A patient who has angina uses 0.4 mg of sublingual nitroglycerin for angina episodes. The patient brings a log of angina episodes to an annual physical examination
The primary care NP notes that the patient has experienced an increase in frequency of episodes in the past month but no increase in duration or severity of pain. The NP should: a. increase the nitroglycerin dose to 0.6 mg per dose.
b. change from a sublingual to a transdermal patch nitroglycerin.
c. discontinue the nitroglycerin and order ranolazine (Ranexa ER).
d. contact the patient's cardiologist to discuss admission to the hospital.
D
Unstable angina is a change in pattern or pain, such as an increase in frequency, severity, or duration of pain and fewer precipitating factors. Patients with unstable angina should be admitted to a coronary care unit. The primary care NP should not change any medications without consultation with the patient's cardiologist.
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