Why is a patient who is using a transdermal nitroglycerin patch instructed to remove the patch at bedtime and apply a new one in the morning?
To avoid allergic response.
To prevent tolerance.
To prevent overdosage.
To prevent the patient from forgetting to remove the patch in the morning.
The Correct Answer is B
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Nitroglycerin sublingual is a medication that is used to treat chest pain or angina by relaxing the blood vessels and reducing the oxygen demand of the heart.A common side effect of nitroglycerin sublingual is headache, which may be severe and throbbing.Headache is often a sign that the medication is working.Other possible side effects include flushing, dizziness, lightheadedness, nausea, vomiting, fast heart rate, numbness, tingling, burning pain, rash, hives, sweating, pale skin, difficulty breathing and allergic reaction.
Choice A is wrong because nausea is not the most common adverse effect of nitroglycerin sublingual.Nausea may occur in some people, but it is usually mild and transient.
Choice B is wrong because bradycardia (slow heart rate) is not a common adverse effect of nitroglycerin sublingual.Nitroglycerin sublingual may cause tachycardia (fast heart rate) in some people as a result of vasodilation and reflex stimulation of the heart.
Choice C is wrong because hypertension (high blood pressure) is not a common adverse effect of nitroglycerin sublingual.Nitroglycerin sublingual may cause hypotension (low blood pressure) in some people due to its vasodilating action.Hypotension may lead to lightheadedness, fainting or shock in severe cases.
The normal range for blood pressure is less than 120/80 mmHg for adults.
The normal range for heart rate is 60 to 100 beats per minute for adults.
Correct Answer is D
Explanation
Alpha 1 adrenergic blocking agents have a vasodilating effect and can be used for the management of hypertension.They work by preventing the hormone norepinephrine from tightening the muscles in the walls of smaller arteries and veins, thus lowering the blood pressure.Some examples of alpha 1 blockers are doxazosin, prazosin, and terazosin.
Choice A is wrong because alpha 3 adrenergic blockers do not exist.There are only two subtypes of alpha receptors: alpha 1 and alpha 2.
Choice B is wrong because alpha 2 adrenergic antagonists are not used for hypertension.They are used for conditions like attention deficit hyperactivity disorder (ADHD) and opioid withdrawal.Alpha 2 antagonists block the negative feedback mechanism of norepinephrine release, thus increasing the amount of norepinephrine in the blood and raising the blood pressure.
Choice C is wrong because alpha 1 adrenergic agonists have the opposite effect of alpha 1 blockers.They stimulate the alpha 1 receptors and cause vasoconstriction, which increases the blood pressure.Alpha 1 agonists are used for conditions like nasal congestion and hypotension.
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