A client with a history of angina pectoris complains of substernal chest pain. The nurse checks the client's blood pressure and administers nitroglycerin, gr 1/4 sublingually. Five minutes later, the client is still experiencing chest pain
If the blood pressure is still stable, the nurse should take which of the following actions next? 1. Administer another nitroglycerin tablet.
2. Administer 10 L of oxygen via nasal cannula.
3. Call for a 12-lead electrocardiogram (ECG) to be performed.
4. Wait an additional 5 minutes, then give a second nitroglycerin tablet.
1
Rationale: Nitroglycerin tablets are usually prescribed one every 5 minutes PRN for chest pain, up to a total dose of three tablets. The nurse should administer the second tablet. The client with known angina pectoris should have low-flow oxygen at a rate of 1 to 3 L/min via nasal cannula. A 12-lead ECG would be done if prescribed by standing protocol or by individual physician prescription.
You might also like to view...
A nurse assesses a client who has psoriasis. Which action should the nurse take first?
a. Don gloves and an isolation gown. b. Shake the client's hand and introduce self. c. Assess for signs and symptoms of infections. d. Ask the client if she might be pregnant.
The majority of North Americans belong to which cultural group?
1. Asian 2. Native American/Indian 3. European 4. African
The home health nurse discovers that a homebound cancer patient is using marijuana to control nausea from chemotherapy. What advice should the nurse give this patient?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. The effect of marijuana on decreasing nausea is fleeting and not worth the health problems caused by using it. 2. Since the patient is homebound, it is likely the use of marijuana will not be discovered by anyone else. 3. Possession of marijuana is illegal under federal law. 4. Some states have current legislative guidelines for legal possession of medical marijuana. 5. As long as it is documented that an illness exists that can be treated with marijuana, no risk of prosecution is present.
In second-degree and third-degree AV blocks, _____
a. P waves occur regularly b. every other P wave is dropped c. P waves are periodically dropped d. there are more QRS complexes than P waves