Author Question: A nurse is providing discharge teaching instructions for a patient taking cholestyramine (Questran). ... (Read 52 times)

strangeaffliction · **on:** Jul 23, 2018

A nurse is providing discharge teaching instructions for a patient taking cholestyramine (Questran). Which statement made by the patient demonstrates a need for further teaching?

a. I will take warfarin (Coumadin) 1 hour before my medicine.
b. I will increase the fluids and fiber in my diet.
c. I can take cholestyramine with my hydrochlorothiazide .
d. I will take digoxin 4 hours after taking the cholestyramine.

Question 2

A nurse is reviewing the medications of a patient with diabetes before discharge. The nurse realizes that the patient will be going home on colesevelam, a bile acid sequestrant, and insulin.

What patient education should the nurse provide in the discharge teaching for this patient?
a. The patient needs to monitor the blood sugar carefully, because colesevelam can cause hypoglycemia.
b. The patient needs to monitor the blood sugar carefully, because colesevelam can cause hyperglycemia.
c. The patient needs to take the insulin at least 3 hours before the colesevelam.
d. The patient needs to use an oral antidiabetic agent or agents, not insulin, with colesevelam.

Dunkey · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: C
Drugs known to form complexes with the sequestrants include thiazide diuretics, such as hydrochlorothiazide, digoxin, warfarin, and some antibiotics. To reduce the formation of sequestrant-drug complexes, oral medication should be administered either 1 hour before the sequestrant or 4 hours after. Further teaching is needed. Warfarin should be taken 1 hour before or 4 hours after cholestyramine. Adverse effects of Questran are limited to the gastrointestinal (GI) tract. Constipation, the principal complaint, can be minimized by increasing dietary fiber and fluids. Digoxin should be taken 1 hour before or 4 hours after cholestyramine.

Answer to Question 2

ANS: A
Colesevelam can help control hyperglycemia in patients with diabetes; therefore, hypoglycemia is a possible risk. Hyperglycemia is not a risk for patients with diabetes who take colesevelam. Insulin and colesevelam do not interact; therefore, the insulin can be taken at the patient's preferred time or times. Either insulin or oral antidiabetic agents can be taken with colesevelam.