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 C
Explanation
A. Give 2 rescue breaths: In cardiac arrest due to V.Fib, the priority is circulation. High-quality chest compressions are initiated immediately to maintain perfusion until defibrillation can be performed. Rescue breaths are not the first step.
B. Start chest compressions: V.Fib is a lethal rhythm with no effective cardiac output. Immediate chest compressions are essential to circulate oxygenated blood to vital organs while preparing for defibrillation. This is the first action in Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS).
C. Assess the client: While assessment is important, in the context of a witnessed rhythm strip showing V.Fib and an alarm, the nurse should assume cardiac arrest and act immediately. Delaying compressions to reassess wastes critical seconds.
D. Call a code blue/call 911: This is necessary, but it comes after starting chest compressions. The priority is to begin CPR without delay, then activate emergency response and prepare for defibrillation.
Correct Answer is A
Explanation
A. Apply oxygen, administer morphine, and place the client on bed rest with cardiac monitoring: These interventions prioritize reducing myocardial oxygen demand and alleviating ischemic pain in the acute phase of NSTEMI. Morphine acts as a potent analgesic and vasodilator, while oxygen improves tissue saturation. Bed rest and continuous monitoring ensure hemodynamic stability and rapid detection of dysrhythmias.
B. Have the client chew two aspirin 325 mg each, administer oxygen and bring the crash cart to the bedside: While aspirin is indicated for its antiplatelet effects, a dose of 650 mg exceeds the standard loading dose of 162 to 325 mg. Administering excessive aspirin increases the risk of gastrointestinal hemorrhage without providing additional cardiac benefit. The crash cart is necessary but secondary to immediate pharmacological stabilization.
C. Administer oxygen, give a dose of nitroglycerin sublingual, and follow with a nonsteroidal anti-inflammatory: Nonsteroidal anti-inflammatory drugs, excluding aspirin, are contraindicated in acute myocardial infarction because they increase the risk of myocardial rupture and mortality. Nitroglycerin helps with vasodilation, but the addition of an NSAID is harmful. This combination fails to provide the necessary sedation and potent analgesia required.
D. Begin a heparin drip, administer oxygen, and call the lab for stat troponin levels: Heparin and troponin levels are essential components of NSTEMI management but do not address the client's immediate, unrelieved pain. Anticoagulation prevents further thrombus formation but does not actively reduce the current ischemic workload. Immediate nursing priorities must focus on symptomatic relief and cardiac workload reduction.
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