The nurse is providing discharge teaching instructions for a patient taking cholestyramine (Questran). Which statement made by the patient demonstrates a need for further teaching?
a. "I will take warfarin (Coumadin) 1 hour prior to my medicine."
b. "I will increase the fluids and fiber in my diet."
c. "I can take cholestyramine with my diuretic."
d. "I will take digoxin 4 hours after taking the cholestyramine."
ANS: C
Drugs known to form complexes with the sequestrants include thiazide diuretics, digoxin, warfarin, and some antibiotics. To reduce the formation of sequestrant-drug complexes, oral medication should be administered either 1 hour before the sequestrant or 4 hours after. Further teaching is needed.
Warfarin should be taken 1 hour before or 4 hours after cholestyramine; this statement indicates that no further teaching is needed.
Adverse effects of Questran are limited to the gastrointestinal (GI) tract. Constipation, the principal complaint, can be minimized by increasing dietary fiber and fluids. This statement indicates that no further teaching is needed.
Digoxin should be taken 1 hour before or 4 hours after cholestyramine; this statement indicates that no further teaching is needed.
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