11. A nurse should hold administration of a nitrate if:
. Pulse rate is under 60.
. Client is allergic to sulfa.
. Blood pressure is less than 90/50 mm Hg.
. Drug therapy has exceeded 2 weeks.
Test-Taking Tip
An example of a nitrate is nitroglycerin. Note the similarity to the drug classification—nitrate and "nitro-." Nitroglycerin is a vasodilator, leading to ↓ BP.
Content Area: Adult Health, Cardiovascular; Integrated Process: Nursing Process, Implementation; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Pharmacological and Parenteral Therapies/Medication Administration
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Answer 1 is incorrect because nitrates vasodilate veins but do not decrease heart rate. This would not be a reason to hold the drug. Answer 2 is incorrect because nitrates are not sulfa drugs. Answer 3 is correct because nitrates are potent vasodilators. This reduces the venous return, cardiac output, and BP. The drug should be held if the BP is too low. Answer 4 is incorrect because, with prolonged therapy, the client may develop tolerance to nitrates. Efficacy can be retained by providing a "nitrate-free" interval each day to allow the receptor to regain sensitivity. Therefore, therapy can proceed over weeks and years.