Which two side effects are most closely associated with the use of nitroglycerin tablets? (Select all
that apply.)
Erectile dysfunction
Backache
Diarrhea
Dizziness
Headache
Correct Answer : D,E
A. Erectile dysfunction: This condition is not a direct physiological side effect of nitrate therapy. While phosphodiesterase inhibitors used for this condition are contraindicated with nitrates due to synergistic hypotension, the medication itself does not cause sexual dysfunction. It primarily affects vascular smooth muscle rather than autonomic pathways.
B. Backache: Nitroglycerin lacks a known mechanism for inducing musculoskeletal pain in the spinal region. Common adverse effects are typically related to systemic vasodilation and subsequent compensatory hemodynamic responses. This symptom is not documented as a frequent or characteristic complication of sublingual nitrate administration.
C. Diarrhea: This medication focuses on vascular smooth muscle relaxation rather than gastrointestinal motility. Nitrates do not typically irritate the enteric lining or accelerate peristalsis to cause frequent loose stools. Side effects usually manifest in the cardiovascular and neurological systems due to rapid vasodilation.
D. Dizziness: Rapid systemic vasodilation leads to a transient decrease in blood pressure and cerebral perfusion. This orthostatic effect often follows the administration of potent vasodilators as the body adjusts to decreased venous return. It remains a significant safety concern during acute anginal management.
E. Headache: The dilation of cerebral vessels increases intracranial pressure and activates pain receptors. This is the most common adverse reaction due to the drug's non-specific effect on all vascular beds. The intensity often correlates with the speed of onset of the medication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Peripheral vascular disease: Intermittent claudication, or pain that occurs during ambulation and is relieved by rest, is a hallmark of arterial insufficiency. Mottling and hairlessness are objective signs of chronic tissue ischemia due to reduced peripheral blood flow. These findings indicate that the arterial supply is failing to meet the metabolic demands of the lower extremity.
B. Coronary artery disease: This condition involves the narrowing of the arteries supplying the heart muscle, typically presenting as chest pain or angina. While it shares the same underlying atherosclerotic process as peripheral vascular disease, it does not directly cause leg mottling or hairlessness. The client’s specific symptoms are localized to the peripheral rather than the cardiac circulation.
C. Right sided heart failure: Right-sided failure primarily manifests as systemic venous congestion, leading to jugular venous distention and dependent edema. It does not typically cause intermittent claudication or the skin changes associated with arterial deprivation. While it affects the lower extremities, it presents with swelling rather than mottling and hair loss.
D. Arterial embolism: An acute embolism usually presents with the "six Ps," including sudden, severe pain, pulselessness, and pallor. The client's report of intermittent pain relieved by rest suggests a chronic, progressive narrowing rather than an acute, total occlusion. An embolism is an emergency that would not typically be relieved simply by resting.
Correct Answer is C
Explanation
A. Cardiac catheterization: This is an invasive procedure where a catheter is threaded through the femoral or radial artery to inject dye and visualize the coronary anatomy. It is performed while the patient is stationary on a procedure table, not while exercising on a treadmill. It is the gold standard for diagnosing blockages but is not a "stress test."
B. Electrocardiogram: A standard 12-lead ECG records the electrical activity of the heart while the patient is at rest. While it can show signs of previous infarction or current ischemia, it does not involve physical exertion. It is a baseline diagnostic tool rather than a functional assessment of the heart under stress.
C. Stress test: An exercise stress test involves monitoring the patient's heart rate, blood pressure, and ECG while they walk on a treadmill at increasing levels of difficulty. This test is designed to uncover myocardial ischemia that may only be present when the heart's oxygen demand is elevated. It is a key functional evaluation for patients with suspected angina.
D. Echocardiogram: An echocardiogram uses ultrasound waves to visualize the structures and motion of the heart valves and chambers. While it can be performed after exercise in a "stress echo," the primary test focused on exercising on a treadmill for ischemia detection is the stress test. A standard echo is typically a resting imaging study.
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