A primary care NP prescribes an oral steroid to a patient and ...

[kellyjaisingh]

A primary care NP prescribes an oral steroid to a patient and provides teaching about the medication. Which statement by the patient indicates a need for further teaching?
 
  a. I should take this medication with food.
  b. I will take the medication at 8:00 AM each day.
  c. I can expect a decreased appetite while I am taking this medication.
  d. I should not stop taking the medication without consulting my provider.

Question 2

A patient who takes digoxin reports taking psyllium (Metamucil) three or four times each month for constipation. The primary care NP should counsel this patient to:
 
  a. decrease fluid intake to avoid cardiac overload.
  b. change the laxative to docusate sodium (Colace).
  c. take the digoxin 2 hours before taking the psyllium.
  d. ask the cardiologist about taking an increased dose of digoxin.

[T4T]

Answer to Question 1

C
Therapeutic administration is least likely to interfere with natural hormone production when the drug is given at the time of natural peak activity. It is generally recommended to administer the full daily dose before 9 AM. Oral glucocorticoids usually are given with meals to limit GI irritation. Common side effects include changes in mood, insomnia, and increased appetite.

Answer to Question 2

C
Laxatives can affect the absorption of drugs in the intestine by decreasing transit time. Digoxin is a drug that is affected by decreased transit time. Patients should be counseled to take the drugs 2 hours apart.