Author Question: A client is being discharged after a hospital admission for chest pain with a multidrug regimen that ... (Read 33 times)

WWatsford · **on:** Jul 23, 2018

A client is being discharged after a hospital admission for chest pain with a multidrug regimen that includes a new prescription for cholestyramine (Questran).

It is most important for the nurse to include which information in discharge teaching about this drug?
1. You must carefully follow instructions for mixing this drug with liquid.
2. If you experience bloating or constipation, you should stop taking this drug.
3. We will monitor your kidney function while you are taking this drug.
4. Do not take vitamin supplements while taking cholestyramine.

Question 2

A nurse is evaluating outcomes of teaching for a client with a new prescription for avorstatin (Lipitor). Which response indicates that the client has understood teaching about this drug?

1. I will avoid taking this drug with meals.
2. I might need to increase my dose of digoxin while I am taking this drug.
3. I will stop taking this drug if I am trying to get pregnant.
4. I should always take this drug right before breakfast.

catron30 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 1
Rationale 1: Failure to mix the powdered form of this drug adequately can cause gastrointestinal tract obstruction.
Rationale 2: Gastrointestinal effects such as bloating and constipation are common side effects of cholestyramine. Since this drug binds with many other drugs in the gastrointestinal tract, suddenly stopping the drug could increase absorption of other drugs and lead to drug toxicity.
Rationale 3: Bile acid sequestrants such as cholestyramine are not systemically absorbed, and do not threaten kidney function.
Rationale 4: Cholestyramine can reduce absorption of fat-soluble vitamins, so supplementation with vitamins A and D might be necessary.
Global Rationale: Failure to mix the powdered form of this drug adequately can cause gastrointestinal tract obstruction. Gastrointestinal effects such as bloating and constipation are common side effects of cholestyramine. Since this drug binds with many other drugs in the gastrointestinal tract, suddenly stopping the drug could increase absorption of other drugs and lead to drug toxicity. Bile acid sequestrants such as cholestyramine are not systemically absorbed, and do not threaten kidney function. Cholestyramine can reduce absorption of fat-soluble vitamins, so supplementation with vitamins A and D might be necessary.

Answer to Question 2

Correct Answer: 3
Rationale 1: Absorption of avorstatin (Lipitor) is not inhibited by food in the gastrointestinal tract.
Rationale 2: Avorstatin (Lipitor) can increase serum digoxin levels significantly. Clients taking avorstatin (Lipitor) might need to decrease their dose of digoxin, and should have digoxin levels monitored frequently.
Rationale 3: Avorstatin is a pregnancy category X drug, and should be avoided by women of childbearing age who might become pregnant.
Rationale 4: Because cholesterol synthesis increases at night, drugs to treat lipid disorders are more effective if taken at bedtime.
Global Rationale: Avorstatin is a pregnancy category X drug, and should be avoided by women of childbearing age who might become pregnant. Absorption of avorstatin (Lipitor) is not inhibited by food in the gastrointestinal tract. Avorstatin (Lipitor) can increase serum digoxin levels significantly. Clients taking avorstatin (Lipitor) might need to decrease their dose of digoxin, and should have digoxin levels monitored frequently. Because cholesterol synthesis increases at night, drugs to treat lipid disorders are more effective if taken at bedtime.