The nurse teaches a client how to use sublingual nitroglycerin for an acute angina attack. Which statement by the client indicates correct understanding?
1I will swallow one tablet with a full glass of water and keep walking so it works faster.
2I will wait 15 minutes before the first tablet and then decide whether to seek medical help.
3I will sit, place one tablet under my tongue, and seek prompt help if pain persists after three tablets.✓ Correct answer
4I will chew three tablets together at the start of chest pain and continue my activity.
Explanation
At the onset of angina, the client should rest in a seated position and dissolve one nitroglycerin tablet under the tongue or in the buccal pouch. One additional tablet can be taken about every 5 minutes, with no more than three tablets in 15 minutes. Persistent or atypical pain requires prompt medical attention. The tablet should not be swallowed, chewed, or taken as three tablets at once.
Clinical reasoning Sublingual delivery provides rapid absorption, while sitting reduces injury risk from nitrate-related dizziness or hypotension. Persistent chest pain can indicate an acute coronary syndrome.
Decision rule Rest, dissolve one tablet sublingually at symptom onset, repeat only at the labeled interval, and obtain prompt medical attention when pain persists or differs from the usual pattern.
Sublingual nitroglycerin — A rapidly absorbed nitrate used to relieve an acute angina attack when dissolved under the tongue or in the buccal pouch.
Persistent angina — Chest pain not relieved by the labeled nitroglycerin regimen that requires prompt medical evaluation.