Although he has been taking sublingual nitroglycerin (SL NTG) for ...

[silviawilliams41]

Although he has been taking sublingual nitroglycerin (SL NTG) for a long time, you want to be certain he is using it correctly. Which actions are correct when taking SL NTG for chest pain? (Select all that apply.)
 
  a. Stop the activity and lie or sit down.
  b. Call 911 immediately.
  c. Call 911 if the pain is not relieved after taking one SL tablet.
  d. Call 911 if the pain is not relieved after taking three SL tablets, 5 minutes apart.
  e. Chew the tablet slowly then swallow.
  f. Place the NTG tablet under the tongue.

Question 2

You know that G.P. has atherosclerosis of the coronary arteries. You need to know his risk factors for CAD to plan teaching for lifestyle modifications.
 
  What will you ask him about?

[karmakat49]

Answer to Question 1

Answers: a, c, f
SL NTG should be placed under the tongue and allowed to dissolve naturally and not swallowed
until the drug is entirely dissolved. G.P. should sit or lie down on first indication of anginal pain and
place the tablet under his tongue. Lying down will reduce hypotensive effects. According to the
latest American Heart Association guidelines, 911 (the emergency medical system EMS) should
be called if the pain is not relieved after one SL tablet. Pain that is not relieved by one tablet may be
indicative of acute myocardial infarction (MI) or severe coronary insufficiency.

Answer to Question 2

Family history: Ask for specific information regarding his relatives who had CAD.
Weight: Obesity is a serious risk factor; calculate his body mass index (BMI) and waist-hip ratio.
Smoking history
Blood pressure: According to the new JNC 8 guidelines, for a person age 60 or older, the goal is systolic
blood pressure (SBP) less than 150 mm Hg and diastolic blood pressure (DBP) less than 90 mm Hg.
Diet: Ask about his favorite foods. For example, ask, What did you eat for breakfast, lunch, and
dinner yesterday and today?
Stress: Find out what stressors he has in his life and what he does when he is feeling stressed.
Exercise: Does he exercise? If so, what kind of exercises does he do? Does he have angina or become
short of breath when he exercises or does yard work?
Drug use: Has he taken any street drugs or abused prescription medication in the past? If yes, take a
complete drug history: type, quantity, frequency, route.