The client admitted with angina is given a prescription for nitroglycerine. The client should be instructed t… - RAK Nursing Officer - 2019

RAK Nursing Officer - 2019

Pharmacology

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Appeared in: RAK Nursing Officer - 2019

Explanation

The primary instruction is to keep nitroglycerin in its original dark-colored (amber/brown) glass bottle.
This special container protects the tablets from light, heat, and moisture, all of which can degrade the medication and reduce its effectiveness.
Proper storage is critical to ensure the drug is potent and works quickly during an episode of angina.
Transferring the medication to other containers or pillboxes can lead to loss of potency.

Option A: While nitroglycerin needs to be replaced regularly, a strict 3-month rule is not the standard guideline. The medication is generally considered stable for 3 to 6 months after opening.
Option B: The correct interval for taking nitroglycerin during an angina attack is one tablet every 5 minutes, not every 15 minutes.
Option D: Sublingual nitroglycerin must be placed under the tongue to dissolve. Crushing and taking it with water would cause it to be swallowed, subjecting it to first-pass metabolism in the liver, which would delay its onset and reduce its effectiveness significantly.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Patient education for sublingual nitroglycerin administration and storage as background academic context rather than a clinical decision trigger.
Effective patient education by the nurse is a critical safety measure. Misunderstanding instructions for nitroglycerin can lead to ineffective treatment of angina, potentially progressing to a myocardial infarction.
Nurses must teach patients to recognize common side effects like headache, dizziness, and flushing, and to manage them by sitting or lying down when taking the medication.
A critical safety warning is to avoid taking erectile dysfunction medications (e.g., sildenafil, tadalafil) with nitroglycerin, as the combination can cause a life-threatening drop in blood pressure.

How to Approach the Question

First, identify the core of the question: it's asking for the correct patient instruction regarding nitroglycerin for angina.
This is a knowledge-based question requiring recall of standard pharmacological protocols for a common cardiac medication.
Evaluate each option against your knowledge of nitroglycerin's properties and administration guidelines.
Option A (Replenish): Recall the standard replacement timeframe (3-6 months). Is 'every 3 months' the most accurate and universal rule?
Option B (Dosing): Recall the dosing interval for acute angina (every 5 minutes). Compare this to the option's 'every 15 minutes'.
Option C (Storage): Recall the stability issues of nitroglycerin (light/heat/moisture sensitivity). Does the brown bottle address this?

Concept Tested & Keywords

Concept Tested: Patient education for sublingual nitroglycerin administration and storage.
Stem keywords: angina, nitroglycerine, prescription, instructed
Lead-in keywords: should be instructed to

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E6 Pharmacology Nursing Lilley 11e Part 2 p. 64-66