The nurse should teach the patient to report which of the following to the health care provider immediately if experienced after taking nitroglycerin?
Flushing of the face
Dizziness upon standing
Persistent chest pain that lasts longer than 15 minutes
Mild headache
The Correct Answer is C
A) Flushing of the face:
Flushing is a common and usually harmless side effect of nitroglycerin, caused by its vasodilation properties. It often resolves quickly and is not typically a cause for concern. While it can be uncomfortable, it is not a sign of a serious problem that would require immediate medical attention.
B) Dizziness upon standing:
Dizziness upon standing (orthostatic hypotension) is a known side effect of nitroglycerin due to its blood pressure-lowering effects. It typically occurs when the patient rises too quickly from a sitting or lying position. While it can be uncomfortable and may cause the patient to feel lightheaded, it is usually not an emergency and can often be managed by rising slowly. If dizziness persists or is severe, the healthcare provider should be notified, but it is not an immediate emergency.
C) Persistent chest pain that lasts longer than 15 minutes:
Chest pain lasting longer than 15 minutes could indicate a myocardial infarction (heart attack) rather than stable angina, even if nitroglycerin has been administered. Chest pain that is not relieved by nitroglycerin or persists for more than a few minutes is an emergency situation and should be reported immediately to the healthcare provider or emergency services.
D) Mild headache:
Headache is a common and benign side effect of nitroglycerin, caused by its vasodilation effect. It is usually mild and transient and does not require immediate medical attention. In most cases, the headache improves over time or with the use of over-the-counter pain relievers, and it is not a reason to contact the healthcare provider unless it becomes severe or persistent.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) 6 Units Regular Insulin sub-cut:
According to the sliding scale, a blood glucose level of 164 mg/dL would not fall within the range requiring 6 units of insulin. The 6-unit dose is for blood glucose levels between 301-490 mg/dL. Since the client's reading of 164 mg/dL is lower than 181 mg/dL, this dosage is not applicable.
B) 2 Units Regular Insulin sub-cut:
This is also incorrect. The 2-unit dose is prescribed for blood glucose levels between 181-240 mg/dL. Since the client's reading is 164 mg/dL, it falls below this range, so 2 units is not appropriate.
C) 0.5 Units Regular insulin sub-cut:
This is not correct because there is no provision in the sliding scale for administering 0.5 units of insulin. The scale provides dosing for specific ranges and does not include fractional doses. Additionally, the blood glucose reading of 164 mg/dL does not require any insulin according to the prescribed sliding scale.
D) No coverage:
According to the sliding scale, a blood glucose level of 164 mg/dL falls within the 0-180 mg/dL range, which specifies no coverage or insulin administration. The sliding scale clearly indicates that no insulin is needed when the blood glucose level is within this range.
Correct Answer is D
Explanation
A) Prevent respiratory infections:
Albuterol does not prevent respiratory infections. It is a bronchodilator, which means it works to relax and open the airways, improving airflow during episodes of bronchospasm (such as during an asthma attack or exacerbation of COPD). Respiratory infections are usually managed by other types of medications, such as antibiotics or antivirals, depending on the type of infection.
B) Decrease mucus production in the lungs:
While albuterol may help improve breathing and airway function by dilating the airways, it does not directly decrease mucus production. Albuterol works to relieve bronchospasms (tightening of the muscles around the airways), making it easier to breathe, but it doesn’t target mucus production. Some other treatments, like mucolytics or expectorants, are more directly aimed at reducing mucus in the lungs.
C) Reduce inflammation in the airways:
Albuterol is not an anti-inflammatory medication. Its main role is as a bronchodilator, which works by relaxing the muscles around the airways, relieving bronchospasm. Inflammation in the airways is a key component of chronic obstructive pulmonary disease (COPD), but albuterol does not directly reduce this inflammation. Inhaled corticosteroids (ICS) are typically used to address inflammation in COPD.
D) Improve airflow and relieve bronchospasms:
Albuterol is a short-acting beta-agonist (SABA) that works by relaxing the smooth muscles around the airways in the lungs, which helps open them up and improves airflow. This action provides quick relief from symptoms of bronchospasm, such as wheezing and shortness of breath, making it the most appropriate explanation for its use in COPD patients.
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