A nurse in a provider's clinic is assessing a client who takes sublingual nitroglycerin for stable angina. The client reports getting a headache each time he takes the medication. Which of the following statements should the nurse make?

"Take only one dose of nitroglycerin to reduce the risk of getting a headache."

"There's nothing that can be done to relieve the headaches that nitroglycerin causes."

"We will ask the provider to prescribe a diﬀerent medication for you."

"Try taking a mild analgesic to relieve the headache."

Answer and Explanation

The Correct Answer is D

Nitroglycerin is a vasodilator that relaxes smooth muscle in blood vessels and reduces myocardial oxygen demand. It is used to treat and prevent angina atacks. A common side eﬀect of nitroglycerin is headache, which is caused by cerebral vasodilation. The nurse should advise the client to take a mild analgesic, such as acetaminophen, to relieve the headache. The headache usually subsides with continued use of nitroglycerin.

The other options are not correct because:

"Take only one dose of nitroglycerin to reduce the risk of getting a headache." This statement is incorrect because it may compromise the eﬀectiveness of nitroglycerin in relieving angina. The client should follow the prescribed dosage and frequency of nitroglycerin, which is usually one tablet every 5 minutes for up to three doses, as needed for chest pain.

"There's nothing that can be done to relieve the headaches that nitroglycerin causes." This statement is incorrect because it is discouraging and dismissive of the client's concern. The nurse should acknowledge the client's

discomfort and oﬀer suggestions for managing the side eﬀect, such as taking a mild analgesic or lying down in a dark room.

"We will ask the provider to prescribe a diﬀerent medication for you." This statement is incorrect because it implies that nitroglycerin is not suitable for the client and may cause unnecessary anxiety or confusion. The nurse should explain that nitroglycerin is an eﬀective and safe medication for angina and that the headache is a common and transient side eﬀect that can be managed with simple measures. The nurse should also inform the client that there are other forms of nitroglycerin, such as patches or sprays, that may have less headache-inducing eﬀects. However, changing the medication or the route of administration should be done only after consulting with the provider.

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Correct Answer is D

Explanation

Hypokalemia is a low serum potassium level, usually below 3.5 mEq/L. It can be caused by diuretics that increase potassium excretion, such as thiazides or loop diuretics. Potassium is essential for normal muscle and nerve function, and hypokalemia can impair cardiac, skeletal, and smooth muscle activity. Symptoms of hypokalemia include fatigue, weakness, muscle cramps, arrhythmias, constipation, and hyporeﬂexia.

Dyspnea is difficulty or labored breathing that can be caused by various respiratory or cardiac conditions, such as asthma, pneumonia, pulmonary edema, or heart failure. It is not a specific sign of hypokalemia, although severe hypokalemia can aﬀect respiratory muscle function and cause respiratory failure.
Oliguria is a reduced urine output, usually less than 400 mL per day or 30 mL per hour. It can be caused by various renal or ﬂuid balance disorders, such as acute kidney injury, dehydration, or shock. It is not a specific sign of hypokalemia, although severe hypokalemia can impair renal function and cause renal failure.
Pitting edema is a swelling of the tissues that leaves an indentation when pressed with a finger. It can be caused by various ﬂuid retention disorders, such as heart failure, liver cirrhosis, or nephrotic syndrome. It is not a specific sign of hypokalemia, although severe hypokalemia can aﬀect ﬂuid and electrolyte balance and cause edema.

A. "Apply ice packs to your legs." B. "Place your legs in a dependent position while in bed." C. "Remain on bed rest." D. "Use elastic stockings."

Correct Answer is D

Explanation

Using elastic stockings is an eﬀective way to improve venous return and prevent edema, stasis, and ulceration in clients who have venous insufficiency. The stockings should be applied before getting out of bed and worn throughout the day.

"Apply ice packs to your legs." is not appropriate, as ice packs can cause vasoconstriction and impair blood ﬂow to the legs, worsening the condition.

"Place your legs in a dependent position while in bed." is not advisable, as dependent position can increase venous pressure and ﬂuid accumulation in the legs, leading to edema, pain, and skin breakdown

"Remain on bed rest." is not necessary, as bed rest can reduce muscle contraction and impair venous return. The client should be encouraged to perform regular exercise, such as walking, to enhance circulation and prevent complications.

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A nurse in a provider's clinic is assessing a client who takes sublingual nitroglycerin for stable angina. The client reports getting a headache each time he takes the medication. Which of the following statements should the nurse make?

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Correct Answer is D

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