If the patient PTT lab level is too long and greater than 80 seconds, the nurse should notify the doctor.
Which doctor’s order should the nurse anticipate?

The correct answer is Choice D: Headache.

Choice A rationale: Nausea is not a common adverse effect of sublingual nitroglycerin. Nausea may occur in some patients, but it is usually mild and transient.Nausea may be related to the vasodilatory effects of nitroglycerin, which can cause hypotension and reflex tachycardia1. Nausea may also be caused by other factors, such as anxiety, stress, or food intolerance.Nausea is not a specific indicator of nitroglycerin toxicity or overdose2.

Choice B rationale: Bradycardia is not a common adverse effect of sublingual nitroglycerin. Bradycardia is a slow heart rate, usually defined as less than 60 beats per minute.Bradycardia may occur in some patients who take nitroglycerin, especially in combination with other drugs that affect the heart rate, such as beta-blockers, calcium channel blockers, or digoxin3. Bradycardia may also be caused by other factors, such as vagal stimulation, hypothyroidism, or electrolyte imbalance.Bradycardia is not a specific indicator of nitroglycerin toxicity or overdose2.

Choice C rationale: Hypertension is not a common adverse effect of sublingual nitroglycerin. Hypertension is a high blood pressure, usually defined as more than 140/90 mmHg.Hypertension may occur in some patients who take nitroglycerin, especially in those who have a history of hypertension, renal impairment, or volume overload4. Hypertension may also be caused by other factors, such as stress, pain, or caffeine intake.Hypertension is not a specific indicator of nitroglycerin toxicity or overdose2.

Choice D rationale: Headache is a common adverse effect of sublingual nitroglycerin.Headache may occur in up to 80% of patients who take nitroglycerin, especially during the first few days of therapy or after an increase in dose5. Headache may be related to the vasodilatory effects of nitroglycerin, which can cause cerebral vasodilation and increased intracranial pressure. Headache may also be caused by other factors, such as dehydration, sinusitis, or migraine. Headache is usually mild to moderate in intensity and can be relieved by analgesics, such as acetaminophen or aspirin.Headache is not a specific indicator of nitroglycerin toxicity or overdose

Diuretics are medicines that help the kidneys get rid of excess water and salt, which can ease the symptoms of heart failure, such as breathlessness and swelling.However, diuretics may also lower the blood pressure by reducing the blood volume and the cardiac output. This can cause symptoms such as dizziness, fatigue, or fainting.Hypotension is defined as a systolic blood pressure lower than 90 mmHg or a diastolic blood pressure lower than 60 mmHg.

Choice A is wrong because fluid retention is the opposite of what diuretics do. Diuretics increase the urine output and decrease the fluid accumulation in the body.

Choice C is wrong because hyperglycemia is not a common side effect of diuretics. Hyperglycemia is a condition where the blood sugar level is too high.Diuretics may affect the blood sugar level in some cases, but usually not significantly.

Choice D is wrong because diarrhea is not a typical side effect of diuretics.

Diarrhea is a condition where the stool is loose and watery.Diuretics may cause some gastrointestinal discomfort, such as nausea or cramps, but not diarrhea.

Normal ranges for blood pressure are 120/80 mmHg for systolic/diastolic in healthy adults, and 140/90 mmHg or higher for hypertension.Normal ranges for blood sugar are 70-100 mg/dL for fasting glucose, and less than 140 mg/dL for postprandial glucose.