Author Question: A patient with angina who uses sublingual nitroglycerin tells the nurse that the episodes are ... (Read 111 times)

leo leo · **on:** Jul 23, 2018

A patient with angina who uses sublingual nitroglycerin tells the nurse that the episodes are increasing in frequency and usually occur when the patient walks the dog.

The patient reports needing almost daily doses of the nitroglycerin and states that one tablet usually provides complete relief. What will the nurse do?
a. Contact the provider to suggest ordering a transdermal patch for this patient.
b. Question the patient about consumption of grapefruit juice.
c. Suggest that the patient limit walking the dog to shorter distances less frequently.
d. Suggest that the patient take two tablets of nitroglycerin each time, because the symptoms are increasing in frequency.

Question 2

A patient is being started on nicotinic acid (Niaspan) to reduce triglyceride levels. The nurse is providing patient education and should include which adverse effects? (Select all that apply.)

a. Facial flushing
b. Constipation
c. Hypoglycemia
d. Gastric upset
e. Itching

chjcharjto14 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: A
Transdermal patches are good for sustained prophylaxis for anginal attacks and are especially useful when patients have a regular pattern of attacks. Grapefruit juice does not affect the metabolism of nitroglycerin. Patients with angina should be encouraged to increase, not decrease, exercise. Taking two tablets is not recommended when one is effective.

Answer to Question 2

ANS: A, D, E
Adverse effects of nicotinic acid include intense flushing of the face, neck, and ears; itching; and GI upset (nausea, vomiting, and diarrhea). Constipation and hypoglycemia are not adverse effects of niacin therapy.