerides.
A client has a nursing diagnosis of Acute Pain related to angina. When teaching a client about antianginal drugs, the nurse would explain which of the following about pain relief? Select all that apply.
- A. Pain will only occur during prolonged exercise.
- B. Pain may be less intense.
- C. Pain may not be completely relieved.
- D. Pain may be less frequent.
- E. Pain will worsen with continued use
Correct Answer: B,C,D
Rationale: Although some clients experience complete angina pain relief, it may not be completely relieved in all clients. In some clients pain may be less intense or less frequent or may only occur during prolonged exercise.