A nurse is reinforcing discharge teaching with client who has stable angina pectoris. Which of the following statements by the client indicates an understanding of what to do when chest pain occurs?

A) "The headaches should decrease as you get used to the medication.": This statement is correct. A common side effect of isosorbide dinitrate is headaches, as the medication works by dilating blood vessels, which can cause a drop in blood pressure. These headaches typically occur when the medication starts, but they often decrease over time as the body adjusts to the drug. The nurse should reassure the client that this side effect is generally temporary.

B) "You should take the medication on an empty stomach to prevent a headache.": This statement is incorrect. While taking certain medications on an empty stomach may affect their absorption, isosorbide dinitrate is typically not recommended to be taken on an empty stomach to avoid headaches. In fact, it is more common for people to take it with food if it causes gastrointestinal discomfort, but this is not directly related to preventing headaches.

C) "You can discontinue the medication until the headache goes away.": This statement is incorrect. The client should not discontinue the medication without consulting the healthcare provider. Abruptly stopping isosorbide dinitrate can lead to withdrawal symptoms and potentially worsen the client's condition. The nurse should encourage the client to talk to their provider if the headache becomes unbearable or persistent, but not to stop the medication without guidance.

D) "Swallow the tablet whole to minimize your headaches.": This statement is incorrect. Isosorbide dinitrate in chewable form is designed to be chewed, as this method of administration helps the drug be absorbed more quickly and effectively. Swallowing the tablet whole would not address the issue of headaches and could affect how the medication works.

A) "I get nervous when I'm in a large group": Social anxiety or nervousness in large groups is common, especially during adolescence. While it can indicate discomfort in social situations, it is not necessarily a warning sign of suicidal ideation.

B) "My partner and I had our first argument last night": Relationship conflicts are a normal part of adolescent development, and although they can cause emotional distress, a single argument does not typically indicate a risk for suicide. It’s important to assess the client’s overall emotional state and coping mechanisms, but this statement alone does not suggest suicidal thoughts.

C) "I am not interested in anything anymore.": This statement is a red flag for depression and potential suicidal ideation. A loss of interest or pleasure in activities that were once enjoyable (anhedonia) is a core symptom of depression, which can be a significant risk factor for suicide. This warrants further exploration and immediate attention from the nurse.

D) "I'm not sleeping much because of all the homework I have.": While lack of sleep can be a concern and may affect an adolescent’s overall health and well-being, it is more likely related to stress or academic pressure rather than suicidal thoughts. Sleep disturbances in adolescents are common, particularly when facing high academic expectations, but this is not an immediate sign of suicide risk.