The nurse cautions the client receiving isosorbide dinitrate for treatment of angina that long-term use can lead to the development of which manifestation?
1. Urinary retention
2. Tachycardia
3. Tolerance
4. Hypotension
Correct Answer: 3
Rationale 1: Urinary retention is not associated with isosorbide dinitrate.
Rationale 2: Reflex tachycardia is an adverse effect of isosorbide dinitrate, but it is a short-term one.
Rationale 3: Tolerance is a common problem with the use of longer-acting organic nitrates. Clients often are instructed to remove the transdermal patch for 6–12 hours each day to delay development of tolerance to the drug.
Rationale 4: Hypotension is an adverse effect of isosorbide dinitrate, but it is dose related.
Global Rationale: Tolerance is a common problem with the use of longer-acting organic nitrates. Clients often are instructed to remove the transdermal patch for 6–12 hours each day to delay development of tolerance to the drug. Urinary retention is not associated with isosorbide dinitrate. Reflex tachycardia is an adverse effect of isosorbide dinitrate, but it is a short-term one. Hypotension is an adverse effect of isosorbide dinitrate, but it is dose related.
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