Nitrates

Question 1

Medications

Answer 1

• Nitroglycerin
• Isosorbide dinitrate
• Isosorbide mononitrate

Question 2

Action

Answer 2

• Act directly on smooth muscle to cause relaxation and depress muscle tone of the blood vessels
• Help restore the appropriate supply-and-demand ration in oxygen delivery to the myocardium

Question 3

Indications

Answer 3

-Prevention and treatment of attacks of angina pectoris

Question 4

Contraindications

Answer 4

• Allergy
• Severe anemia
• Head trauma or cerebral hemorrhage
• Pregnancy/lactation

Question 5

Caution

Answer 5

• Hepatic or renal disease

- Hypotension, hypovolemia, and conditions that limit cardiac output

Question 6

Adverse effects

Answer 6

• Related to the vasodilation and decrease in blood flow
• CNS: headache, dizziness, and weakness
• GI: N/V
• CV: hypotension
• Misc: flushing, pallor, increased perspiration

Question 7

Drug-Drug interactions

Answer 7

• Ergot derivatives
• Heparin
• Sildenafil, tadalafil, vardenafil

Question 8

Assessment

Answer 8

• History: check for any contraindications
• Physical: skin, complaints of pain, including onset, duration, intensity, location, and measures used to relieve it. Respirations, VS, cardiac status, ECG

Question 9

Nursing diagnoses

Answer 9

• Decreased CO r/t vasodilation and hypotensive effects
• Risk for injury r/t CNS or CV effects
• Ineffective tissue perfusion r/t hypotension or change in CO
• Deficient knowledge

Question 10

Implementation

Answer 10

• Have patient lay down or sit down prior to administration
• Instruct patient that a sublingual dose may be repeated in 5 minutes is not felt for a total of 3 doses
• Have emergency life-support equipment readily available
• Taper the dose gradually after long-term therapy
• Provide pt teaching

Question 11

Evaluation

Answer 11

• Evaluation patient response to the drug (alleviation of signs and symptoms of heart failure)
• Monitor for adverse effects
• Evaluate the compliance with the regimen
• Evaluate the effectiveness of the teaching plan