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by gringo

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What are the two types of nitrates and their routes?
- Short acting (SL & IV)
- Long acting (PO & transdermal)
What is the indication of use for nitrates?
acute and prophylactic treatment of angina
What is the action of nitrates?
dilates veins and arteries - dilates coronary arteries
What is the effect of nitrates?
prevention or relief of angina by decreasing preload & afterload while increasing O2 delivery
What is the indication of use for short-acting nitrates?
relief of acute angina
What is the onset time for acute angina?
1-3 minutes
What are 6 nursing teachings for SL nitroglycerin?
- sit or lie down before taking SL med
- Place 1 tablet under tongue, wait 5 min x 3 times
- If no relief of CP after 3 tablets, call EMS
- Do not chew or swallow SL nitroglycerin
- keep SL med in same container away from heat, light and moisture
- replace supply every 6 months
What is the indication of use for long-acting nitrates?
prevention of angina
What are three routes of long-acting nitrates?
- PO - sustained release
- Trandermal Patch
- Ointment
What should be done to avoid tolerance of nitroglycering while using a transdermal patch?
remove patch 6-12 hours/day at night
How is nitroglycerin ointment measured?
in inches (1" = 15mg)
How should nitroglycerin ointment be removed?
remove previous dose by washing skin, wear gloves, do not massage or rub into skin, cover w/ plastic wrap
What are three contraindications of nitrates for angina?
- pt with glaucoma should not take sustain release nitrates
- shock, acute MI, head injury, IICP
- Hypotension - assess before giving especially if IV
What are three drugs that should not be taken within 24hrs of nitrates?
Viagra, Cialis, Levitra
What are five adverse reactions to nitrates?
H/A, diziness, decreased BP, decreased HR, syncope
What are four nursing implications of nitrates?
- assess angina pattern
- monitor BP and HR before / after giving
- rotate transdermal med on nonhairy area of chest or abdomen (avoid extremities)
- do not rub or massage ointment into skin
What are 8 patient teachings for nitrates?
- Change position slowly (orthostatic hypotension)
- do not chew or swallow SL nitroglycerin
- Keep SL med in same container away from heat, light, moisture
- replace RX q6 months
- No Viagra, Levitra or Cialis w/in 24 hrs
- Avoid Etoh
- H/A can be treated w/ASA or tylenol
- Go to ER if CP is not relieved by 3 SL tablets in 15 minutes
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