When using Nitroglycerin IV, it is important to monitor ECG, Blood pressure, pulse, heart rate, MAP, and document how the patient is or is not tolerating Nitroglycerin and the effects of the titration. Anytime there is a change in the drip rate, always document the current drip rate in mcg/min and the ml/hr, and what the changed drip rate will be whether up or down and why you changed the drip rate of Nitroglycerin. Document vital signs and ECG rhythm and what occurred for the rate to increase or decrease. For example, patient has chest pain 8 out of 10 on the pain scale, “crushing, stabbing, sharp pain in middle of chest, Nitroglycerin drip currently at 10mcg/min, will increase to 20mcg/min and re-assess pain level, vital signs stable, heart rate 78, Sinus Rhythm with first degree block, no ectopy noted. The ACLS certification course offers different scenarios to help increase the knowledge of medical professionals during emergency situations dealing with the heart.