A patient begins taking nitroglycerin for acute angina attacks ...

[drink]

A patient begins taking nitroglycerin for acute angina attacks and comes to the clinic for a follow-up appointment. The patient reports the development of a headache when taking a ni-troglycerin tablet. What information should the nurse provide?
 
  a. Headache is common because of the vasodilatory effects of the medication.
  b. Headache means that the levels of the nitroglycerin are effective.
  c. Headache could mean the dose is too high, causing vasodilation.
  d. Headache is an atypical symptom, but blood pressure should be checked.

Question 2

A patient is admitted to the emergency department for a severe migraine headache.
 
  The patient tells the nurse that she has used Cafergot (ergotamine tartrate and caffeine) for frequent migraine headaches over the past 6 months and has been experiencing numbness and tingling in the fingers and toes. The nurse should further assess the patient for which of the following signs and symptoms? (Select all that apply.) a. Diminished peripheral pulses
  b. Muscle aches
  c. Pallor of the extremities
  d. Nausea
  e. Vomiting

[briezy]

Answer to Question 1

A
Initial therapy can produce a severe headache. This response diminishes over the first few weeks of treatment.
A headache would not signify that the level of nitroglycerin is effective, nor does it indicate that the dose is too high.
Headache is a typical symptom, so a response indicating that it is atypical would also be incor-rect.

Answer to Question 2

A, B, C
Chronic use of Cafergot can lead to overdose, which should be suspected in this case because the patient has had frequent episodes of migraines and subsequent numbness and tingling in the fin-gers and toes. Overdose can cause ischemia secondary to constriction of peripheral arteries and arterioles, which can cause the extremities to become cold, pale, and numb. Muscle pain develops, and gangrene eventually may result.
Nausea and vomiting are side effects, not the effects of a possible overdose of Cafergot.

[drink]

Excellent

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