A nurse is reinforcing teaching with a client who has angina pectoris about starting therapy with nitroglycerin sublingual tablets. Which of the following statements by the client indicates an understanding of the teaching?

"I will take the first tablet when the pain becomes severe."

"I will take no more than four tablets in 10 min."

"I will chew the tablet before swallowing."

"I will dial 911 if one tablet does not relieve my pain."

Answer and Explanation

The Correct Answer is D

A) "I will take the first tablet when the pain becomes severe.": This statement is incorrect because nitroglycerin should be taken at the onset of chest pain, not when it becomes severe. Early administration can help prevent the pain from worsening and reduce the risk of a heart attack. Waiting until the pain is severe may delay relief and increase the risk of serious complications.

B) "I will take no more than four tablets in 10 min.": This is incorrect as the standard protocol for nitroglycerin sublingual tablets typically involves taking one tablet every 5 minutes, up to three doses in 15 minutes, if needed. Taking four tablets in 10 minutes exceeds the recommended dosage and could lead to severe hypotension, dizziness, and fainting. It’s crucial to follow the prescribed limits to avoid these adverse effects.

C) "I will chew the tablet before swallowing.": This is incorrect because nitroglycerin sublingual tablets are designed to dissolve under the tongue for rapid absorption into the bloodstream. Chewing or swallowing the tablet would decrease its effectiveness and delay pain relief. The sublingual route allows the medication to bypass the digestive system and work quickly to relieve chest pain.

D) "I will dial 911 if one tablet does not relieve my pain.": This is the correct response. If chest pain is not relieved within 5 minutes after taking the first nitroglycerin tablet, it may indicate a more serious condition such as a heart attack. The client should call 911 to seek immediate medical assistance. Prompt action is critical in managing potential cardiac events and improving outcomes for the client.

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Correct Answer is B

Explanation

A) Serum calcium 10.5 mg/dL:
A serum calcium level of 10.5 mg/dL is within the normal range (8.5-10.5 mg/dL). Spironolactone does not typically affect calcium levels significantly.

B) Serum potassium 5.2 mEq/L:
An elevated serum potassium level (hyperkalemia) is a known adverse effect of spironolactone. Spironolactone is a potassium-sparing diuretic that inhibits aldosterone, leading to decreased potassium excretion and potential hyperkalemia, especially in clients with impaired renal function.

C) Serum chloride 99 mEq/L:
A serum chloride level of 99 mEq/L is within the normal range (96-106 mEq/L). Spironolactone does not typically affect chloride levels significantly.

D) Serum sodium 140 mEq/L:
A serum sodium level of 140 mEq/L is within the normal range (135-145 mEq/L). Spironolactone does not typically affect sodium levels significantly.

Correct Answer is ["1"]

Explanation

To determine how many hydrochlorothiazide tablets to administer per dose, we can perform a simple calculation:

Identify the prescribed dose: The nurse needs to administer 25 mg of hydrochlorothiazide per dose.

Identify the tablet strength: Each available tablet contains 50 mg of hydrochlorothiazide.

Calculate the number of tablets: We need to find out how many 50 mg tablets are needed to deliver the prescribed 25 mg dose.

Here, dividing the prescribed dose by the tablet strength will tell us how many tablets are required:

Number of tablets = Prescribed dose / Tablet strength

Number of tablets = 25 mg / 50 mg/tablet

Since the division results in 0.5, we need to round to the nearest whole number for medication administration.

Therefore, the nurse should administer 1 tablet of hydrochlorothiazide per dose.

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A nurse is reinforcing teaching with a client who has angina pectoris about starting therapy with nitroglycerin sublingual tablets. Which of the following statements by the client indicates an understanding of the teaching?

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