The nurse is caring for a patient taking chenodiol (Chenix). Which patient statements indicate the need for immediate follow-up by the nurse?
Select all that apply.
1. "I could see the big gallstone on the x-ray, but this medication doesn't seem to be helping at all. I don't feel better after taking it for 4 months."
2. "My rectal area is tender from all the diarrhea I've been having."
3. "My skin looks yellow."
4. "I can't afford my medication and have been cutting pills in half to make it last longer."
5. "I can see bits of gallstones in my stools."
Correct Answer: 1, 2, 3, 4
Chenodiol (Chenix) reduces the cholesterol content of gallstones, leading to their gradual dissolution. Chenodiol has a high incidence of diarrhea at therapeutic doses and is hepatotoxic, so periodic liver function studies are required during therapy. A primary disadvantage of pharmacologic treatment for gallstones is its cost. Because of the gradual rate at which the medication acts, pieces of gallstones are not visible in the patient's stools.
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