RNPedia PNLE Nursing Practice 4 Test 1 Practice

For a patient on intravenous nitroglycerin for chest pain, what is the priority nursing action?

Assess blood pressure and heart rate; hold infusion if SBP < 90 mmHg or symptomatic; notify prescriber. Increase the infusion rate to improve perfusion. Discontinue the infusion immediately without notification. Switch to oral nitrate therapy.

Correct Answer:

Assess blood pressure and heart rate; hold infusion if SBP < 90 mmHg or symptomatic; notify prescriber.

Explanation:

IV nitroglycerin rapidly dilates veins, lowering preload and reducing myocardial oxygen demand, which helps chest pain but can cause dangerous drops in blood pressure. The priority action is to assess blood pressure and heart rate, and to hold the infusion if the systolic BP falls below 90 mmHg or the patient becomes symptomatic, then notify the prescriber. This safety step allows dose adjustments or discontinuation as needed to prevent hypotension and maintain perfusion. Increasing the infusion rate would risk worsening hypotension; discontinuing without notifying the prescriber could leave the patient unstable or in pain; switching to an oral nitrate would not provide the same rapid, controlled effect during acute chest pain.

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