Nitroglycerin Medication Nursing Sublingual Tablets & Oral Spray Pharmacology Review & Adminstration

Summary

This video provides a comprehensive guide on administering sublingual nitroglycerin and oral nitroglycerin spray. It explains the medication’s role in treating chest pain by improving blood flow to the heart. The video covers safety protocols, including confirming patient allergies, checking blood pressure, and monitoring side effects like dizziness, facial flushing, and hypotension. It also details the proper administration techniques for both the tablet and spray, as well as guidelines for managing doses and when to consult a physician. Nurses are reminded to always follow hospital protocols and manufacturer's instructions to ensure patient safety.

Takeaways

• 😀 Always follow hospital protocols and manufacturer's instructions when administering nitroglycerin.
• 😀 Nitroglycerin is used to relieve chest pain by causing vasodilation and increasing blood flow to the heart muscle.
• 😀 Common side effects of nitroglycerin include facial flushing, tingling sensation under the tongue, headache, dizziness, and hypotension.
• 😀 It’s important to confirm that the patient is not allergic to nitroglycerin and has not taken phosphodiesterase inhibitors (e.g., Viagra or Cialis) before administering it.
• 😀 Nitroglycerin should not be given to patients with increased intracranial pressure.
• 😀 Always wear gloves when handling nitroglycerin to avoid absorption and potential side effects.
• 😀 Sublingual nitroglycerin comes in a dark vial, sensitive to light, heat, and moisture, and should be discarded three months after opening.
• 😀 Prior to administration, make sure the patient is seated and baseline vital signs, especially blood pressure, are obtained.
• 😀 Sublingual nitroglycerin tablets should dissolve under the tongue without chewing, and the patient should not rinse their mouth.
• 😀 For both sublingual tablets and oral spray, monitor blood pressure and chest pain levels continuously. If chest pain persists after three doses, notify the physician.
• 😀 When using the nitroglycerin spray, prime the bottle by spraying 5-8 times before the first use and avoid shaking the bottle. Give one spray under the tongue, and the patient should avoid swallowing the medication immediately.

Q & A

What is the purpose of administering nitroglycerin?

Nitroglycerin is used to relieve or treat chest pain by causing vasodilation, which opens up blood vessels and increases blood flow to the heart, while also decreasing its workload.

What are some common side effects of nitroglycerin administration?

Common side effects include facial flushing, a burning or tingling sensation under the tongue, headache, dizziness, and hypotension (low blood pressure).

What should a nurse do before administering nitroglycerin?

Before administering nitroglycerin, the nurse should confirm the patient isn't allergic to it, ensure they haven't taken a phosphodiesterase inhibitor (like Viagra or Cialis) recently, and check that the systolic blood pressure is above 90. The nurse should also follow hospital protocols and wear gloves.

Why is the nitroglycerin vial dark in color?

The dark vial protects nitroglycerin from light, which can degrade the medication. Nitroglycerin is also sensitive to heat and moisture.

What is the proper way to administer sublingual nitroglycerin?

To administer sublingual nitroglycerin, place one tablet under the patient’s tongue without chewing or swallowing it. The patient should not rinse their mouth after administration, as the medication will absorb through the lining under the tongue.

What should the nurse monitor after administering sublingual nitroglycerin?

The nurse should monitor the patient's blood pressure (particularly systolic) to ensure it stays above 90, as well as track the patient's chest pain and its intensity. If chest pain persists after a second dose, the nurse can administer a third dose within five minutes.

How many doses of nitroglycerin can be given to a patient?

No more than three doses of nitroglycerin should be given. If chest pain persists after the third dose, the nurse should notify the physician for further orders.

What is the correct procedure for administering oral nitroglycerin spray?

To administer oral nitroglycerin spray, remove the cap, prime the bottle by spraying 5 to 8 times, and then spray one dose under the patient’s tongue while they hold their breath. The patient should not inhale the medication, and they should avoid eating, drinking, or rinsing their mouth for at least 10 minutes.

What precautions should be taken when handling nitroglycerin?

Nitroglycerin should be handled with care to avoid accidental exposure. Nurses should wear gloves, and the medication should be stored in a dark, cool place away from heat and moisture. It should never be shaken or stored upside down.

What is the importance of the standing orders or protocols in the hospital for chest pain treatment?

Standing orders or protocols provide a standardized approach to managing chest pain, which typically includes administering nitroglycerin, monitoring the patient's vital signs, administering morphine if necessary, providing oxygen, performing an EKG, and drawing cardiac enzymes.