A patient is taking a HMG CoA reductase inhibitor and reports ...

[frankwu]

A patient is taking a HMG CoA reductase inhibitor and reports muscle aches, soreness, and weakness. The nurse suspects these symptoms to indicate early signs of myopathy.
 
  When notifying the physician of these symptoms, the nurse will also be sure to report the results of the patient's
  a. serum creatine phosphokinase levels.
  b. red blood cell count.
  c. urine culture.
  d. echocardiogram.

Question 2

The nurse is educating a patient about niacin prescribed to treat his hyperlipidemia. Which important teaching point(s) should be included in the educational plan? (Select all that apply.)
 
  a. Effectiveness of niacin in lowering total cholesterol
  b. Information on high cholesterol foods and food preparation using unsaturated fats
  c. Importance of smoking cessation and daily exercise
  d. Alternative funding resource information because of the high cost of niacin
  e. Adverse effects to report (e.g., fatigue, anorexia, nausea, malaise, jaundice, muscle aches)

[zoeyesther]

Answer to Question 1

ANS: A
Serum creatine phosphokinase levels more than 10 times the upper limit of normal confirm the diagnosis of myopathy. Red blood cell and urine cultures and an echocardiogram would not confirm the diagnosis of myopathy.

Answer to Question 2

ANS: A, B, E
Therapeutic outcomes expected with niacin use include reduction in LDL and total cholesterol levels, reduction in triglyceride levels, and increase in HDL levels. Niacin is used in conjunction with dietary therapy to decrease elevated cholesterol concentrations in hyperlipidemia and to reduce the risks of atherosclerosis leading to coronary heart disease. Initial adverse effects to expect include nausea, gas, abdominal discomfort, dizziness, faintness, and hypotension. Jaundice, malaise, muscle aches, and anorexia should be reported to the health care provider. Although these are healthy lifestyle behaviors, they are not indicated in patient teaching about antilipemic medications. Niacin is not expensive in comparison with other antilipemic medications.

[frankwu]

TYSM

[Joy Chen]

Excellent