▸40 Which instructions should the nurse include in the teaching plan for a client who will be taking simvastatin (Zocor) when discharged? Select all that apply.
1 Increase dietary intake of potassium.
2 Avoid prolonged exposure to the sun.
3 Schedule regular ophthalmic examinations.
4 Take the medication at least a half hour before meals.
5 Contact your health care provider if skin becomes gray-bronze.
40 Answer: 2, 3, 5.
1 Simvastatin (Zocor) does not affect levels of potassium. 2 Simvastatin increases photosensitivity; the client should avoid sun exposure and use sunblock. 3 The client should be monitored for the adverse effects of glaucoma and cataracts. 4 The medication is most effective when taken at bedtime because cholesterol synthesis is highest at night. 5 Gray-bronze skin and unexplained muscle pain are signs of rhabdomyolysis. Rhabdomyolysis, a life-threatening response, is the disintegration of muscle associated with myoglobin in the urine.
Client Need: Pharmacological and Parenteral Therapies; Cognitive Level: Analysis; Nursing Process: Planning/Implementation; Reference: Ch 6, Related Pharmacology, Antilipidemics
5 Which factor does the nurse consider most likely contributes to the increased incidence of hip fractures in older adults?
2 Fragility of bone
3 Sedentary existence
4 Rheumatoid diseases
5 2 Bones become more fragile because of loss of bone density associated with the aging process; this often is associated with lower circulating levels of estrogens or testosterone.
1 Carelessness is a characteristic applicable to certain individuals rather than to people within a developmental level. 3 Although prolonged lack of weight-bearing activity is associated with bone demineralization, hip fractures also occur in active older adults. 4 Rheumatoid diseases can affect the skeletal system but do not increase the incidence of hip fractures.
Client Need: Health Promotion and Maintenance; Cognitive Level: Application; Nursing Process: Assessment/Analysis; Reference: Ch 5, The Middle-Older and Old-Older Adults, Data Base