Chapter 23 Quiz Flashcards
Which nitrate preparation or dosage form has the longest duration of action? A) sublingual nitroglycerin B) sublingual isosorbide dinitrate C) oral isosorbide dinitrate D) transdermal nitroglycerin patch
D) transdermal nitroglycerin patch
– The transdermal patch has an 8-212-our duration of action, compared with 0.5 to 6 hours for the other choices
Which statement by the patient demonstrates the need for further education regarding nitroglycerin?
A) “I can take up to four tablets at five-minute intervals for chest pain.”
B) “if I get a headache, I should keep taking my nitroglycerin and use Tylenol for pain relief. “
C) “I should keep my nitroglycerin in a cool, dry place. “
D) “I should change positions slowly to avoid getting dizzy from the nitroglycerin’s affect on my blood pressure. “
A) “I can take up to four tablets at five-minute intervals for chest pain. “
– Patients are taught to take up to three tablets five minutes apart. According to current guidelines, if the chest pain or discomfort is not relieved in five minutes, after one dose, the patient or family member must call 911 immediately.
Which are common side effects of nitroglycerin? (Select all that apply.) A) blurred vision B) Flushing C) headache D) hypotension
B, C, D
What is included in the priority assessment before administering isosorbide mono nitrate (Imdur)?
A) serum electrolytes
B) blood urea nitrogen (BUN) and creatinine
C) blood pressure
D) level of consciousness
C) blood pressure
– Mononitrate is a vasodilator and thus can cause hypotension. It is important to assess blood pressure before administering.
Calcium channel blocker’s reduce myocardial oxygen demand by reducing afterload. How would the nurse explain afterload to the patient?
A) it is the blood volume within the heart.
B) it is the pressure within the heart.
C) it is the pressure against which the heart must pump.
D) is the contractility of the heart muscle.
C) it is the pressure against which the heart must pump
– Afterload is determined by the pressure in the aorta just before systole
When applying nitroglycerin ointment, the nurse should perform which action?
A) use the fingers to spread the ointment evenly over a 3 inch area.
B) replied it went meant to a non-hairy part of the upper torso
C) massage that women into the skin
D) apply to stick lines of pointman over the prescribed measured area on the nitroglycerin paper
B) apply the ointment to a non-hairy part of the upper torso
– Absorption is best over a non-hairy portion of the skin. The upper torso is the preferred site of application. The nurse should wear gloves when applying to prevent transdermal absorption by the applier. The ointment is measured as one straight-line on the nitroglycerin patch and is gently spread over paper and applied, but not rub, into the skin. Rubbing would increase absorption and risks of side effects.
Which instruction should be included in the discharge teaching for a patient with a transdermal nitroglycerin patch?
A) “apply the patch to a non-hairy, non-irritated area of the upper torso or arms. “
B) “apply the patch to the same site each day to maintain consistent drug absorption.”
C) “if you get a headache, remove the patch for four hours and then reapply. “
D) “if you get chest pain, apply a second patch right next to the first patch. “
A) “apply the patch to a non-hairy, non-irritated area of the upper torso or arms. “
– A nitroglycerin patch should be applied to a non-hairy, non-irritated area for the best and most consistent absorption rates. Sites should be rotated to prevent skin irritation, and a joke should be continued if headache occurs because tolerance will develop. Sublingual nitroglycerin it should be used to treat chest pain
The patient asks how nitroglycerin should be store-bought traveling. What is the nurses best response?
A) “you can protect it from heat by placing the bottle and a nice chest. “
B) “it’s best to keep it in its original container away from heat and light. “
C) “you can put a few tablets in a resealable bag and carry in your pocket. “
D) “it’s best to lock them in the glove compartment of your car to keep them away from heat and light. “
B) “it’s best to keep it in its original container away from heat and light. “
– Although nitroglycerin needs to be kept in a cool, dry place, it should not be placed in a nice chest where it could freeze. It should also not be locked up the needs to be kept away from light, not in a clear plastic bag.
A patient who is taking sub lingual nitroglycerin is complaining of flushing and headaches. What is the nurses best response?
A) “this is a normal response to your chest pain. “
B) “stop taking the nitroglycerin because you’re probably allergic to it. “
C) “these are the most common side effects of nitroglycerin. They should subside with continued use of nitroglycerin. “
Do you) “the symptoms are not related to sublingual nitroglycerin. You should notify your doctor for diagnostic testing. “
C) “these are the most common side effects of nitroglycerin. They should subside was continued use of nitroglycerin. “
– Headache and flushing the most common side effects of nitroglycerin it will subside with continued use
When titrating intervenous nitroglycerin, which assessment findings does the nurse monitor? (Select all that apply.)
A) blood pressure
B) heart rate
C) chest pain
D) respiratory rate
A, B, C
Patient teaching regarding sublingual nitroglycerin should include which statement?
A) “you can take up to five doses every three minutes for chest pain.
B) “Jenna tablet for the quickest effect.”
C) “keep the tablets locked in a safe place until you need them.”
D) “sit or lie down after you take a nitroglycerin tablets prevent dizziness.”
D) “sit or lie down after you take a nitroglycerin tablet to prevent dizziness.”
– Nitroglycerin is a vasodilator and can cause orthostatic hypotension, resulting in dizziness.
It should be kept in a readily accessible location for mediate use should chest pain occurred. Three tablets maybe given five minutes apart. It should be placed under the tongue and allowed to dissolve
Which statement indicates that the patient understands discharge teaching about nitroglycerin?
A) “I will need to refill my prescription once a year in order to maintain potency.”
B) “I will need to keep the nitroglycerin stored in the bottle it comes in.”
C) “I will take a nitroglycerin tablet every 15 minutes until my chest pain is gone.”
D) “I should take a nitroglycerin tablet two hours before I want to engage in activity that will cause chest pain.”
B) “I will need to keep the nitroglycerin stored in the bottle it comes in.”
– Nitroglycerin needs to be stored away from heat, humidity, and light, all of which can decrease it’s Groton see. Keep it in the brown light-resistant bottle helps achieve this. It should replaced every 3 to 6 months in order to maintain potency. Nitroglycerin is used every five minutes for pain relief or just before engaging in activity that is known to cause chest pain.
Nitrates relieve angina by reducing prelude. How is the nurse explain the term preload to a patient?
A) it is the volume within the heart.
B) it is the pressure within the superior vina cava.
C) it is the pressure against which the heart must pump.
D) it is the oxygen demand of the heart.
A) it is the blood volume within the heart.
– Preload is determined by the amount of blood in the ventricle just before contraction.
When caring for a patient with angina, the nurse would question in order for noncardioselective beta blocker and the patient was what coexisting medical diagnosis?
A) hypertension
B) atrial fibrillation
C) bronchial asthma
D) myocardial infarction
C) bronchial asthma
– Noncardioselective beta blockers should be used with caution in patients with bronchial asthma since any level of blockade of beta-2 receptors can promote bronchial constriction through unopposed parasympathetic (vagal) tone.
It is most important to instruct the patient prescribed nitroglycerin to avoid which substance (s)?
A) antacids
B) grapefruit juice
C) thiazide diuretics
D) erectile dysfunction medications
D) erectile dysfunction medications
– Concurrent administration of erectile dysfunction medications such as sildenafil citrate (Viagra) can cause an acute exacerbation of nitrate-related hypotension
