Nitroglycerin – Pharmacology for Nurses: Practical Apps

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Chapter 23: Anti-Anginal Drugs Test , Nitroglycerin Ointment, Pharmacology for Nurses

The key terms in this Pharmacology course include Anti-anginal drugs test, Nitroglycerin Ointment, Calcium Channel Blocker (CCB), Patient, Nurse, Prevent, Medication, Transdermal Nitroglycerin Patch, Intravenous Nitroglycerin, Acute Myocardial Infarction, Sublingual Nitroglycerin Tablets, Adverse Effects.

When the nurse is administering topical nitroglycerin ointment, which technique is correct?

Apply the ointment only in the case of a mild angina episode.

Remove the old ointment before new ointment is applied.

Massage the ointment gently into the skin, and then cover the area with plastic wrap.

Apply the ointment on the skin on the forearm.

The old ointment should be removed before a new dose is applied. The ointment should be applied to clean, dry, hairless skin of the upper arms or body, not below the elbows or below the knees. The ointment is not massaged or spread on the skin, and it is not indicated for the treatment of acute angina.

A calcium channel blocker (CCB) is prescribed for a patient, and the nurse provides instructions to the patient about the medication. Which instruction is correct?

To increase the effect of the drug, take it with grapefruit juice.

A high-fiber diet with plenty of fluids will help prevent the constipation that may occur.

Chew the tablet for faster release of the medication.

If the adverse effects of chest pain, fainting, or dyspnea occur, discontinue the medication immediately.

Constipation is a common effect of CCBs, and a high-fiber diet and plenty of fluids will help to prevent it. Grapefruit juice decreases the metabolism of CCBs. Extended-release tablets must never be chewed or crushed. These medications should never be discontinued abruptly because of the risk for rebound hypertension.

When teaching a patient who has a new prescription for transdermal nitroglycerin patches, the nurse tells the patient that these patches are most appropriately used for which situation?

To prevent low blood pressure

To keep the heart rate from rising too high during exercise

To prevent the occurrence of angina

To relieve shortness of breath

Transdermal dosage formulations of nitroglycerin are used for the long-term prophylactic management (prevention) of angina pectoris. Transdermal nitroglycerin patches are not appropriate for the relief of shortness of breath, to prevent palpitations, or to control the heart rate during exercise.

The nurse is giving intravenous nitroglycerin to a patient who has just been admitted because of an acute myocardial infarction. Which statement is true regarding the administration of the intravenous form of this medication?

Non-polyvinylchloride (non-PVC) plastic intravenous bags and tubing must be used.

It can be given in infusions with other medications.

The solution will be slightly colored green or blue.

The intravenous form is given by bolus injection.

The non-PVC infusion kits are used to avoid absorption and/or uptake of the nitrate by the intravenous tubing and bag and/or decomposition of the nitrate. The medication is given by infusion via an infusion pump and not with other medications. It is not given by bolus injection. If the parenteral solution is not clear, it should be discarded.

The nurse is providing education about the use of sublingual nitroglycerin tablets. She asks the patient, “What would you do if you experienced chest pain while mowing your yard? You have your bottle of sublingual nitroglycerin with you.” Which actions by the patient are appropriate in this situation? (Select all that apply.)

Place a tablet in the space between the gum and cheek.

Call 911 immediately.

Call 911 if the pain is not relieved after taking three sublingual tablets in 15 minutes.

Stop the activity, and lie down or sit down.

Call 911 if the pain is not relieved after taking one sublingual tablet.

Place a tablet under the tongue.

Take another sublingual tablet if chest pain is not relieved after 5 minutes, up to three total.