Nitrates Flashcards
1
Q
Medications
A
- Nitroglycerin
- Isosorbide dinitrate
- Isosorbide mononitrate
2
Q
Action
A
- Act directly on smooth muscle to cause relaxation and depress muscle tone of the blood vessels
- Help restore the appropriate supply-and-demand ration in oxygen delivery to the myocardium
3
Q
Indications
A
-Prevention and treatment of attacks of angina pectoris
4
Q
Contraindications
A
- Allergy
- Severe anemia
- Head trauma or cerebral hemorrhage
- Pregnancy/lactation
5
Q
Caution
A
- Hepatic or renal disease
- Hypotension, hypovolemia, and conditions that limit cardiac output
6
Q
Adverse effects
A
- Related to the vasodilation and decrease in blood flow
- CNS: headache, dizziness, and weakness
- GI: N/V
- CV: hypotension
- Misc: flushing, pallor, increased perspiration
7
Q
Drug-Drug interactions
A
- Ergot derivatives
- Heparin
- Sildenafil, tadalafil, vardenafil
8
Q
Assessment
A
- History: check for any contraindications
- Physical: skin, complaints of pain, including onset, duration, intensity, location, and measures used to relieve it. Respirations, VS, cardiac status, ECG
9
Q
Nursing diagnoses
A
- Decreased CO r/t vasodilation and hypotensive effects
- Risk for injury r/t CNS or CV effects
- Ineffective tissue perfusion r/t hypotension or change in CO
- Deficient knowledge
10
Q
Implementation
A
- Have patient lay down or sit down prior to administration
- Instruct patient that a sublingual dose may be repeated in 5 minutes is not felt for a total of 3 doses
- Have emergency life-support equipment readily available
- Taper the dose gradually after long-term therapy
- Provide pt teaching
11
Q
Evaluation
A
- Evaluation patient response to the drug (alleviation of signs and symptoms of heart failure)
- Monitor for adverse effects
- Evaluate the compliance with the regimen
- Evaluate the effectiveness of the teaching plan
