Question

The nurse is providing care for a client admitted to the hospital with reports of chest pain. After receiving a total of three nitroglycerin sublingual tablets, the client states, "The pain has not gotten any better." What does the nurse do next?

a. Place the client in a semi-Fowler's position.
b. Administer intravenous nitroglycerin.
c. Begin supplemental oxygen at 2 L/min.
d. Notify the health care provider.

Answer 1

The nurse should immediately notify the health care provider if chest pain persists after administering three doses of sublingual nitroglycerin, as this may indicate a more serious condition requiring urgent medical intervention.

Step-by-step explanation:

If a client admitted to the hospital reports that chest pain has not improved after receiving three sublingual nitroglycerin tablets, the nurse's next step should be to notify the health care provider immediately. Chest pain that is unresponsive to nitroglycerin may be indicative of an unstable angina or myocardial infarction (MI), which requires urgent medical attention. The fact that nitroglycerin, a vasodilator that usually helps relieve chest pain by improving blood flow to the heart muscle, did not alleviate the pain suggests the possibility of a more serious underlying issue. Once the health care provider is notified, they can assess the patient further and may order additional treatments, such as supplemental oxygen, aspirin, or other medications, and potentially order diagnostic tests or interventions like angioplasty or surgery. It is crucial for the nurse to continuously monitor the patient's vital signs and provide them with support and care while awaiting further instructions.