Author Question: A patient with stable exertional angina has been receiving a beta blocker. Before giving the drug, ... (Read 44 times)

plus1 · **on:** Jul 23, 2018

A patient with stable exertional angina has been receiving a beta blocker. Before giving the drug, the nurse notes a resting heart rate of 55 beats per minute. Which is an appropriate nursing action?

a. Administer the drug as ordered, because this is a desired effect.
b. Withhold the dose and notify the provider of the heart rate.
c. Request an order for a lower dose of the medication.
d. Request an order to change to another antianginal medication.

Question 2

A hospitalized patient complains of acute chest pain. The nurse administers a 0.3 mg sublingual nitroglycerin tablet, but the patient continues to complain of pain. Vital signs remain stable. What is the nurse's next step?

a. Apply a nitroglycerin transdermal patch.
b. Continue dosing at 10-minute intervals.
c. Give a second dose of nitroglycerin in 5 minutes.
d. Request an order for intravenous nitroglycerin.

tashiedavis420 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: A
When beta blockers are used for anginal pain, the dosing goal is to reduce the resting heart rate to 50 to 60 beats per minute. Because this heart rate is a desired effect, there is no need to withhold the dose or notify the provider. The dosage does not need to be lowered, because a heart rate of 55 beats per minute is a desired effect. There is no indication of a need to change medications for this patient.

Answer to Question 2

ANS: C
An initial dose of sublingual nitroglycerin is taken, and if the chest pain persists, as in this case, the patient should take another dose in 5 minutes. Transdermal delivery systems are not useful for terminating an ongoing attack. Dosing at 10-minute intervals is incorrect. If the patient fails to respond or if the pain intensifies, intravenous nitroglycerin may be indicated.