The nurse is providing teaching to a client who has been placed on oral cholestyramine for management of a lipid disorder. Which statement by this client indicates the need for further teaching about this drug?

Question

1. "I should take my warfarin at least 1 hour before I take my cholestyramine."
2. "Before I take this medicine, I should mix it in 2 ounces of water, then add another 2–4 ounces before I swallow it."
3. "I should stop taking a daily multivitamin pill."
4. "I should keep all appointments for monitoring my warfarin therapy, since I might need to decrease the dose of this drug."

Answer 1

Correct Answer: 4
Rationale 1: Cholestyramine has a strong potential for delaying absorption of other drugs from the gastrointestinal tract, and so should be taken 1 hour after or 4 hours before other oral medications.
Rationale 2: Failure to mix cholestyramine powder with an adequate volume of water can lead to gastrointestinal obstruction.
Rationale 3: Cholestyramine can interfere with vitamin absorption, so vitamin supplementation might be needed.
Rationale 4: The interaction between cholestyramine and warfarin produces an increased risk of bleeding by lowering vitamin K levels, so the dose of warfarin the client is taking might need to be lowered.
Global Rationale: The interaction between cholestyramine and warfarin produces an increased risk of bleeding by lowering vitamin K levels, so the dose of warfarin the client is taking might need to be lowered. Cholestyramine has a strong potential for delaying absorption of other drugs from the gastrointestinal tract, and so should be taken 1 hour after or 4 hours before other oral medications. Failure to mix cholestyramine powder with an adequate volume of water can lead to gastrointestinal obstruction. Cholestyramine can interfere with vitamin absorption, so vitamin supplementation might be needed.