A nurse is teaching a client who has angina about a new prescription for sublingual nitroglycerin tablets. Which of the following instructions should the nurse include in the teaching?

"Keep the tablets at room temperature in their original glass bottle."

"Discard any tablets you do not use every 6 months."

"Take one tablet each morning 30 minutes prior to eating."

"Place the tablet between your cheek and gum to dissolve

Answer and Explanation

The Correct Answer is D

A. "Keep the tablets at room temperature in their original glass bottle." This is a correct storage instruction. Nitroglycerin tablets are sensitive to heat and light, so they should be stored in their original container, protected from light, and kept at room temperature.

B. "Discard any tablets you do not use every 6 months." This is not an accurate instruction. Nitroglycerin tablets usually have an expiration date printed on the label, and they should be discarded after that date.

C. "Take one tablet each morning 30 minutes prior to eating." This is not an accurate instruction. Sublingual nitroglycerin is taken as needed to relieve angina symptoms, not on a regular schedule like a daily medication.

D. "Place the tablet between your cheek and gum to dissolve."

Sublingual nitroglycerin tablets are used to relieve angina symptoms by causing vasodilation, which increases blood flow to the heart muscle. To take sublingual nitroglycerin tablets effectively, the client should be instructed to place the tablet between the cheek and gum to dissolve. This allows the medication to be absorbed through the mucous membranes in the mouth and enter the bloodstream quickly, providing rapid relief from angina symptoms.

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Correct Answer is C

Explanation

A. Naloxone IV:
This choice is incorrect. Naloxone is an opioid receptor antagonist used to reverse the effects of opioid overdose. It works by displacing opioids from the receptors and rapidly reversing their effects. However, in this scenario, the client is experiencing pain 1 hour after receiving morphine, indicating that the morphine's analgesic effects have likely worn off. Naloxone is not used to manage pain, but rather to reverse opioid overdose.

B. Fentanyl transmucosal:
This choice is incorrect. Fentanyl transmucosal formulations are used for breakthrough pain in opioid-tolerant patients with chronic pain conditions. It is not typically the first choice for immediate pain relief after intravenous morphine administration. Additionally, it's worth noting that fentanyl transmucosal products, like fentanyl lollipops, are usually reserved for chronic pain management and may not be suitable for immediate post-administration pain relief.

C. Morphine tablet:
This is the correct choice. If the client is experiencing pain 1 hour after receiving morphine intravenously, it's reasonable to administer an oral or sublingual form of morphine for continued pain relief. Morphine tablets are commonly used for pain management and can provide sustained relief over a longer duration. This choice aligns with the patient's initial prescription for pain control.

D. Lidocaine patch:
This choice is incorrect. Lidocaine patches are used to manage localized neuropathic pain, such as postherpetic neuralgia. They work by numbing the skin and underlying tissues in the area where they are applied. While lidocaine patches can be effective for certain types of pain, they are not typically used to address the acute pain associated with cancer and immediate post-administration pain relief.

A. Dispose of the remaining medication while another nurse observes. B. Store the remaining half of the pill in the automated medication dispensing system. C. Place the remaining half of the pill in the unit-dose package. D. Return the remaining medication to the facility's pharmacy.

Correct Answer is A

Explanation

A. Dispose of the remaining medication while another nurse observes:
This is the correct choice. When a nurse administers a fraction of a tablet, it is not safe or appropriate to store the remaining portion for future use, even if another dose is scheduled. Hydromorphone tablets are meant to be taken whole, and cutting or breaking them can lead to inconsistent dosages. It's important to follow safe medication administration practices and dispose of the unused portion while another nurse observes, ensuring proper disposal.
B. Store the remaining half of the pill in the automated medication dispensing system:
This choice is incorrect. Storing a fraction of a tablet in the automated medication dispensing system is not appropriate. The system is designed for intact medications, and splitting tablets could compromise the accuracy and safety of future doses.
C. Place the remaining half of the pill in the unit-dose package:
This choice is incorrect. Placing a partial tablet back into a unit-dose package could lead to confusion and potential administration errors in the future. The medication packaging should reflect the correct and complete dosage as prescribed.
D. Return the remaining medication to the facility's pharmacy:
This choice is incorrect. Returning a partially used tablet to the pharmacy is not advisable, as the pharmacy cannot ensure the tablet's integrity or accurately verify its dosage. Medication storage and handling standards are in place to ensure patient safety, and using a fraction of a tablet may compromise those standards.

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A nurse is teaching a client who has angina about a new prescription for sublingual nitroglycerin tablets. Which of the following instructions should the nurse include in the teaching?

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