A client is to start on nitroglycerin for acute angina attacks. A nurse should teach the client to

A client is to start on nitroglycerin for acute angina attacks. A nurse should teach the client to

• A. Wait five minutes before taking the medication
• B. Discontinue the medication if the client experiences a headache
• C. Take a second dose ten minutes after the first dose, if no relief
• D. Allow the medication to dissolve under the tongue

Answer: (D)

The key idea is how nitroglycerin reaches the bloodstream quickly to relieve acute angina. It works fastest when absorbed directly through the oral mucosa, which is why the tablet should be placed under the tongue and allowed to dissolve rather than swallowed or chewed. Sublingual absorption bypasses the liver, so the medication acts rapidly—often within a couple of minutes—to dilate veins and reduce myocardial oxygen demand. Swallowing or chewing would delay absorption and reduce effectiveness, making the under-tongue route the most reliable method for a quick attack. If pain persists after the first dose, repeat every five minutes for up to three doses total, and seek emergency care if there's no relief after the second dose or if the pain worsens. Headache is a common side effect but does not mean you should stop the medication.

The key idea is how nitroglycerin reaches the bloodstream quickly to relieve acute angina. It works fastest when absorbed directly through the oral mucosa, which is why the tablet should be placed under the tongue and allowed to dissolve rather than swallowed or chewed. Sublingual absorption bypasses the liver, so the medication acts rapidly—often within a couple of minutes—to dilate veins and reduce myocardial oxygen demand. Swallowing or chewing would delay absorption and reduce effectiveness, making the under-tongue route the most reliable method for a quick attack. If pain persists after the first dose, repeat every five minutes for up to three doses total, and seek emergency care if there's no relief after the second dose or if the pain worsens. Headache is a common side effect but does not mean you should stop the medication.