A nurse is caring for a client 2 hours following a cardiac catheterization. Which following actions should the nurse take?

A. Nitroglycerine and Viagra should be taken at the same time: Taking nitroglycerine and Viagra together is extremely dangerous. Both drugs cause vasodilation and can lead to severe hypotension, syncope, or even cardiovascular collapse. Patients must be explicitly warned against simultaneous use.

B. Viagra is not effective when used in combination with nitroglycerine: The issue is not the efficacy of Viagra but the risk of life-threatening hypotension when the two medications are combined. Effectiveness of Viagra is not the concern; safety is the priority.

C. Viagra should not be used within 24 hours of taking nitroglycerine: The safest practice is to avoid nitrates for at least 24 hours after taking sildenafil (Viagra) due to the risk of profound hypotension. This instruction directly addresses patient safety and is a critical point for discharge teaching to prevent potentially fatal interactions.

D. The effect of nitroglycerine is impaired by concurrent use of Viagra: Nitroglycerine’s effectiveness is not impaired; instead, the combination potentiates vasodilation, leading to dangerously low blood pressure. The concern is additive hypotensive effects, not reduced efficacy of nitroglycerine.

A. Complete blood count: While a complete blood count (CBC) provides information about red and white blood cells and platelets, statin therapy is not typically associated with hematologic toxicity. Routine CBC monitoring is not required for patients on statins unless there are specific clinical concerns or comorbid conditions.

B. Cardiac enzymes: Cardiac enzymes such as troponin and CK-MB are used to detect myocardial injury. Statins do not usually cause acute cardiac injury, so monitoring these enzymes is not part of routine statin therapy. However, CK (creatine kinase) may be monitored if myopathy or muscle pain develops.

C. Blood urea nitrogen: Blood urea nitrogen (BUN) assesses renal function. Statins are metabolized primarily by the liver, not the kidneys, and do not typically affect BUN. Monitoring BUN is not routinely required unless the patient has preexisting kidney disease or is taking nephrotoxic medications concurrently.

D. Liver enzymes: Statins can cause hepatotoxicity and elevate liver transaminases (ALT and AST). Monitoring liver enzyme levels before starting therapy and periodically afterward is recommended to detect hepatocellular injury early and ensure safe use of the medication.