Question

Chapter 34, Antihyperlipidemic Drugs

Susan Smith is a 40-year-old African American woman. She has a history significant for diabetes, hypertension, and smoking (1 pack/day). She is being discharged from the hospital today after having a myocardial infarction. The only new prescription she will be leaving with is pravastatin (Pravachol) 40 mg with directions to take one tablet daily at bedtime. The physician has asked the nurse to go over discharge instructions with Mrs. Smith. During the discharge counseling, Mrs. Smith inquires about her new medication.

1. What class of antihyperlipidemic medication is pravastatin and what should Mrs. Smith be told about the medication?
2. What lifestyle modifications should Mrs. Smith be encouraged to follow?
3. What are Mrs. Smith’s cholesterol goals and when should she have follow-up laboratory work for her pravastatin?

Chapter 36, Antianginal and Vasodilating Drugs

An elderly patient visits a local health care facility for the treatment of anginal pectoris. The assigned nurse administers isosorbide dinitrate to the patient according to the physician’s order. The patient develops postural hypotension after the administration of isosorbide dinitrate.

1. What is the possible cause of the patient’s condition?
2. What nursing intervention should the nurse perform in this case?
3. What are the adverse reactions to isosorbide dinitrate?

Answer 1

#Pravastatin belongs to HMG-COA Reductase inhibitor .Mrs. Smith has to be told that this medication is used to treat high cholesterol levels and prevent cardiovascular issues.

The following lifestyle changes has to be made

• Following medication adherence and taking the medication as ordered daily
• Inculcating active exercise daily
• A diet low in fats especially saturated fats
• No alcohol
• No OTC medications

The cholesterol goal level for this patient will be to bring low density lipid at or less than 70mg/dL.

The changes in the blood cholesterol levels can be observed right from second to fourth week. The blood check up can be done at one month after starting pravastatin .Then once in three months after provider's advice

#Isosorbite dinitrate after administration of this drug it leads to vasodilation of the blood vessels and decrease blood pressure .When patient gets up from supine position to sitting position there is Vasodilation leading to drop in blood pressure and therefore called as orthostatic hypotension

The possible cause of this condition is because reduced blood pressure .

The nursing intervention required in this case is

• Encourage the patient to get up slowly from supine position
• Increase the fluid intake

The following are the adverse effects

• CNS:Dizziness,headache, light headedness anxiousness
• CVS:Palpitation,low blood pressure ,bruises ,tachycardia
• General :weakness
• GIT: nausea
• Musculoskeletal : peripheral neuropathy ,paleness
• Renal: dark colored urine