A nurse is reinforcing teaching with a client who uses a nitroglycerine patch to treat angina. The client now has a new prescription for nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?

(A) Swallow the tablet whole with an 8 oz glass of water.
Sublingual nitroglycerin tablets should not be swallowed. They need to be placed under the tongue where they can dissolve and be absorbed quickly to provide rapid relief from angina.

(B) Store the medication in a pill box at the bedside.
Nitroglycerin sublingual tablets should be stored in their original container and kept tightly closed to protect them from light and moisture. Storing them in a pill box at the bedside could lead to degradation of the medication.

(C) Take the medication at the first indication of chest pain.
This is the correct instruction. Nitroglycerin sublingual tablets should be taken at the first sign of chest pain to provide prompt relief. The rapid onset of action helps to alleviate angina symptoms quickly.

(D) Remove the nitroglycerine patch before taking the sublingual tablet.
It is not necessary to remove the nitroglycerin patch before taking a sublingual tablet. The two forms of nitroglycerin can be used together, as the patch provides a continuous dose while the sublingual tablet offers rapid relief of acute symptoms.

A. "Report any incidents of swelling to your lips, tongue or face."

Angioedema is a serious side effect of lisinopril, which is an ACE inhibitor. Swelling of the lips, tongue, or face can indicate angioedema, which can be life-threatening and requires immediate medical attention.

B. "Report the development of a persistent dry cough."

A persistent dry cough is a common side effect of ACE inhibitors like lisinopril. If this occurs, the healthcare provider should be notified as an alternative medication may be needed.

C. "Your cholesterol levels should be monitored monthly while taking this medication."

Monitoring cholesterol levels is not typically necessary for clients taking lisinopril. This instruction is more relevant for medications affecting lipid levels, such as statins.

D. "Make sure your diet contains a lot of potassium-rich foods."

Lisinopril can cause hyperkalemia (high potassium levels). Therefore, it is important to avoid excessive intake of potassium-rich foods to prevent complications. Clients should be advised to monitor potassium intake rather than increase it.

E. "Monitor your blood pressure on a regular basis."

Regular monitoring of blood pressure is essential for clients taking lisinopril to ensure the medication is effectively managing their hypertension and to adjust dosages as necessary.