Nokea
After administering an antihyperlipidemic drug, the nurse continues to assess which of the following?
- A. Blood glucose
- B. Vital signs
- C. Assessment of bowel function
- D. Input and output
- E. Stool sample
Correct Answer: B,C
Rationale: Clients on antihyperlipidemic medications should have vital signs checked and bowel function assessed because an adverse reaction to these drugs is constipation. Constipation may become serious if not treated early in the medication regimen.
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A client with hypercholesterolemia is prescribed lovastatin. When instructing the client how to take the drug, which of the following would the nurse include?
- A. Taking the drug with his evening meal
- B. Combining the drug with the artificial sweetener aspartame
- C. Mixing the drug with highly fluid soups or pulpy fruits
- D. Taking the drug with grapefruit juice
Correct Answer: A
Rationale: For the self-administration of lovastatin, the nurse should suggest the client take the drug with his evening meal. Cholestyramine powder is mixed with highly fluid soups or pulpy fruits. Cholestyramine is available combined with the artificial sweetener aspartame. The client should not drink grapefruit juice when taking lovastatin.
A client is receiving warfarin therapy as part of the treatment plan for atrial fibrillation. The client is also to begin therapy with cholestyramine. When assessing the client, the nurse would be alert for which of the following?
- A. Bruising
- B. Blood in the stool
- C. Subtherapeutic INR
- D. Supratherapeutic INR
- E. Calf pain and warmth
Correct Answer: C,E
Rationale: Coadministration of warfarin and cholestyramine can result in a decreased anticoagulant effect, leading to subtherapeutic INR and increased chance of clotting (signs and symptoms of DVT or PE).
Which of the following would the nurse include in the client teaching about HMG-CoA reductase inhibitors (statins)?
- A. Photosensitivity can occur
- B. The drug should be continued even if the client feels better
- C. Muscle pain and weakness are normal
- D. Juices other than grapefruit juice are okay to use
- E. Statins should be administered in the evening
Correct Answer: A,B,D,E
Rationale: When teaching about statins, the nurse should include information about the possibility of photosensitivity, the need to continue the drug even if feeling better, juices other than grapefruit juice as appropriate, and administration in the evening. MusclePain and weakness should be reported to the client's physician as soon as they occur.
A client is prescribed nicotinic acid. When teaching the client about this drug, which of the following would the nurse include as a normal skin reaction that may occur?
- A. Flushing
- B. Sensations of warmth
- C. Tuggling
- D. Rash
- E. Pustule formation
Correct Answer: A,B,C
Rationale: Generalized skin flushing, a sensation of warmth, and severe itching and tingling can occur with the administration of nicotinic acid, especially at higher doses.
A nurse is caring for a client taking a cholestyramine drug. What instructions should the nurse give to this client to prevent constipation?
- A. Eat foods high in dietary fiber
- B. Follow a complete liquid diet
- C. Be sure to stay on complete bed rest
- D. Take the water-soluble form of vitamin A
Correct Answer: A
Rationale: The nurse should instruct the client taking a cholestyramine drug to eat foods high in dietary fiber to prevent constipation. The nurse need not instruct the client to have a complete liquid diet or complete bed rest, instead, the nurse should instruct the client to exercise to prevent constipation. Clients are asked to take a water-soluble form of vitamin A if they are experiencing impaired digestion of fats and absorption of the fat-soluble vitamins due to long-term therapy of bile acid sequestrants.