A nurse is teaching a client who has a new prescription for a nitroglycerin transdermal patch.
Which of the following instructions should the nurse include?
Apply a new patch if you have chest pain.
Discontinue the patch if you experience a headache.
Remove the patch prior to going to bed.
Cover the patch with dry gauze when taking a shower.
The Correct Answer is C
Nitroglycerin transdermal patches are used to prevent episodes of angina (chest pain) in people who have coronary artery disease (narrowing of the blood vessels that supply blood to the heart). They work by relaxing the blood vessels so that the heart does not need to work as hard and therefore does not need as much oxygen.
Choice A is wrong because nitroglycerin transdermal patches cannot be used to treat an attack of angina once it has begun. They can only be used to prevent attacks of angina. If you have chest pain, you should use another form of nitroglycerin, such as sublingual tablets or spray.
Choice B is wrong because headache is a common side effect of nitroglycerin transdermal patches and does not mean that you should stop using them. However, you should tell your doctor if the headaches are severe or do not go away. You may also take acetaminophen to relieve the headache.
Choice D is wrong because you do not need to cover the patch with dry gauze when taking a shower. You may shower while you are wearing a nitroglycerin skin patch. If a patch loosens or falls off, replace it with a fresh one.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The most appropriate action for the nurse to take in this situation is:
d. Apply a warm, moist compress.
Here's why the other options are not recommended:
- a. Initiate a new IV distal to the initial site:This is not the first course of action. While starting a new IV might be necessary eventually, it's crucial to address the issue at the current site first.
- b. Slow the IV solution rate:Slowing the rate doesn't directly address the coolness and edema, which indicate potential infiltration or extravasation.
- c. Maintain the extremity below the level of the heart:This action would actually worsen the edema by promoting fluid accumulation at the site.
Applying a warm, moist compress can help promote absorption of any leaked fluid and improve circulation at the site. However, it's important to remember that this is just one step in the process. The nurse should also:
- Stop the IV infusion.
- Assess the extent of the infiltration or extravasation.
- Document the findings.
- Elevate the affected extremity.
- Consult with a physician for further instructions and potential treatment.
Correct Answer is D
Explanation
Distended neck veins are a sign of increased central venous pressure, which can result from fluid volume excess. Fluid volume excess can also cause edema, crackles in the lungs, and increased blood pressure.
Choice A is wrong because decreased bowel sounds are not related to fluid volume excess.
Decreased bowel sounds can indicate ileus, obstruction, or peritonitis. Choice B is wrong because bilateral muscle weakness is not a sign of fluid volume excess.
Bilateral muscle weakness can be caused by electrolyte imbalances, neuromuscular disorders, or stroke.
Choice C is wrong because thready pulse is a sign of fluid volume deficit, not excess.
Thready pulse indicates poor perfusion and low cardiac output, which can result from dehydration, hemorrhage, or shock.
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