A nurse is reinforcing teaching about transdermal nitroglycerin paste with a client. Which of the following client statements indicates understanding of the teaching?
“I should apply some paste under my tongue if I experience angina.”
“I should rub the paste into my skin thoroughly.”
“I should get up slowly when I stand or get out of bed.”
“I should stop taking this medication if I experience headaches.”
The correct answer and explanation is :
The correct answer is:
“I should get up slowly when I stand or get out of bed.”
Explanation:
Transdermal nitroglycerin is a medication used to prevent angina (chest pain) by dilating blood vessels, which reduces the workload on the heart and improves oxygen supply. While it is effective in preventing chest pain, it can cause side effects such as hypotension (low blood pressure) and dizziness, especially when changing positions quickly. This is why the client should rise slowly from sitting or lying positions to prevent orthostatic hypotension and dizziness, reducing the risk of falls.
Explanation of Incorrect Answers:
- “I should apply some paste under my tongue if I experience angina.”
- This statement is incorrect because transdermal nitroglycerin paste is not intended for immediate relief of angina. Instead, sublingual nitroglycerin tablets or sprays are used for rapid symptom relief. The paste is a long-acting form of the medication meant for prevention, not acute treatment.
- “I should rub the paste into my skin thoroughly.”
- This is incorrect because transdermal nitroglycerin paste should be applied in a thin layer to clean, dry, hairless skin using an applicator or dose-measuring paper. It should not be massaged into the skin, as this could alter absorption and affect the medication’s effectiveness.
- “I should stop taking this medication if I experience headaches.”
- This is incorrect because headaches are a common side effect of nitroglycerin due to its vasodilating effects. Clients should be informed that headaches usually diminish over time. If headaches are severe, they should consult their healthcare provider rather than discontinuing the medication abruptly.
By understanding these key points, the client can safely and effectively use transdermal nitroglycerin paste while minimizing risks.