 Show
Chapter 46 What effect, if any, would extensive facial and oral trauma have on a client’s sublingual nitroglycerin therapy prescribed to manage the angina? route changed to transdermal The nurse is teaching a client with angina who is prescribed sublingual tablets. The nurse would instruct the client to use a tablet at which frequency when experiencing an acute attack? Every 5 minutes A patient is using propranolol for treatment of angina. The nurse understands that this drug is administered by which route? Oral Anti-anginal drugs are used in the treatment of cardiac disease for what purposes? (Select all that apply.) Relieve the pain of acute anginal attacks. Prevent angina attacks. Treatment chronic stable angina pectoris. A patient arrives at the community health care center reporting chest pain and is diagnosed with angina pectoris. Which drug is administered for treating angina? Nicardipine Beta-adrenergic blocking agents decrease the oxygen demands of the heart by what mechanism? Decreasing the heart rate, allowing for longer filling time and increased blood to the heart A 54-year-old client has been prescribed sublingual nitroglycerin. After the nurse has finished teaching the client about the medication, what statement could the client make to suggest that the client understands proper self- administration? "I can take up to three tablets at five-minute intervals." The client is taking a calcium-channel blocker. What adverse effects might the client experience? Open Resources for Nursing (Open RN) Antianginal medication is used to treat angina pectoris. Angina is chest pain caused by inadequate blood flow, resulting in hypoxia of the cardiac tissue. Angina can be chronic pain caused by atherosclerosis in coronary artery disease or acute pain caused by a myocardial infarction. Antianginals increase blood flow to the heart or decrease oxygen demand by the heart. Nitrates promote vasodilation of coronary arteries and veins. Beta blockers and calcium channel blockers are also used to decrease workload of the heart and decrease oxygen demands. Nitrates may come in a variety of routes, such as sublingual, extended-release tablets, creams, transdermal patches, and intravenously. The grid below focuses on administration via sublingual tablets. Sublingual tablets are prescribed PRN (“as needed”) for patients who are experiencing chronic, stable angina due to coronary artery disease. Mechanism of Action Nitroglycerin relieves angina by relaxing vascular smooth muscle, resulting in vasodilation. Indications for Use Nitroglycerin is used to relieve angina due to coronary artery disease, during times of an acute attack, or prophylactically. Nursing Considerations Across the Lifespan Patients taking sildenafil (Viagra) or similiar medications for erectile dysfunction in the previous 24 hours may not take nitroglycerin as this may result in a dangerous drop in blood pressure. Nitroglycerin should not be used in pregnant women or those who are breastfeeding. Nitroglycerin is contraindicated in patients who have severe anemia, increased intracranial pressure, hypersensitivity, or circulatory failure. Adverse/Side Effects Patients taking nitroglycerin may experience hypotension, palpitations, headache, weakness, sweating, flushing, nausea, vomiting, or dizziness. Patients should allow medication to dissolve under their tongue. This route allows immediate absorption into the circulation and avoids first-pass metabolism by the liver. Patients may take up to one tablet every 5 minutes, up to 3 sublingual tablets within 15 minutes to relieve chest pain. If chest pain is not relieved after the first dose, 911 should be called. Nitroglycerin may also be used prophylactically 5 to 10 minutes prior to engaging in activities that might precipitate an acute attack. Patient Teaching & Education Instruct patients to avoid eating or smoking during administration as this may alter absorption. Patients should sit during administration to decrease the risk for injury due to the possibility of hypotension, dizziness, and weakness. Nitroglycerin decomposes when exposed to heat or light, so it should be stored in the original, airtight glass container. See Figure 6.24[1] for an image of nitroglycerin containers. [2] Historically, patients have been taught to seek emergency help (call 911) if pain persists after the 3rd dose of medication. However, new guidelines from the American Heart Association urge patients to call 911 after the first dose if symptoms are not improved or become worse.[3] Now let’s take a closer look at the medication grid for nitroglycerin in Table 6.8.[4] Table 6.8 Nitroglycerine Medication Grid
A patient was administered the first dose of nitroglycerin at 1305 for acute angina. What should the nurse evaluate after administration? Note: Answers to the Critical Thinking activities can be found in the “Answer Key” sections at the end of the book. Which lifestyle modifications will the nurse include when educating the patient with angina pectoris?Educate the patient on lifestyle modifications.
Treating the underlying cause requires lifestyle modifications such as reducing sodium and fat intake, quitting smoking, and increasing physical activity.
What would the nurse teach the client about the safe and effective use of nitroglycerin?Take nitroglycerin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Nitroglycerin may not work as well after you have used it for some time or if you have taken many doses. Take the fewest tablets needed to relieve the pain of your attacks.
Which medication combinations may be beneficial in treating angina?Combined treatment with beta blockers — The dihydropyridine calcium channel blockers and, in some cases, diltiazem can be used in combination with beta blockers for better control of angina. Verapamil, however, is usually not combined with beta blockers because combining the two drugs can markedly slow the heart rate.
Which rationale is behind administering calcium channel blockers to patients with angina?Calcium channel blockers minimise symptoms of angina by dilating coronary and other arteries and increasing coronary blood flow. Non-dihydropyridine calcium channel blockers (verapamil and diltiazem) also reduce myocardial contractility and heart rate and decrease myocardial oxygen demand.
|
Which instruction will the nurse include for a patient prescribed sublingual nitrate PRN for angina
zusammenhängende Posts
Urheberrechte © © 2024 membukakan Inc.
