Question

A 55-year-old male client complains of crushing chest pain, shortness of breath, and profuse sweating is observed. His symptoms are only slightly improved by rest. This client has a history of angina pectoris and has his nitroglycerin tablets with him. Which of the following is the recommended protocol for taking the nitroglycerin medication?

1) Take one tablet every 5 minutes for a maximum of three doses
2) Take one tablet every 10 minutes for a maximum of three doses
3) Take one tablet every 15 minutes for a maximum of three doses
4) Take one tablet every 30 minutes for a maximum of three doses

Answer 1

The recommended protocol is to take one nitroglycerin tablet every 5 minutes for a maximum of three doses, seeking emergency assistance if pain persists after the first dose as it may indicate a myocardial infarction.

Step-by-step explanation:

Nitroglycerin is a critical medication used to treat episodes of angina pectoris, which is chest pain resulting from reduced blood flow to the heart muscle. The drug acts as a vasodilator, enhancing blood flow and oxygen to the heart muscle by dilating the coronary arteries. In the case of stable angina, the pain usually improves with rest and nitroglycerin.

However, the scenario described suggests unstable angina, a more dangerous condition that may precede a heart attack and requires urgent medical attention. The standard emergency protocol for the use of nitroglycerin is to take one sublingual tablet at the onset of symptoms and then every 5 minutes for two more doses if necessary. If chest pain or other symptoms such as shortness of breath and sweating do not improve significantly after the first dose, it is crucial to seek emergency assistance, as these can be signs of an acute MI. Patients should not exceed three doses of nitroglycerin within a 15-minute period without medical supervision due to the risk of hypotension and other potential adverse effects.