A nurse is reinforcing teaching with a client who has angina pectoris about starting therapy with nitroglycerin sublingual tablets. Which of the following statements by the client indicates an understanding of the teaching?

"I will take the first tablet when the pain becomes severe."

"I will take no more than four tablets in 10 min."

"I will chew the tablet before swallowing."

"I will dial 911 if one tablet does not relieve my pain."

Answer and Explanation

The Correct Answer is D

A) "I will take the first tablet when the pain becomes severe.": This statement is incorrect because nitroglycerin should be taken at the onset of chest pain, not when it becomes severe. Early administration can help prevent the pain from worsening and reduce the risk of a heart attack. Waiting until the pain is severe may delay relief and increase the risk of serious complications.

B) "I will take no more than four tablets in 10 min.": This is incorrect as the standard protocol for nitroglycerin sublingual tablets typically involves taking one tablet every 5 minutes, up to three doses in 15 minutes, if needed. Taking four tablets in 10 minutes exceeds the recommended dosage and could lead to severe hypotension, dizziness, and fainting. It’s crucial to follow the prescribed limits to avoid these adverse effects.

C) "I will chew the tablet before swallowing.": This is incorrect because nitroglycerin sublingual tablets are designed to dissolve under the tongue for rapid absorption into the bloodstream. Chewing or swallowing the tablet would decrease its effectiveness and delay pain relief. The sublingual route allows the medication to bypass the digestive system and work quickly to relieve chest pain.

D) "I will dial 911 if one tablet does not relieve my pain.": This is the correct response. If chest pain is not relieved within 5 minutes after taking the first nitroglycerin tablet, it may indicate a more serious condition such as a heart attack. The client should call 911 to seek immediate medical assistance. Prompt action is critical in managing potential cardiac events and improving outcomes for the client.

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Correct Answer is D

Explanation

A) Dyspnea:
Diphenhydramine, an antihistamine, primarily addresses allergic reactions associated with blood transfusions, such as urticaria (hives), rather than respiratory symptoms like dyspnea.

B) Fever:
While diphenhydramine may help alleviate some symptoms of an allergic reaction, its primary role in the context of blood transfusions is to mitigate hypersensitivity reactions like urticaria, not fever.

C) Low-back pain:
Low-back pain is not typically associated with allergic reactions to blood transfusions. Diphenhydramine is not indicated for preventing or managing this symptom.

D) Urticaria:
Diphenhydramine is administered to prevent or reduce symptoms of an allergic reaction to blood transfusions, such as urticaria (hives). It works by blocking histamine receptors, which are involved in allergic responses.

Correct Answer is ["25"]

Explanation

Calculating IV Drip Rate for Manual Infusion

Here's how to calculate the drip rate for the manual IV infusion:

Identify total volume and infusion time:

Total volume of saline solution (NS) to infuse: 100 mL

Infusion time: 4 hours

Convert infusion time to minutes:

4 hours x 60 minutes/hour = 240 minutes

Determine the drip factor:

Drip factor: 60 gtt/mL (indicates the number of drops delivered per milliliter of solution by the IV tubing)

Calculate the desired flow rate (mL/min):

We want to know how many milliliters the nurse needs to infuse per minute.However, the question asks for the rate in gtt/min. We'll calculate the mL/min rate first and then convert it to gtt/min.

Flow rate (mL/min) = Total volume (mL) / Infusion time (minutes)

Flow rate (mL/min) = 100 mL / 240 minutes

Flow rate (mL/min) = 0.4167 mL/min (round to four decimal places for accurate conversion)

Convert mL/min to gtt/min:

Flow rate (gtt/min) = Flow rate (mL/min) x Drip factor (gtt/mL)

Flow rate (gtt/min) = 0.4167 mL/min x 60 gtt/mL

Flow rate (gtt/min) = 25 gtt/min (round to nearest whole number)

Therefore, the nurse should set the manual IV infusion to deliver approximately 25 gtt/min.

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A nurse is reinforcing teaching with a client who has angina pectoris about starting therapy with nitroglycerin sublingual tablets. Which of the following statements by the client indicates an understanding of the teaching?

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer diphenhydramine to a client who is to receive a blood transfusion. The nurse should explain that the purpose of diphenhydramine is to prevent which of the following manifestations of a transfusion reaction?

Correct Answer is D

Explanation

A nurse is preparing to administer 0.9% sodium chloride (NS) 100 mL IV to infuse over 4 hr. The drip factor of the manual IV tubing is 60 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number.)

Correct Answer is ["25"]

Explanation

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