Patients taking which cholesterol-lowering agent may require supplements of fat-soluble vitamins A, D, E, and K?

Nitroglycerin is a medication that dilates the blood vessels and improves blood flow to the heart. It is used to treat angina, a condition that causes chest pain due to reduced oxygen supply to the heart. However, nitroglycerin can lose its effectiveness over time if it is used continuously. This is called tolerance, and it means that the patient will need higher doses of the medication to achieve the same relief. To avoid tolerance, patients who use transdermal nitroglycerin patches are instructed to remove the patch at bedtime and apply a new one in the morning. This creates a nitrate-free interval of about 8 to 12 hours, which allows the body to restore its sensitivity to nitroglycerin.

Choice A is wrong because an allergic response is not a common side effect of nitroglycerin. Some patients may experience skin irritation or rash at the site of application, but this is usually mild and does not require discontinuation of the medication.

Choice C is wrong because overdosage is unlikely with transdermal nitroglycerin patches. The patches deliver a controlled amount of nitroglycerin through the skin over a period of time. The risk of overdosage is higher with other forms of nitroglycerin, such as tablets or sprays, which are taken as needed for acute angina attacks.

Choice D is wrong because forgetting to remove the patch in the morning is not a serious problem. The patch will continue to deliver nitroglycerin until it is removed, but it will not cause harm to the patient. However, it may reduce the effectiveness of the next patch if there is no nitrate-free interval between them.

This is because elevating the legs can help reduce swelling and improve blood flow back to the heart by reducing the effects of gravity.Elevating the legs can also prevent blood from pooling in the veins and reduce the risk of blood clots.

Choice A is wrong because dangling the legs can increase swelling and pressure in the veins, which can worsen peripheral venous disease (PVD) symptoms and complications.

Choice B is wrong because sitting in one position for prolonged hours can impair blood circulation and increase the risk of blood clots, especially in the lower legs.People with PVD should avoid crossing their legs, wearing tight clothing, or sitting for long periods without moving.

Choice D is wrong because standing in one position can also increase swelling and pressure in the veins, which can lead to pain, ulcers, and skin changes.People with PVD should avoid standing for long periods without moving or changing positions.

Some additional information:

Peripheral venous disease (PVD) is a condition that affects blood flow in the veins and arteries outside of your heart and brain.

It can be caused by narrowing, blocking, or spasming of the blood vessels, or by blood clots in the veins.PVD can cause pain and fatigue, especially in the legs, and can lead to serious complications such as gangrene or amputation.

The most common cause of PVD is atherosclerosis, the buildup of plaque inside the artery wall.

Plaque reduces the amount of blood flow to the limbs and decreases the oxygen and nutrients available to the tissue.Other causes of PVD may include injury, infection, irregular anatomy of muscles or ligaments, or inflammation of the blood vessels.

The normal range of blood pressure in the veins is about 10 to 20 mmHg.

The normal range of oxygen saturation in the veins is about 60 to 80%.

The normal range of pulse rate in the veins is about 60 to 100 beats per minute.