A patient with a history of angina and hypertension is being ...

[SO00]

A patient with a history of angina and hypertension is being started on nicotinic acid (Niacin). The nurse is providing patient education. What statement made by the patient demonstrates a need for further teaching?
 
  a. I will take Tylenol with my medication to reduce the inflammatory effects.
  b. I will be cautious taking this medication, because I have mild liver damage.
  c. I will take an aspirin 30 minutes before my niacin to reduce flushing.
  d. This medication will lower my triglyceride levels.

Question 2

A prescriber is considering prescribing the amiodarone derivative dronedarone (Multaq) for a patient with atrial flutter. The nurse should be concerned about which of the following?
 
  a. History of asthma
  b. History of hypothyroidism
  c. PR interval of 260 msec
  d. QT interval of 520 msec

[nyrave]

Answer to Question 1

ANS: A
Intense flushing of the face, neck, and ears occurs in practically all patients taking nicotinic acid in pharmacologic doses. Tylenol will not reduce the flushing or inflammatory effects of the medication; further patient teaching is required. The flushing reaction diminishes in several weeks and can be attenuated by taking 325 mg of aspirin 30 minutes before each dose. Nicotinic acid is hepatotoxic; therefore, the patient should be taught to have the liver enzymes checked and to self-monitor for signs and symptoms. Nicotinic acid reduces low-density lipoprotein (LDL) cholesterol and triglyceride (TG) levels.

Answer to Question 2

ANS: D
Because dronedarone prolongs the QT interval by about 10 msec, it should not be used in patients with a QT interval of more than 500 msec. It does not have significant pulmonary or thyroid toxicity. It should not be used in patients with a PR interval of more than 280 msec.

[SO00]

TY

[nyrave]

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