A nurse is teaching a client who has angina about nitroglycerin sublingual tablets. Which of the following statements should the nurse include in the teaching?
A.
“Place one tablet under your tongue every 5 minutes for 30 minutes to relieve chest pain.”
B.
“Nitroglycerin decreases chest pain by dissolving blood clots that are occluding the arteries.”
C.
“You can store the bottle of tablets in your bathroom medicine cabinet.”
D.
“Nitroglycerin dilates cardiac blood vessels to deliver more oxygen to the heart.”
The correct answer and Explanation is :
The correct answer is D: “Nitroglycerin dilates cardiac blood vessels to deliver more oxygen to the heart.”
Explanation:
Nitroglycerin is a nitrate medication commonly used to treat angina, a condition characterized by chest pain due to reduced blood flow to the heart. The primary mechanism of action for nitroglycerin is vasodilation, specifically the dilation of veins and coronary arteries. Here’s a detailed explanation:
- Mechanism of Action: Nitroglycerin works by converting to nitric oxide, which is a potent vasodilator. This leads to the relaxation of vascular smooth muscle, primarily in the veins, reducing venous return to the heart (preload). The decreased preload reduces the heart’s workload and oxygen demand. Additionally, nitroglycerin can dilate coronary arteries, increasing blood flow to the heart muscle itself, which can relieve angina symptoms by providing more oxygen to the heart.
- Dosage and Administration: For acute angina attacks, nitroglycerin sublingual tablets are used. The correct dosage is typically one tablet placed under the tongue every 5 minutes as needed, up to a maximum of three tablets within 15 minutes. This rapid administration is designed to provide quick relief of angina symptoms.
- Storage: Nitroglycerin tablets should be stored in their original container, tightly closed, and kept away from light and moisture. Bathrooms are generally not ideal due to high humidity, which can degrade the medication.
- Common Misconceptions:
- Option A is incorrect because placing one tablet every 5 minutes for up to 30 minutes is not standard practice. The correct approach is to take up to three tablets within 15 minutes.
- Option B is incorrect because nitroglycerin does not dissolve blood clots. Instead, it works by dilating blood vessels to improve blood flow and reduce the heart’s oxygen demand.
- Option C is incorrect because the bathroom medicine cabinet is not recommended for storing nitroglycerin due to moisture, which can affect the tablet’s potency.
By understanding these key points, patients can use nitroglycerin effectively to manage their angina and seek medical help if symptoms persist.