Page 1781 - Saunders Comprehensive Review For NCLEX-RN

1. Monitor vital signs.
2. Monitor white blood cells, and protein, albumin, BUN,
creatinine, and potassium levels.
3. Monitor for hypoglycemic reactions in the client with
diabetes mellitus.
4. If captopril is prescribed, instruct the client to take the
medication 20 to 60 minutes before a meal.
5. Monitor for bruising, petechiae, or bleeding with
captopril.
6. Instruct the client not to discontinue medications,
because rebound hypertension can occur.
7. Instruct the client not to take over-the-counter
medications.
8. Instruct the client in how to take the BP.
9. Inform the client that the taste of food may be
diminished during the first month of therapy.
10. Instruct the client to report adverse effects to the
PHCP.

X. Antianginal Medications (Box 53-13)

A. Nitrates (see Priority Nursing Actions)

Priority Nursing Actions

Chest Pain in a Hospitalized Client with Cardiac Disease
1. Quickly assess the client, specifically characteristics of pain, heart rate and rhythm, and blood
pressure (BP).
2. Administer a nitroglycerin tablet sublingually.
3. Stay with the client.
4. Reassess in 5 minutes.
5. Administer another nitroglycerin tablet sublingually if pain is not relieved and the BP is stable.
6. Reassess in 5 minutes.
7. Administer a third nitroglycerin tablet sublingually if pain is not relieved and the BP is stable.
8. Reassess in 5 minutes; contact the primary health care provider (PHCP) if the third
nitroglycerin tablet does not relieve the pain.
9. Document the event, actions taken, and the client’s response to treatment.

Reference

Burchum, Rosenthal (2016), pp. 604-605, 622.

1. Description
a. Nitrates produce vasodilation, decrease preload and
afterload, and reduce myocardial oxygen
consumption.
b. Contraindicated in the client with significant
hypotension, increased intracranial pressure, or
severe anemia and in those taking medication to treat
erectile dysfunction

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