A patient with stable exertional angina has been receiving a beta ...

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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]

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.

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Excellent

[strudel15]

TYSM