A nurse is teaching a client who has angina pectoris about starting therapy with SL nitroglycerin tablets. The nurse should include which of the following instructions regarding how to take the medication?
Take this medication after each meal and at bedtime.
Take one tablet every 15 min during an acute atack.
Take this medication with 8 ounces of water.
Take one tablet at the first indication of chest pain.
The Correct Answer is D
Taking one tablet at the first indication of chest pain is the correct way to use SL nitroglycerin tablets, as they are fast- acting and can relieve anginal symptoms within minutes. The client should place the tablet under the tongue and let it dissolve.
Taking one tablet at the first indication of chest pain is the correct way to use SL nitroglycerin tablets, as they are fast- acting and can relieve anginal symptoms within minutes. The client should place the tablet under the tongue and let it dissolve.
Taking this medication after each meal and at bedtime is not appropriate, as SL nitroglycerin tablets are not meant for routine or prophylactic use, but only for acute episodes of angina.
Taking one tablet every 15 min during an acute attack is not correct, as the client should not exceed three doses in 15 min. If the pain is not relieved after three doses, the client should seek emergency medical attention.
Taking this medication with 8 ounces of water is not necessary, as SL nitroglycerin tablets do not need to be swallowed or washed down with water. They should be dissolved under the tongue for optimal absorption.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
a.This is appropriate as regular, moderate exercise can help improve cardiovascular health and functional capacity in clients with heart failure. It is essential to discuss appropriate types and levels of exercise based on the individual’s condition.
b.This is incorrect because clients should be instructed to notify the provider if they gain 1 kg (2.2 lbs) in one day or 2 kg (4.4 lbs) in one week. A weight gain of 0.5 kg is not typically a threshold for concern.
c. Take diuretics early in the morning and before bedtime is wrong because it may disrupt the client's sleep patern and cause nocturia. The nurse should advise the client to take diuretics early in the morning and avoid taking them in the evening or at night, unless prescribed otherwise.
d. Take naproxen for generalized discomfort is wrong because naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that can worsen heart failure by causing sodium and water retention, increasing blood pressure, and reducing the effectiveness of diuretics and other heart failure medications. The nurse should advise the client to avoid NSAIDs and use acetaminophen or other alternatives for pain relief, as prescribed by the provider.
Correct Answer is A
Explanation
Phenytoin is an anticonvulsant medication that is used to prevent and treat seizures. It works by stabilizing the electrical activity of the brain and reducing the spread of abnormal impulses. Phenytoin is usually taken for life or until the seizures are controlled by other means, such as surgery or diet. The client should not stop taking phenytoin without consulting their doctor, as this can cause withdrawal symptoms or increase the risk of seizures.
The other options are correct and indicate that the client understands the discharge teaching because:
- "I have made an appointment to see my dentist next week." This statement is correct because phenytoin can cause gingival hyperplasia, which is an overgrowth of gum tissue that can lead to bleeding, infection, or difficulty chewing. The client should practice good oral hygiene and see their dentist regularly to prevent or treat this condition.
- "I will notify my doctor before taking any other medications." This statement is correct because phenytoin can interact with many other medications, such as antibiotics, anticoagulants, oral contraceptives, or antacids. These interactions can affect the blood levels and effectiveness of phenytoin or the other medications, causing adverse effects or reduced seizure control. The client should inform their doctor of any other medications they are taking or planning to take, including over-the-counter, herbal, or dietary supplements.
- "I know that I cannot switch brands of this medication." This statement is correct because different brands of phenytoin may have different formulations or bioavailability, which can affect the absorption and metabolism of the drug. Switching brands can cause changes in the blood levels and effectiveness of phenytoin, leading to toxicity or reduced seizure control. The client should always use the same brand of phenytoin and check with their pharmacist if they notice any changes in the appearance or labeling of their medication.
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