Pratica di Shadowing: Nitrates: Nursing Pharmacology - Impara a parlare inglese con i video
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What?
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you Nitrates are medications that come under the umbrella of a larger group called vasodilators, which dilate the walls of blood vessels.
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Nitrates are primarily used to treat angina pectoris, which is pain caused by reduced blood flow to the heart muscle as well as hypertension and heart failure.
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More recently, they've also been approved for the topical treatment of anal fissures.
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The most commonly used nitrates include nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate.
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Out of these, nitroglycerin has a rapid and short -lasting action, so when treating acute anginal pain or hypertension,
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it's typically given through rapidly absorbable routes, like sublingual, oral spray, or intravenously, to bypass the first -pass metabolism in the liver,
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which would slow its absorption.
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For long -term prevention, though, routes of administration can include transdermal patches, topical ointments, or extended -release oral capsules.
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Nitroglycerin can also be administered rectally for the treatment of anal fissures.
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On the other hand, isosorbide dinitrate and isosorbide mononitrate have a longer duration of action and are typically administered orally as tablets,
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or sustained release capsules which makes them useful for the long -term prevention of angina pectoris
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or to treat clients with heart failure.
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Once absorbed into the blood, nitrates quickly get converted into their active form,
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called nitric oxide, Nitric oxide diffuses to the smooth muscle cells of both veins and arteries, causing wall relaxation and vasodilation.
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The result of venous vasodilation is peripheral blood pooling, which in turn decreases the return of venous blood to the heart.
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This way, nitrates predominantly reduce preload, which is the pressure that stretches the heart as it fills with blood from venous return.
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At the same time, arterial vasodilation lowers the systemic vascular resistance, which will also reduce the afterload,
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or the pressure that the heart must work against to eject the blood.
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Ultimately, by reducing preload and afterload, nitrates reduce the amount of work the heart has to do, eventually decreasing the heart's oxygen consumption.
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Nitrates also have a minor effect on the dilation of the coronary arteries, which helps increase oxygen delivery to heart tissue.
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Common side effects of nitrates include headache, dizziness, flushing, nausea, and vomiting.
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Another important side effect of nitrates is orthostatic hypotension, where the blood pressure falls significantly when the client stands up too quickly.
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As a result, these clients could experience lightheadedness or syncope due to decreased blood flow to the brain.
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In addition, clients may experience reflex tachycardia,
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which is caused by the sympathetic system triggering an increase in heart rate in response to the hypotension caused by nitrates, in order to maintain tissue perfusion.
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Now, clients who continuously use nitrates soon develop tolerance to these side effects.
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Unfortunately, clients may also develop tolerance to the therapeutic effects of nitrates, especially with uninterrupted use.
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Clients can prevent this by avoiding using nitrates for several hours each day.
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Finally, nitrates are contraindicated in individuals with hypotension, hypovolemia, severe anemia, and cardiomyopathy.
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Nitrates should be used carefully during pregnancy or breastfeeding, as well as in clients with increased intracranial pressure or cerebral hemorrhage,
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renal or hepatic disease, and syncope.
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As far as drug interactions go, nitrates should never be combined with other substances that cause vasodilation,
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such as alcohol, Medications used to treat erectile dysfunction including sildenafil,
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tadalafil, or vardenafil or antihypertensive agents like beta blockers or calcium channel blockers.
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If taken together, their effects add up and may lead to a steep fall in blood pressure, cardiovascular collapse, and even death.
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Now, before administering a nitrate,
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complete a baseline assessment, including frequency and severity of angina pain and vital signs especially blood pressure.
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Review their health history for angina risk factors, such as hypertension.
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Next, check your client's latest laboratory report including CBC, hepatic and renal function, as well as their lipid profile.
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Then be sure they understand how angina happens, and explain how the medication helps reduce or prevent angina by improving blood flow to the heart.
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Lastly, after administering the nitrate, remain with your client and continuously monitor their vital signs, especially blood pressure.
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Continue to assess for worsening symptoms, such as chest pain and side effects, and for the desired therapeutic response.
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Ok, when teaching your client about sublingual nitroglycerin, explain that nitrates are sensitive to light,
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moisture and heat, so advise them to store their nitroglycerin pills in their original container at room temperature
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but also remind them to carry a small number of their pills with them at all times.
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Teach them that taking a sip of water before putting their pill under their tongue will help it dissolve
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and get into their system faster.
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In addition, let them know that it's normal for them to feel a slight burning
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or tingling under their tongue while the medication dissolves.
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Be sure to remind your client to not swallow the medication
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and instruct them to avoid eating or drinking anything for 15 minutes after administration to ensure the medication is fully absorbed.
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Let them know about common side effects they may experience, such as headache, which can be managed with acetaminophen,
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and orthostatic hypotension, which can increase the risk of falls.
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So teach your client to make position changes slowly, especially if they feel lightheaded.
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Lastly, stress the importance of avoiding other substances that can excessively lower blood pressure, such as alcohol and medications used for erectile dysfunction.
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If your client experiences angina with activity, remind them to take the nitroglycerin prior to precipitating activities or situations,
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such as playing sports or mowing the lawn.
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If they're taking the nitrate for acute angina, instruct them to call emergency services if the pain does not resolve within five minutes after one dose.
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While awaiting emergency care to arrive, let them know that they may take a second and third dose five minutes apart.
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Now, if your client is prescribed transdermal nitroglycerin patches, instruct them to apply a new patch each day on a hairless part of their body.
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To prevent the development of nitrate tolerance, stress the importance of incorporating about 12 hours of nitrate free time every 24 hours, usually during the night.
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For example, if your client has angina with activity, instruct them to apply their patch at 8 a .m and then remove it at 8 p .m.
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Finally, remind your client to take their medication as directed, and warn them that stopping abruptly could result in vasospasm.
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Alright, as a quick recap, nitrates are medications mainly used to treat angina pectoris, hypertension, and heart failure.
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Once administered, nitrates are quickly converted into their active form, nitric oxide, which causes vasodilation and ultimately reduces preload and afterload.
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while improving blood flow through the coronary arteries.
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Clients who are prescribed nitrates should be advised about side effects, including headache, dizziness, flushing, nausea,
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orthostatic hypotension, and reflex tachycardia.
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Nitrates should be avoided in clients with problems such as hypotension and hypovolemia, and they should never be combined with other substances that cause vasodilation,
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such as alcohol or medications for erectile dysfunction.
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Finally, continuous administration of nitrates can lead to tolerance, and clients can prevent this by avoiding using nitrates for several hours each day.
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Informazioni su Questa Lezione
In questa lezione, gli studenti avranno l'opportunità di praticare il linguaggio medico e la terminologia legata ai nitrati, inclusi i loro usi e effetti collaterali. Imparare a discutere di argomenti di farmacologia è importante per arricchire il proprio lessico, in particolare per chi aspira a lavorare nel settore sanitario o a comunicare efficacemente in un contesto professionale. La lezione si concentrerà sui concetti chiave e sulle frasi utili che possono essere utilizzate in conversazioni riguardanti la salute e i farmaci. Gli studenti possono seguire il video e praticare la tecnica del shadowspeak per migliorare la pronuncia inglese.
Vocabolario e Frasi Chiave
- Nitrati: gruppi di farmaci utilizzati per trattare angina pectoris e ipertensione.
- Vasodilatatori: sostanze che dilatano le pareti dei vasi sanguigni.
- Angina pectoris: dolore toracico causato da una riduzione del flusso sanguigno al cuore.
- Effetti collaterali: reazioni negative che possono verificarsi con l'uso di farmaci, come mal di testa e vertigini.
- Precarico e postcarico: termini utilizzati per descrivere le pressioni che il cuore deve affrontare.
- Assorbimento: il processo tramite il quale i farmaci entrano nel flusso sanguigno.
- Controindicazioni: condizioni in cui un farmaco non dovrebbe essere utilizzato.
Consigli per la Pratica
Per migliorare la pronuncia inglese, è utile applicare la tecnica del shadowspeaks. Inizia seguendo il video a una velocità normale e cerca di ripetere ogni frase nella stessa intonazione e ritmo dell'oratore. Fai attenzione alla pronuncia delle parole chiave e cerca di riprodurre i suoni in modo preciso. Un metodo efficace è quello di mettere in pausa il video dopo frasi brevi per riflettere sulla pronuncia e l'accento, poi riprendere per ascoltare come l'oratore originale prosegue. Inoltre, prova a registrare te stesso mentre pratichi: ascoltare le tue registrazioni ti aiuterà a riconoscere le aree in cui puoi migliorare.
Ricorda di praticare in modo regolare, magari dedicando qualche minuto ogni giorno all'esercizio del shadowspeak per consolidare le tue abilità linguistiche. Affrontare contenuti complessi, come quello dei nitrati, non solo espande il tuo vocabolario tecnico, ma aumenta anche la fiducia nelle tue capacità di comunicare in inglese. Imparare l'inglese con YouTube rende il processo più interattivo e coinvolgente, permettendoti di ascoltare e riprodurre frasi nel contesto.
La grammatica di questo video
Le strutture che chi parla usa di più, con le parole esatte del video:
| Struttura | Nel video |
|---|---|
| “Used to” used to + verbo — un’abitudine o uno stato passato che non è più vero | used to treat |
| Forma passiva be + participio passato — conta ciò che accade, non chi lo fa | been approved · be administered · is caused |
| Frasi relative who / which + frase — un’informazione in più su una persona o una cosa | pectoris, which is · capsules which makes · preload, which is |
Cos'è la tecnica dello Shadowing?
Shadowing è una tecnica di apprendimento delle lingue supportata da studi scientifici, originariamente sviluppata per la formazione dei traduttori professionisti e resa popolare dal poliglotta Dr. Alexander Arguelles. Il metodo è semplice ma potente: ascolti un audio in inglese di madrelingua e lo ripeti immediatamente ad alta voce — come un'ombra che segue il parlante con un ritardo di solo 1–2 secondi. A differenza dell'ascolto passivo o degli esercizi di grammatica, lo shadowing costringe il tuo cervello e i muscoli della bocca a elaborare e riprodurre simultaneamente i modelli di discorso reale. La ricerca dimostra che migliora significativamente la precisione della pronuncia, l'intonazione, il ritmo, il discorso connesso, la comprensione dell'ascolto e la fluidità del parlato — rendendolo uno dei metodi più efficaci per la preparazione alla prova di speaking dell'IELTS e per la comunicazione reale in inglese.