Pharmacology Nitro / Angina #5

Question

Which best indicates effective nitroglycerin therapy in a client admitted with a myocardial infarction awaiting transport to the cath lab?

Answers

  1. Increased troponin levels
    • Rationale:

      This answer is not correct because increasing troponin levels indicates increasing myocardial tissue death. Although these levels can result well after cardiac procedures, this finding would not be an indication of effective nitroglycerin therapy.

  2. Increased blood pressure
    • Rationale:

      This answer is not correct because nitroglycerin decreases blood pressure. In fact, the nurse should monitor the client carefully for this side effect to prevent severe hypotension.

  3. Decreased chest pain
    • Rationale:

      This answer is correct because acute angina pain is the result of decreased oxygen to the myocardium. Angina pain, in most clients, indicates progressive death of tissue. Vasodilation of nitroglycerin tries to allow as much blood to get to the myocardium as possible. An indicator that this has occurred, includes decreasing chest pain.

  4. Decreased headache
    • Rationale:

      This answer is not correct because effective nitroglycerin therapy generally produces a headache. This is due to the vasodilation and congestion of cranial blood vessels increasing the intracranial pressure.

Overview

Nitroglycerin is utilized to produce vasodilation in clients with acute angina with a potential myocardial infarction or extreme refractory hypertension. The desired responses include decreased chest pain and blood pressure.

Explanation

Learning Outcomes

Nitroglycerin is a potent vasodilator used to decrease angina associated with myocardial infarction. Angina pain in this client is due to the lack of perfusion (oxygen) to the myocardium. Angina pain, in most clients, indicates progressive death of tissue. Vasodilation of nitroglycerin tries to allow as much blood to get to the myocardium as possible. An indicator that this has occurred, includes decreasing chest pain.

Test Taking Tip

When asked if a therapy is “effective”, consider choosing its desired effects, not the side effects.

Video Rationale