The nurse understands that to reduce tolerance to nitrates in a patient with stable angina, the patient should be dosed with
a. SL nitroglycerin prn.
b. sustained-release oral tablets on an intermittent schedule.
c. transdermal nitroglycerin patches q 24 hours.
d. nitroglycerin ointment q 8 hours.
ANS: B
Tolerance is most likely to develop with high-dose therapy and uninterrupted therapy. To prevent tolerance, nitroglycerin and other nitrates should be used in the lowest effective dosages, and long-acting formulation (eg, patches, sustained-release preparations) should be used on an intermittent schedule that allows at least 8 drug-free hours each day, usually during the night.
SL nitroglycerin is not used for stable angina; it is a prn agent for acute angina.
Transdermal patches should be used q 12 hours, not q 24 hours.
Nitroglycerin ointment is not indicated around the clock, because tolerance will develop; a period of at least 8 drug free-hours is necessary to prevent this.
You might also like to view...
A nurse is working with a patient who has limited English proficiency. What action by the nurse is best?
a. Use a qualified interpreter. b. Ask family members to translate. c. Use drawings and pictures. d. Speak in simple sentences.
Older adults are at high risk for pressure ulcers because such individuals are more frequently affected by immobile and edematous conditions. Which of the following intervention best minimizes the occurrence of pressure ulcers?
A) Elevate the head of the bed 45 degrees, and turn the patient every hour. B) Make sure the patient cannot feel pressure, and turn the patient every 2 hours. C) Advise using pillows on a water bed, and turn the patient every hour. D) Provide a high-carbohydrate diet, and turn the patient every 2 hours.
A home care nurse is looking over the charts of four elderly female patients. The nurse knows that which patient has the highest risk for developing diabetes and heart disease?
1. A Caucasian woman. 2. A woman of Italian descent. 3. An Amish woman. 4. An African American woman
A patient has TB. Standard Precautions and isolation precautions are needed
Indicate whether the statement is true or false