If a client’s chest pain is not relieved by sublingual organic nitrate, what does the nurse expect the provider to prescribe?

When a client experiences chest pain that is not relieved by sublingual organic nitrate, the next step in management typically involves the use of intravenous nitroglycerin. This medication is particularly effective in cases of angina and acute coronary syndromes by acting as a potent vasodilator. It works by relaxing the smooth muscle of blood vessels, which helps to decrease myocardial oxygen demand by reducing preload and afterload.

Using intravenous nitroglycerin allows for more rapid titration of the dose and nearer control of the pain compared to oral or sublingual routes, which can be limited in their effect or dependent on absorption rates. The continuous infusion also enables health professionals to closely monitor its effects and make necessary adjustments.

In contrast, while morphine and fentanyl can help to relieve pain, they do not address the underlying causes of angina or myocardial ischemia as effectively as nitroglycerin would. Nonsteroidal anti-inflammatory agents provide pain relief but lack the mechanism to significantly alter the hemodynamic status or relieve ischemia in the heart tissue. Thus, the use of intravenous nitroglycerin is the most appropriate response in this scenario.