cerebral hemorrhage – 脑出血
hypovolemia – n. 血容量不足
intactness – n. 完整性
buccal mucosa – 颊粘膜
“RN-ISPN考试复习要点提示”
帮助您尽快理清复习思路，准确抓住复习重点，是ISPN/RN考试复习的一大利器！
————RN/ISPN Review ————
Assessment for Patients Receiving Nitrates 硝酸盐使用患者评估
Assess for contraindications or cautions: Any known allergies to nitrates to avoid hypersensitivity reactions; impaired liver or kidney function, which could alter the metabolism and excretion of the drug; any condition that could be exacerbated by the hypotension and change in blood flow caused by these drugs, such as early MI, head trauma, cerebral hemorrhage, hypotension, hypovolemia, anemia, or low-cardiac-output states; and current status of pregnancy or lactation because of the potential for adverse effects on the fetus or nursing baby.
Perform a physical assessment to establish baseline status before beginning therapy and during therapy to determine effectiveness and to evaluate for any potential adverse effects.
进行体检评估，确立治疗前及治疗期间基线状况，确定治疗效果，评估任何潜在的不良效应。
Inspect the skin for color, intactness, and any signs of redness, irritation, or breakdown, especially if the patient is using the transdermal or topical form of the drug, to prevent possible skin reaction and ensure adequate surface for application and absorption of transdermal or topical drug. Also check the patient’s oral or buccal mucosa (including the area under the tongue) if sublingual or buccal forms are ordered to reduce the risk of irritation and ensure adequate surface for absorption.
Assess the patient’s complaint of pain, including onset, duration, intensity, location, and measures used to relieve it. Investigate activity level prior to and after the onset of pain to aid in identifying possible contributing factors to the pain and its progression.
评估患者疼痛，包括发作、持续时间、强度、位置和缓解措施。调查疼痛发作前和发作后的活动水平，帮助确认疼痛及其进展的可能促成因素。
Assess the patient’s neurological status, including level of alertness, affect, and reflexes, to evaluate for CNS effects.
评估患者的神经学状况，包括警醒程度、情感和反射，评价其CNS效应
Monitor respirations and auscultate lungs to evaluate changes in cardiac output.
监测呼吸，听诊肺音，评价心排血量变化。
Assess cardiopulmonary status closely, including pulse rate, blood pressure, heart rate, and rhythm, to determine the effects of therapy and identify any adverse effects.
紧密评估心肺状况，包括脉率、血压、心率和心律，确定疗法效果，确认任何不良效应。
Obtain an ECG as ordered to evaluate heart rate and rhythm, which could indicate changes in cardiac perfusion.
按处方做ECG，评价心率和心律，这些可能显示心脏灌注变化。
Monitor laboratory test results, including liver and renal function tests, complete blood count, and hemoglobin level, to determine the need for possible dose adjustment.
监测实验室试验结果，包括肝、肾功能，全血计数，血红蛋白水平等，确定可能的剂量调整需要。
————Video ————
Angina – Nursing Care Plan
————Tests ————
1. The client has been managing angina episodes with nitroglycerin. Which of the following indicate the drug is effective?
A. Decreased chest pain.
B. Increased blood pressure.
C. Decreased blood pressure.
D. Decreased heart rate. 2. As an initial step in treating a client with angina, the physician prescribes nitroglycerin tablets, 0.3 mg given sublingually. This drug's principal effects are produced by:
A. Antispasmodic effects on the pericardium.
B. Causing an increased myocardial oxygen demand.
C. Vasodilation of peripheral vasculature.
D. Improved conductivity in the myocardium.
奥医教育“在线自测”题库 ISPN/RN复习练习、效果检验一站完成。
答案Answers
1. A. Decreased chest pain Rationale: Nitroglycerin acts to decrease myocardial oxygen consumption. Vasodilation makes it easier for the heart to eject blood, resulting in decreased oxygen needs. Decreased oxygen demand reduces pain caused by heart muscle not receiving sufficient oxygen. While blood pressure may decrease ever so slightly due to the vasodilation effects of nitroglycerine, it is only secondary and not related to the angina the patient is experiencing. Increased blood pressure would mean the heart would work harder, increasing oxygen demand and thus angina. Decreased heart rate is not an effect of nitroglycerine. 2. C. Vasodilation of peripheral vasculature. Rationale: Nitroglycerin produces peripheral vasodilation, which reduces myocardial oxygen consumption and demand. Vasodilation in coronary arteries and collateral vessels may also increase blood flow to the ischemic areas of the heart. Nitroglycerin decreases myocardial oxygen demand. Nitroglycerin does not have an effect on pericardial spasticity or conductivity in the myocardium.
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