Nitroglycerin medication administration of sublingual tablets and oral spray: Nursing pharmacology review and demonstration on how to administer sublingual or oral spray nitroglycerin to a patient.

What is it nitroglycerin used for?

It used to relieve or prevent chest pain. It is part of the drug family of nitrates, and because of this it causes vasodilation of the blood vessels. This will lead to an increase in blood supply to the heart, which will help decrease its workload.

What can you expect to see in a patient who has received nitroglycerin?

Facial flushing, burning or tingling under tongue, headache, dizziness, hypotension etc.

Things to Consider BEFORE Giving Nitro:

No known allergy to Nitroglycerin
Confirm the patient has NOT recently taken a phosphodiesterase inhibitor like Sildenafil (Viagra) or Tadalafil (Cialis)...can lead to severe hypotension
Not for patients with increased intracranial pressure

When giving nitroglycerin have the patient sit down and:

Follow your hospitals protocol for chest pain, which usually includes following an order set. This will include obtaining a 12 Lead EKG, drawing cardiac enzymes, administering nitroglycerin along with other medications.

It is important to obtain baseline vital signs: this medication will lower the blood pressure. In addition, make sure the patient’s SBP is within parameters before administering. Most hospital protocols require SBP (systolic blood pressure) to be greater than 90, if it is not contact the MD for further orders.

When giving sublingual or oral spray nitroglycerin you will monitor the patient’s blood pressure and chest pain rating throughout. After the first dose of nitro, you can give a 2nd dose of the medication in 5 minutes if the patient is still having chest pain and the patient’s blood pressure is within parameters. If the patient is still having chest pain after a 2nd dose, a 3rd dose can be given within 5 minutes if the patient's blood pressure is within parameters. No more than 3 doses are given. Contact the physician for further orders.

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