The patient takes nitroglycerine (Nitrostat) for relief of occasional stable angina. The nurse would be most concerned about which statement made by the patient?
1. "I'm getting married tomorrow; I hope my erectile dysfunction isn't a problem."
2. "I'm going water skiing tomorrow; I hope my angina isn't a problem."
3. "I really don't like those little pills. I've heard about patches: can I try them?"
4. "My angina has been a little more frequent. Do I need a painkiller too?"
1
Rationale 1: A patient with erectile dysfunction is likely to use sildenafil (Viagra). Concurrent use of sildenafil (Viagra) and nitroglycerine (Nitrostat) may cause life-threatening hypotension and cardiovascular collapse.
Rationale 2: An activity like waterskiing could precipitate angina; however, this can be prevented by taking nitroglycerine (Nitrostat) prior to the activity (prophylactic use).
Rationale 3: Patches can be substituted for pills in many cases; this is a reasonable question but not the primary concern at this time.
Rationale 4: Occurrences of stable angina can change somewhat in frequency; however, an analgesic is not indicated.
Global Rationale: A patient with erectile dysfunction is likely to use sildenafil (Viagra). Concurrent use of sildenafil (Viagra) and nitroglycerine (Nitrostat) may cause life-threatening hypotension and cardiovascular collapse. An activity like waterskiing could precipitate angina; however, this can be prevented by taking nitroglycerine (Nitrostat) prior to the activity (prophylactic use). Occurrences of stable angina can change somewhat in frequency; however, an analgesic is not indicated. Patches can be substituted for pills in many cases; this is a reasonable question but not the primary concern at this time.
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