A nurse working in an alternative therapy clinic is assisting in the care of a client who has elevated cholesterol levels. Which of the following should the nurse recommend?

Rationale:

A. Nifedipine: Nifedipine is a calcium channel blocker that helps reduce myocardial oxygen demand by decreasing afterload and dilating coronary arteries. However, it is not the priority in acute chest pain management because it has a slower onset compared to nitroglycerin.

B. Nitroglycerin: Nitroglycerin is the priority medication for acute angina. It works rapidly by dilating coronary arteries and reducing myocardial oxygen demand, which helps relieve chest pressure and prevent progression to myocardial infarction.

C. Atenolol: Atenolol, a beta-blocker, decreases heart rate and contractility to reduce myocardial oxygen consumption. While useful for long-term angina management, it is not the first-line agent for immediate chest pain relief in acute settings.

D. Clopidogrel: Clopidogrel is an antiplatelet agent that prevents clot formation, often used in long-term management or following stent placement. It does not provide immediate relief from angina and is therefore not the priority medication in this scenario.

Rationale:

A. Mix the medication in juice prior to administration: Montelukast can be mixed with soft foods like applesauce, but mixing it in juice is not specifically recommended due to potential taste masking and dosing accuracy issues. Instructions should follow the manufacturer’s guidelines.

B. Administer the medication when the toddler has an acute asthma attack: Montelukast is a maintenance medication used to prevent asthma symptoms and is not effective for treating acute asthma attacks. A rescue inhaler like albuterol should be used during acute episodes.

C. Provide an additional dose of the medication prior to physical activity: Montelukast is not typically dosed in response to physical activity. While it can help prevent exercise-induced bronchospasm, it should be taken once daily in the evening, not additionally before exertion.

D. Administer the medication to the toddler each evening: Montelukast is prescribed as a once-daily maintenance therapy and is most effective when given in the evening. This helps maintain consistent blood levels and prevents nighttime asthma symptoms.