A patient with chronic stable angina is prescribed a nitroglycerin spray. Which teaching should the practical nurse include?

A patient with chronic stable angina is prescribed a nitroglycerin spray. Which teaching should the practical nurse include?

• A. The aerosol should be inhaled as she takes a deep breath.
• B. If she experiences headache, she should immediately notify the physician.
• C. She will experience pain relief in approximately 30 minutes.
• D. The spray should be taken before exercise or stressful physical activity.

Answer: (D)

Nitroglycerin spray for stable angina is used proactively to prevent an angina episode during planned exertion. It works quickly as a vasodilator, lowering venous return and myocardial oxygen demand, so taking it before exercise or stressful activity helps avert chest pain rather than waiting for it to start. Instruct that the spray is to be used sublingually, under the tongue, and absorbed rather than inhaled—this is a fast-acting, short-duration spray, with relief occurring within minutes, not after a long delay like 30 minutes. Headache is a common side effect and not an urgent reason to notify the physician, though persistent or severe symptoms should be discussed. If chest pain occurs despite prophylaxis, follow the prescribed emergency plan, which typically involves repeating doses as directed and seeking medical attention if relief isn’t achieved. So, the best teaching is to take the spray before planned exercise or stressful activity to prevent angina.

Nitroglycerin spray for stable angina is used proactively to prevent an angina episode during planned exertion. It works quickly as a vasodilator, lowering venous return and myocardial oxygen demand, so taking it before exercise or stressful activity helps avert chest pain rather than waiting for it to start.

Instruct that the spray is to be used sublingually, under the tongue, and absorbed rather than inhaled—this is a fast-acting, short-duration spray, with relief occurring within minutes, not after a long delay like 30 minutes. Headache is a common side effect and not an urgent reason to notify the physician, though persistent or severe symptoms should be discussed. If chest pain occurs despite prophylaxis, follow the prescribed emergency plan, which typically involves repeating doses as directed and seeking medical attention if relief isn’t achieved.

So, the best teaching is to take the spray before planned exercise or stressful activity to prevent angina.