Nokea
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.
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A client is prescribed nitrate therapy as treatment for angina. On a follow-up visit to the clinic, the client tells the nurse that he gets dizzy and weak when he takes the medication. The nurse would identify which nursing diagnosis as most likely?
- A. Risk for Injury
- B. Risk for Infection
- C. Deficient Fluid Volume
- D. Acute Pain
Correct Answer: A
Rationale: The client is at risk for injury because of his complaints of dizziness and weakness. There is no indication that the client is experiencing an infection or has a fluid volume deficit. Complaints of pain would lead to a nursing diagnosis of Acute Pain.
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.
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 reviewing information about antianginal drugs, a student demonstrates understanding by identifying which of the following as indicated for the prevention of angina pectoris? Select all that apply.
- A. Diltiazem
- B. Isosorbide mononitrate
- C. Topical nitroglycerin
- D. Oral nitroglycerin
- E. Amlodipine
Correct Answer: B,C,D
Rationale: All nitrates are indicated for the prevention of angina pectoris. Diltiazem and amlodipine are used to treat chronic stable angina.
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.