A patient is administered sublingual nitroglycerin (NTG). Which of the following adverse effects should the nurse expect? .

Appeared in: NORCET 9 Mains - 2025

Explanation

Nitroglycerin (NTG) is a potent vasodilator, which means it widens blood vessels throughout the body.
This vasodilation is the direct cause of its most common side effects.
Dilation of cerebral (brain) blood vessels leads to a throbbing headache.
Systemic vasodilation causes a drop in blood pressure (hypotension), leading to dizziness, lightheadedness, and risk of falls.

Option A: Hyperglycemia (high blood sugar) is not a known pharmacological effect of nitroglycerin. It is related to metabolic processes, not vasodilation.
Option B: Constipation is not associated with nitroglycerin. In fact, some cardiovascular drugs that cause constipation (like certain calcium channel blockers) have different mechanisms of action.
Option D: Diplopia (double vision) is not a typical or expected adverse effect of nitroglycerin.

Visual 1: Diagram - An illustration showing how nitroglycerin causes vasodilation in coronary arteries and peripheral veins, with labels indicating 'decreased preload' and 'decreased afterload'.
Visual 2: Flowchart - A simple flowchart connecting 'Nitroglycerin Administration' -> 'Systemic Vasodilation' -> 'Cerebral Vasodilation (Headache)' and 'Venous Pooling (Hypotension & Dizziness)'.

Clinical Relevance

Nursing practice connection: Use the key finding related to Adverse effects of sublingual nitroglycerin (NTG) to guide bedside assessment, documentation, and the next nursing action.
Patient safety is the primary concern. The nurse must educate the patient to sit or lie down before taking sublingual NTG to prevent falls from orthostatic hypotension.
The nurse should teach the patient that a headache is a common side effect and often indicates the drug is working, but it can be managed with mild analgesics if approved by the provider.
It is critical to assess the patient's blood pressure before and after administration. If systolic BP is below 90 mmHg, the dose should be held and the provider notified.

How to Approach the Question

First, identify the drug in the question: sublingual nitroglycerin (NTG).
Recall the primary drug class and mechanism of action for NTG. It is a nitrate, and its main action is vasodilation.
Think through the physiological consequences of widespread vasodilation. What happens when blood vessels in the head widen? What happens when vessels in the whole body widen?
Evaluate each option against this mechanism. Does vasodilation cause high blood sugar? Constipation? Dizziness and headache? Double vision?
Select the option that is a direct and common result of the drug's mechanism. Headache (from cerebral vasodilation) and dizziness (from hypotension) are classic effects.

Concept Tested & Keywords

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