A nurse is teaching a group of nurses about the administration of nitroglycerin. Which of the following routes of administration provides the most rapid onset for the client?

Topical ointment

Sustained-release

Sublingual

Transdermal patch

Answer and Explanation

The Correct Answer is C

Choice A: Topical ointment Topical ointment forms of nitroglycerin are used for their long-acting effects. The medication is absorbed slowly through the skin, providing a steady level of drug in the bloodstream. This form is not designed for rapid relief of acute angina attacks but rather for prevention.

Choice B: Sustained-release Sustained-release forms of nitroglycerin are designed to release the medication slowly over an extended period. This route is also not suitable for treating acute symptoms because it does not provide immediate relief but is used for long-term management of angina pectoris. Nitroglycerin is a medication used primarily to treat angina pectoris (chest pain) and heart failure. It works by relaxing the smooth muscles and dilating the blood vessels, which increases blood flow to the heart and decreases its workload. The route of administration can significantly affect the onset and duration of the medication’s action.

Choice C: Sublingual The sublingual route, where the medication is placed under the tongue, allows for rapid absorption into the bloodstream through the rich supply of blood vessels found in the area. This form of nitroglycerin acts quickly, usually within 1 to 3 minutes, and is the preferred choice for immediate relief of angina pain. When rapid onset is required for relief from acute angina symptoms, the sublingual route is the most appropriate choice for administering nitroglycerin. It provides quick absorption and fast action, making it an essential treatment option for patients experiencing chest pain due to angina.

Choice D: Transdermal patch Transdermal patches release nitroglycerin slowly through the skin and into the bloodstream. Like topical ointments and sustained-release forms, they are used for long-term prophylaxis of angina and not for rapid relief.

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Correct Answer is C

Explanation

Choice A: RBC count The red blood cell (RBC) count is not typically decreased by hemodialysis. Hemodialysis does not remove cells from the blood. However, patients with chronic kidney disease often have anemia, which is a low RBC count, due to a decrease in the production of erythropoietin by the kidneys. Erythropoietin is a hormone that stimulates the bone marrow to produce RBCs. Anemia in these patients is treated with erythropoiesis-stimulating agents, not dialysis.

Choice B: Protein Protein levels are not directly affected by hemodialysis. However, patients on hemodialysis may have lower protein levels due to dietary restrictions or protein loss during the treatment. It is important for patients to manage their protein intake to prevent malnutrition and maintain overall health.

Choice C: Potassium Potassium levels are expected to decrease following hemodialysis. Potassium is an electrolyte that is normally filtered out by the kidneys. In patients with kidney failure, potassium levels can build up in the blood and cause serious heart problems. Hemodialysis removes excess potassium from the blood, which helps to prevent complications such as cardiac arrhythmia. The normal range for serum potassium is 3.5 to 5.0 mmol/L. After a hemodialysis treatment, a nurse should expect to find a decrease in potassium levels in the laboratory data of a client. This is because hemodialysis effectively removes excess potassium, which can accumulate in the blood due to reduced kidney function. Maintaining proper potassium levels is crucial for preventing heart complications in patients with kidney failure.

Choice D: Calcium Calcium levels are not typically decreased by hemodialysis. In fact, calcium levels can be affected by the dialysate used during hemodialysis. Some dialysates contain calcium, and this can actually increase the patient’s blood calcium levels. Patients with kidney failure may also have secondary hyperparathyroidism, which affects calcium levels, and they may be treated with calcium supplements or vitamin D analogs to manage their calcium levels.

A. Administer oxygen therapy B. Start an IV infusion of Lactated Ringer's C. Initiate cardiac monitoring D. Give morphine IV

Correct Answer is A

Explanation

Choice A reason: Administering oxygen therapy is the first and immediate intervention for a client with a pulmonary embolism to address hypoxemia.

Choice B reason: Starting an IV infusion of Lactated Ringer's is important for fluid resuscitation but is not the first intervention for pulmonary embolism.

Choice C reason: Initiating cardiac monitoring is important for observing the client's heart function but comes after ensuring the client is receiving adequate oxygen.

Choice D reason: Giving morphine IV may be used for pain management in pulmonary embolism but is not the first-line intervention.

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A nurse is teaching a group of nurses about the administration of nitroglycerin. Which of the following routes of administration provides the most rapid onset for the client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the laboratory data of a client following a hemodialysis treatment. The nurse should expect to find a decrease in which of the following laboratory values?

Correct Answer is C

Explanation

A nurse is caring for a client who develops a pulmonary embolism. Which of the following interventions should the nurse implement first?

Correct Answer is A

Explanation

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