A client with primary hypertension reports dizziness with ambulation when taking the prescribed alpha-adrenergic blocker. When teaching this client, what should the nurse emphasize?

A. "Only take one nitroglycerin tablet for each episode of angina."

This instruction is correct. Sublingual nitroglycerin is typically administered as needed for the relief of angina symptoms, with one tablet being the initial dose. If the chest pain persists after 5 minutes, the client may take a second tablet, and if needed, a third tablet after another 5 minutes. However, if the pain is not relieved after three tablets, they should seek immediate medical attention.

B. "Place the nitroglycerin tablet between cheek and gum."

This instruction is incorrect. Sublingual nitroglycerin tablets should be placed under the tongue, allowing them to dissolve and be absorbed directly into the bloodstream. Placing the tablet between the cheek and gum is not the recommended administration route for sublingual nitroglycerin.

C. "Call 911 if you develop a headache following nitroglycerin use."

This instruction is partially correct. Headache is a common side effect of nitroglycerin due to its vasodilatory effects. Clients should be informed about this potential side effect, but not every headache following nitroglycerin use requires immediate medical attention. However, if the headache is severe, persistent, or accompanied by other concerning symptoms, the client should seek medical evaluation.

D. "See if rest relieves the chest pain before using the nitroglycerin."

This instruction is incorrect. Sublingual nitroglycerin is a rapid-acting medication used to relieve angina symptoms quickly. Clients should not delay taking nitroglycerin and wait for rest to relieve chest pain, as this can lead to worsening symptoms and complications.

A. Increasing fluids to maintain BP: While staying well-hydrated is generally beneficial for overall health and blood pressure management, increasing fluids is not the primary intervention for dizziness associated with alpha-adrenergic blockers. Alpha-blockers can cause orthostatic hypotension, which may lead to dizziness upon standing, especially if rising quickly.

B. Taking medication first thing in the morning: Taking medication in the morning is a common recommendation for many medications, including some antihypertensive drugs. However, for alpha-adrenergic blockers that can cause orthostatic hypotension, timing of medication administration is not the primary concern in addressing dizziness.

C. Stopping medication if dizziness persists: Abruptly stopping medication without consulting a healthcare provider is not recommended, especially for antihypertensive medications. It's important for clients to follow their prescribed treatment plan and communicate any side effects or concerns to their healthcare provider for appropriate management.

D. Rising slowly from a lying or sitting position: This is the correct emphasis for the nurse. Alpha-adrenergic blockers can cause orthostatic hypotension, a drop in blood pressure upon standing, which can lead to dizziness or lightheadedness. To minimize this risk, the client should be advised to rise slowly from lying down or sitting to standing positions. This gradual movement helps the body adjust to changes in blood pressure more effectively.