CARDIAC DRUGS

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A client who is receiving cholestyramine also takes digoxin. The nurse teaches the client about the drug and administration. The client demonstrates understanding of the teaching when stating:

"I will take the digoxin about an hour before the cholestyramine." The absorption of digoxin can be decreased or delayed with colestyramine, a bile acid sequestrant. Therefore, the digoxin should be taken 1 hour before for 4 to 6 hours after the colestyramine.

What should the nurse teach an older adult client about the potential adverse effects of atorvastatin?

"The most common side effects of atorvastatin involve some mild gastrointestinal upset."

Which client statement demonstrates an accurate understanding of the action of a prescribed anticoagulant?

"This medication will keep unnecessary clots from forming in my blood."

INR

0.8-1.1

PT

11-12.5 seconds

Sodium levels

135-145

PTT levels

25-35 seconds

Potassium levels

3.5-5.0

aPTT (activated partial thromboplastin time)

30-40 seconds

A client with atrial fibrillation who is receiving oral anticoagulant therapy is receiving atorvastatin. The nurse would monitor this client for:

Bleeding Increased serum levels and resultant toxicity can occur if a statin is combined with warfarin, an oral anticoagulant. This would increase the client's risk for bleeding. Abdominal pain and cataract development are related to the use of atorvastatin alone. Liver failure also is associated with atorvastatin use alone.

When describing the action of atorvastatin, which would the nurse include?

Blocking the enzyme that is involved in cholesterol synthesis

A client has had cholestyramine added to his or her treatment plan for dyslipidemia. What effect will cholestyramine have on the pharmacokinetics of the thiazide diuretic that the client is currently prescribed?

Cholestyramine may decrease absorption of thiazide diuretics.

LDL (Male and Female)

both under 100 mg/dL

dromotropy

conduction speed in the AV node (electrical conduction)

inotropy

contraction of myocardium (contractibility)

chronotropy

firing of SA node (heart rate)

Niacin

increases HDL levels

HDL (male and female)

male: over 45 female: over 60

cholestyramine

reduce LDL cholesterol

afterload

the amount of resistance the heart must overcome to open the aortic valve and push the blood volume out into the systemic circulation **think of a balloon- the knot- to get the air out, the resistance must overcome the knot

preload

the amount of ventricular stretch at the end of diastole; the more blood, the greater the stretch **think of a balloon- the more air, the greater the stretch

Total cholesterol levels

under 200 mg/dL


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