Nitro-bide

Nitrostate

Nitrong

Nitrolinguate

ALL of the following must be met:

1. Patient complains of chest pain

2. Patient has a history of cardiac problems

3. Patient's physician has prescribed nitroglycerin (NTG)

4. Systolic blood pressure is greater than 100 mm Hg

5. Medical direction authorizes administration of the medication

*Patient has hypotension or a systolic blood pressure below 100 mm Hg

Patient has a head injury

Not used for infants or children

Patient has taken maximum prescribed dosage

Patient has taken other vasodilators within 24 hours (erectile dysfunction medicine)

Tablet

Sublingual Spray

One dose. Repeat in five minutes IF: no relief of pain, systolic remains above 100 and if authorized by medical direction

Maximum of three doses

1. Complete cardiac assessment

2. Systolic BP greater than 100 mm Hg

3. Contact medical control if no standing orders

4. Confirm:

    Name of patient

    Correct medication

    Medication belongs to patient

    Expiration date of medication

    Dosage is correct

5. Patient must be alert

6. When was the last dose administered; what were its effects?

7. Lift the tongue and place tablet under tongue OR Lift the tongue and spray once under the tongue

8. Close the mouth and allow tablet to dissolve or spray to be absorbed

9. Recheck blood pressure within two minutes

10. Chart that nitroglycerin was administered, route of administration and time given

11. Reassess patient

Relaxes blood vessels

Decreases work load on heart

Hypotension

Headache

Pulse rate change

Monitor blood pressure

Ask patient about effect on pain relief

Seek medical direction before re-administering

Record assessments