A patient who has recently started taking pravastatin (Pravachol) ...

[melly21297]

A patient who has recently started taking pravastatin (Pravachol) and niacin (Nicobid) reports the following symptoms to the nurse. Which is most important to communicate to the health care provider?
 
  a. Generalized muscle aches and pains
  b. Dizziness when changing positions quickly
  c. Nausea when taking the drugs before eating
  d. Flushing and pruritus after taking the medications

Question 2

The nurse is caring for a patient who was admitted to the coronary care unit following an acute myocardial infarction (AMI) and percutaneous coronary intervention the previous day. Teaching for this patient would include
 
  a. when cardiac rehabilitation will begin.
  b. the typical emotional responses to AMI.
  c. information regarding discharge medications.
  d. the pathophysiology of coronary artery disease.

[wuly]

Answer to Question 1

ANS: A
Muscle aches and pains may indicate myopathy and rhabdomyolysis, which have caused acute kidney injury and death in some patients who have taken the statin medications. These symptoms indicate that the pravastatin may need to be discontinued. The other symptoms are common side effects when taking niacin, and although the nurse should follow-up with the health care provider, they do not indicate that a change in medication is needed.

Answer to Question 2

ANS: A
Early after an AMI, the patient will want to know when resumption of usual activities can be expected. At this time, the patient's anxiety level or denial will interfere with good understanding of complex information such as the pathophysiology of coronary artery disease (CAD). Teaching about discharge medications should be done closer to discharge. The nurse should support the patient by decreasing anxiety rather than discussing the typical emotional responses to myocardial infarction (MI).