A nurse performing an admission history on a patient learns that ...

[ishan]

A nurse performing an admission history on a patient learns that the patient is taking orlistat (Xenical), warfarin (Coumadin), and levothyroxine (Synthroid). What will the nurse do?
 
  a. Contact the provider to discuss increasing the warfarin dose.
  b. Give the levothyroxine at least 4 hours before giving the orlistat.
  c. Suggest that the patient avoid fatty foods while taking these medications.
  d. Tell the patient to take the orlistat on an empty stomach.

Question 2

Which statement by a patient about to begin taking orlistat (Xenical) for weight loss therapy indicates an understanding of this drug's actions?
 
  a. I can eat as much as I want and still lose weight.
  b. I should avoid fat-soluble vitamin supplements while taking this drug.
  c. If I take a bulk-forming laxative, I can reduce the incidence of fecal incontinence.
  d. If I take the drug 4 times daily instead of twice daily, I will lose weight faster.

[jaygar71]

Answer to Question 1

ANS: B
Orlistat may cause hypothyroidism in patients taking levothyroxine; these two drugs should be administered at least 4 hours apart. The vitamin K deficiency that can occur with orlistat may compound the effects of warfarin, so coagulation should be monitored; it is more likely that the warfarin dose would need to be reduced. The patient may still consume foods containing fat, as long as fat accounts for about 30 of the total intake. Orlistat should be taken with food.

Answer to Question 2

ANS: C
Because orlistat reduces fat absorption, stools often are fatty or oily, and fecal incontinence can occur. Bulk-forming laxatives can help with this side effect. For orlistat to be effective, patients still need to adopt a reduced-calorie diet with a 30 fat content. Patients should take fat-soluble vitamin supplements to replace those lost in stools. Taking the drug more often does not increase weight loss.

[ishan]

Excellent

[ryhom]

TYSM