A patient with angina has been given 0.4 mg of nitroglycerin SL. The patient reports continued chest pain 5 min later. The nurse assesses a heart rate of 84 beats per minute and a blood pressure of 88/68 mm Hg. The nurse will take which action?

A. Notify the provider of the patient's vital signs: The patient’s blood pressure is low (88/68 mm Hg), and administering additional nitroglycerin could worsen hypotension and lead to dizziness, syncope, or shock. Immediate provider notification is necessary before giving further doses. B. Give nitroglycerin by translingual spray: Administering another form of nitroglycerin without addressing the hypotension risk could further lower blood pressure. Changing the route does not mitigate the danger of giving vasodilators to a hypotensive patient. C. Administer 0.4 mg of nitroglycerin SL: Repeating the same SL dose while the patient is hypotensive may precipitate severe hypotension, syncope, or cardiovascular collapse. Further nitroglycerin must be held until guidance is obtained. D. Administer 0.3 mg of nitroglycerin SL: Even a slightly lower dose could still dangerously reduce blood pressure. Administering additional nitroglycerin without provider approval is unsafe in the context of the patient’s current vital signs.