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Asked by amore98

Mr. Wilson is a newly diagnosed angina patient. He is 59 years old, and he has been having increasing numbers of chest pain episodes especially after he climbs the steps in his home to get to the second floor of his house. He has also had a few angina- like attacks in his workshop behind the garage of his home. They occurred when he had to lift and rearrange several heavy boxes in order to get to the tools and manuals he was looking for. Both the stair climbing and box moving episodes were short lived and stopped within 2 minutes of stopping the activity. He came to your clinic, and you referred him to cardiology for a work-up. After a treadmill test, which demonstrated transient ST segment alterations during high workloads, he was given the diagnosis of intermittent ischemic angina. He was prescribed a standard 1⁄4 gr sublingual dose in a brown colored bottle. He was given a prescription for three of the bottles to be filled at once. He comes back to your clinic for some clarification.

Question

1) You assess that your patient knows how to take the nitroglycerin and the timing of doses when he experiences angina. What response from your patient will show correct understanding?

2)Your student nurse practitioner (NP) questions why this patient was given the standard ¼ gr form, when the last patient seen with angina had a different form of NTG ordered. You start to explain that not all antianginal agents are the best for different patient variables. There are many agents that fit circumstances better than others. These agents include NTG sl, oral, patch, spray, Isosorbide, and Ranolazine. You send the student to her resources to identify the typically recommended medication formulation for each group noted below and to explain why that formulation would be recommended.

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