Pharmacology Nitro / Angina #1

Question

Which is a medically benign side effect of sublingual nitroglycerin tablets?

Answers

  1. Increasing chest pain
    • Rationale:

      This answer is not correct because if a client is taking sublingual nitroglycerin tablets and chest pain is increasing, this is very concerning. The angina pain is reflecting lack of perfusion and potential tissue death in the myocardium.

  2. Headache pain of 6/10
    • Rationale:

      This answer is correct because although a headache is uncomfortable to the client, it is a benign side effect of the vasodilator action of nitroglycerin. Vasodilation causes filling and congestion of cranial blood vessels, which increases the intracranial pressure, causing a headache. The client can be treated with acetaminophen to help decrease the pain.

  3. BP of 84/58 mm Hg
    • Rationale:

      This answer is not correct because a blood pressure of 84/58 mm Hg is too low to perfusion the brain and other end organs. Nitroglycerin is a potent vasodilator and the client should be monitored for severe hypotension during therapy.

  4. Hbg 8, Hct 30%
    • Rationale:

      This answer is not correct because a Hbg of 8 and Hct of 30 is not a benign finding, in general. These abnormal laboratory results are not related to the nitroglycerin, but are not benign either.

Overview

Nitroglycerin dilates blood vessels in the brain, as well as the heart. This can cause the common, yet medically benign side effect of a headache.

Explanation

Learning Outcomes

Nitroglycerin is a vasodilator most often used to treat acute angina and myocardial infarction. This medication dilates blood vessels all over the body, including the brain. This influx and congestion of blood in the brain can cause pressure to occur in the cranium. This pressure causes the symptoms of a headache. This is uncomfortable to the client, but can be treated with acetaminophen, if needed. The discomfort caused by the nitroglycerin is not priority over the life-saving effects needed on the coronary arteries.

Test Taking Tip

Other selections are all abnormal findings and quite concerning. A headache is an expected side effect with nitroglycerin. Consideration of ABCs is important here.

Video Rationale