Chest Pain Chronicles
This condition occurs when the myocardium does not receive enough oxygen-rich blood.
What is angina pectoris?
This medication is commonly used sublingually for rapid relief of an acute angina attack.
What is nitroglycerin?
This beta blocker is commonly used for angina, hypertension, and after myocardial infarction.
What is atenolol (Tenormin)?
This calcium channel blocker relaxes smooth muscle and increases coronary artery dilation.
What is nifedipine?
Before administering nitroglycerin, the nurse should check this assessment finding.
What is blood pressure?
This disease is the most common cause of angina due to plaque buildup in coronary arteries.
What is coronary artery disease (CAD)?
Nitroglycerin decreases cardiac workload by reducing this factor through venous dilation.
What is preload?
Beta blockers improve survival after MI by blocking these stress hormones.
What are norepinephrine and epinephrine (catecholamines)?
Calcium channel blockers decrease this by preventing calcium from entering cells during contraction.
What is systemic vascular resistance/workload of the heart?
The nurse should teach patients taking long-acting nitrates that this may occur over time.
What is tolerance?
This type of angina occurs due to temporary coronary artery spasms.
What is variant (Prinzmetal’s or vasospastic) angina?
This is the most common adverse effect caused by widespread blood vessel dilation with nitrates.
What is headache?
The nurse should assess this vital sign before administering a beta blocker because the medication can cause severe slowing.
What is heart rate?
These are common adverse effects of calcium channel blockers.
What are hypotension, flushing, edema, palpitations, and tachycardia?
A patient taking atenolol has diabetes. The nurse should explain that beta blockers may mask this symptom of hypoglycemia.
What is tachycardia/increased heart rate?
A patient reports squeezing substernal chest pain radiating to the jaw and left arm. The nurse recognizes this as a classic sign of this condition.
What is angina pectoris/myocardial ischemia?
A patient taking nitroglycerin should avoid these medications because the combination can cause life-threatening hypotension.
What are phosphodiesterase type 5 inhibitors (ED medications such as sildenafil)?
The nurse should use caution when administering beta blockers to patients with this respiratory condition because bronchoconstriction may occur.
What is asthma?
Ranolazine is reserved for patients who do not respond adequately to this medication class.
What are beta blockers?
A patient taking nitroglycerin with alcohol is at increased risk for this complication.
What is hypotension?
These are the three overall goals of antianginal therapy.
What are decreasing anginal attacks, improving functional capacity with minimal adverse effects, and preventing/delaying myocardial infarction?
The nurse should hold nitroglycerin if the patient’s systolic blood pressure falls below this value.
What is 90 mmHg?
A patient taking atenolol reports dizziness and has a heart rate of 42 bpm. The nurse recognizes this as this adverse effect.
What is severe bradycardia?
A patient should avoid ranolazine if they have this ECG abnormality because it increases the risk of dangerous rhythms.
What is a prolonged QT interval?
A patient receiving IV nitroglycerin has a BP of 84/50 and reports dizziness. The nurse’s priority action is to do this.
What is hold the medication and notify the provider?