A nurse is teaching a client who has angina about nitroglycerin sublingual tablets. Which of the following statements should the nurse include in the teaching?
"This medication decreases chest pain by dissolving blood clots that are occluding the arteries."
"Place one tablet under your tongue every 15 minutes and repeat up to 5 times for relief of chest pain"
"This medication is the first line treatment for hypertension"
"This medication dilates cardiac blood vessels to deliver more oxygen to the heart."
The Correct Answer is D
A) "This medication decreases chest pain by dissolving blood clots that are occluding the arteries.": This statement is incorrect because nitroglycerin does not dissolve blood clots. Instead, it works by relaxing and dilating blood vessels, which helps improve blood flow to the heart muscle and relieve angina.
B) "Place one tablet under your tongue every 15 minutes and repeat up to 5 times for relief of chest pain.": This is not accurate; while nitroglycerin can be taken sublingually, the typical recommendation is to take one tablet every 5 minutes as needed for chest pain, not every 15 minutes, and not to exceed 3 tablets within 15 minutes.
C) "This medication is the first-line treatment for hypertension.": Although nitroglycerin can lower blood pressure, it is not typically considered a first-line treatment for hypertension. It is primarily used for angina relief rather than as a primary antihypertensive agent.
D) "This medication dilates cardiac blood vessels to deliver more oxygen to the heart.": This statement accurately describes the action of nitroglycerin. By dilating the coronary arteries, nitroglycerin increases blood flow and oxygen delivery to the heart muscle, which helps alleviate angina symptoms. This is a key point to emphasize during patient education.
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Correct Answer is B
Explanation
A) Carvedilol: While carvedilol is a beta-blocker that can be used to treat hypertension, it is not considered a first-line treatment. Beta-blockers are typically used when other first-line agents are not effective or in specific situations such as heart failure or ischemic heart disease.
B) Lisinopril: Lisinopril is an ACE inhibitor and is considered a first-line treatment for hypertension. It effectively reduces blood pressure by inhibiting the angiotensin-converting enzyme, leading to vasodilation and decreased blood volume. Its well-documented efficacy and favorable side effect profile make it a common choice for initial therapy.
C) Clonidine: Clonidine is an alpha-2 adrenergic agonist that can lower blood pressure but is generally not used as a first-line treatment due to its side effects and potential for rebound hypertension if discontinued abruptly.
D) Doxazosin: Doxazosin is an alpha-1 blocker that can be used to treat hypertension but is not typically a first-line choice. It may be used in specific cases, such as in patients with benign prostatic hyperplasia, but other classes of medications are usually preferred for initial hypertension treatment.
Correct Answer is ["A","C","D"]
Explanation
A) Masking of hypoglycemia: Propranolol can mask the symptoms of hypoglycemia, such as tachycardia, which is important for clients with diabetes to be aware of. This means that while they may have low blood sugar, they might not experience the typical warning signs due to the medication's effects on the autonomic nervous system.
B) Tachycardia: Propranolol is a beta-blocker that is used to reduce heart rate and blood pressure. Therefore, tachycardia is not a side effect associated with this medication; in fact, it generally works to prevent this condition.
C) Bradycardia: Bradycardia, or a slow heart rate, is a common side effect of propranolol due to its action on beta-adrenergic receptors. Clients should be educated about monitoring their heart rate and reporting any significant drops.
D) Orthostatic Hypotension: This is a potential side effect of propranolol, especially when starting the medication or increasing the dose. Clients should be advised to rise slowly from sitting or lying positions to minimize the risk of dizziness or fainting.
E) Hypertension: Propranolol is prescribed to manage hypertension, so it should not be expected as a side effect. In fact, it is intended to lower blood pressure, and clients should be educated that they should not experience increased hypertension while taking this medication.