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When a client is discharged with nitroglycerin (Nitrostat), what should the nurse include in client education?
- A. "Your chest pain should go away with one tablet."
- B. "If your chest pain doesn't go away after three tablets, call 911; you might be having a heart attack."
- C. "If your chest pain doesn't go away with one tablet, you can repeat the dose as many times as you need to."
- D. "Be sure to call 911 before you take any tablets."
Correct Answer: B
Rationale: The correct answer instructs the client on the appropriate use of nitroglycerin. Nitroglycerin is used to relieve chest pain or angina. If the chest pain does not subside after taking one tablet, the client should take a maximum of three tablets at 5-minute intervals. If the pain persists after three tablets, it could indicate a heart attack, and emergency medical help should be sought. This education is crucial to ensure the client knows when to seek immediate medical attention.
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A client taking nitroglycerin (Nitrostat) complains of a headache. Which conclusion is most appropriate by the nurse?
- A. A headache indicates a serious allergic reaction to nitroglycerin.
- B. The client will not have a headache if the nitroglycerin is taken with a high-fat meal.
- C. Nitroglycerin does not cause a headache.
- D. The most common side effect of nitroglycerin is a headache.
Correct Answer: D
Rationale: Nitroglycerin is known to cause headaches as a common side effect due to its vasodilatory properties. It dilates blood vessels, which can lead to headaches. While a headache can indicate other serious conditions, the most common association with nitroglycerin use is a headache. It is crucial for the nurse to recognize this side effect and provide appropriate education and support to the client.
A client taking nitroglycerin (Nitrostat) for angina asks the nurse to explain possible side effects. What should NOT be included in client teaching?
- A. Reflex tachycardia
- B. Dizziness
- C. Hyponatremia
- D. Hypotension
Correct Answer: C
Rationale: Hyponatremia is not a common side effect associated with nitroglycerin use. Nitroglycerin typically causes side effects such as reflex tachycardia, dizziness, and hypotension due to its vasodilatory effects. Therefore, it is important for the nurse to educate the client about these potential side effects to promote understanding and appropriate management.
Following a stroke, a client has been started on clopidogrel (Plavix). Why is this medication being administered?
- A. To prevent stroke in high-risk patients, such as those with prosthetic heart valves
- B. To decrease blood pressure
- C. To increase heart rate
- D. To provide antiplatelet activity in patients who cannot tolerate aspirin
Correct Answer: D
Rationale: Clopidogrel (Plavix) is an antiplatelet medication that inhibits platelet aggregation, reducing the risk of blood clots. It is commonly used in patients who have had a stroke and cannot tolerate aspirin due to allergies or intolerances. Choosing clopidogrel in these cases helps prevent further clot formation and reduces the risk of recurrent strokes.
Why has an ACE inhibitor been prescribed following an MI?
- A. "This medication will lower your potassium level."
- B. "ACE inhibitors have been found to reduce mortality following MI."
- C. "ACE inhibitors are always prescribed with a beta blocker and calcium channel blocker following an MI."
- D. "This medication will treat your hypotension."
Correct Answer: B
Rationale: Following a myocardial infarction (MI), ACE inhibitors are commonly prescribed due to their proven benefit in reducing mortality and improving outcomes post-MI. These medications help by decreasing the workload of the heart, preventing remodeling of the heart chambers, and improving survival rates. While ACE inhibitors may have effects on potassium levels, the primary reason for their prescription post-MI is their mortality-reducing properties.
Why should the nitrate patch be off for 8 hours per day?
- A. "There is no reason to take the patch off each day."
- B. "The patch can be addictive; leaving it off reduces the addiction."
- C. "You should only leave the patch off for 15 minutes."
- D. "Leaving the patch off for 8 hours per day helps to delay the development of tolerance."
Correct Answer: D
Rationale: Removing the nitrate patch for 8 hours each day is essential to prevent the body from developing tolerance to the medication. By allowing the body to have a drug-free period, the effectiveness of the medication is maintained over time. This practice helps in ensuring that the nitrate patch continues to provide its intended therapeutic effects without diminishing its efficacy. Therefore, it is important for the client to adhere to the prescribed schedule of removing the patch for 8 hours daily to optimize the treatment outcomes.