The nurse is preparing a patient’s daily dose of digoxin (Lanoxin), an inotropic drug. The adult patient has an apical pulse of 48/min.
What should the nurse do next?

Taking niacin with an NSAID such as ibuprofen can reduce flushing, the most common adverse effect of niacin therapy. Flushing is a side effect of taking large doses of niacin (vitamin B3) supplements.It happens when the niacin causes the small blood vessels in your skin to dilate so more blood can rush through.Flushing can cause skin redness, warmth, itching, tingling, or burning sensations.

Choice A is wrong because taking niacin before starting daily activities can increase the risk of flushing and interfere with your routine.Flushing usually occurs within 15 to 30 minutes of taking niacin and lasts for about an hour.

Choice B is wrong because taking niacin with a sedative can increase the risk of liver damage, especially if the sedative is acetaminophen (Tylenol).Niacin can also cause liver problems at high doses, so combining it with another liver-toxic drug is not advisable.

Choice C is wrong because taking niacin with grapefruit juice can increase the risk of side effects, such as low blood pressure, dizziness, or fainting.Grapefruit juice can interfere with the metabolism of some drugs, including niacin, and make them more potent or toxic.

Normal ranges for niacin intake vary depending on age and gender.The recommended dietary allowance (RDA) for adult males is 16 mg per day and for adult females is 14 mg per day.Higher doses of niacin may be prescribed by a doctor to treat high cholesterol or other conditions, but they should be taken under medical supervision and with caution.

According to the World Health Organization (WHO), noncommunicable diseases (NCDs) are the leading cause of death globally, accounting for 74% of all deaths. NCDs are chronic diseases that are not transmitted from person to person, such as cardiovascular diseases, cancers, chronic respiratory diseases and diabetes.The main risk factors for NCDs are modifiable behaviours, such as tobacco use, physical inactivity, unhealthy diet and the harmful use of alcohol.These behaviours can lead to metabolic risk factors, such as raised blood pressure, increased blood glucose, elevated blood lipids and obesity, which in turn increase the risk of developing NCDs. Therefore, lifestyle changes that reduce these risk factors can prevent or delay many NCDs and improve health outcomes.

Choice A is wrong because trauma is not a major contributing factor to many diseases.Trauma is an injury or damage to living tissue caused by an external force, such as accidents, violence or natural disasters.Trauma can result in acute or chronic conditions, such as infections, fractures, burns, bleeding or organ failure.

However, trauma is not a common cause of NCDs, which are the main burden of disease globally.

Choice C is wrong because congenital factors are not the greatest contributing factor to many diseases.Congenital factors are those that are present at birth, such as genetic disorders, birth defects or inherited diseases.Congenital factors can affect the development and function of various organs and systems in the body, leading to various health problems.

However, congenital factors are not the main cause of NCDs, which are largely influenced by environmental and behavioural factors.

Choice D is wrong because genetics is not the greatest contributing factor to many diseases.

Genetics is the study of how traits are inherited and expressed in living organisms.

Genetics can influence the susceptibility and resistance to various diseases, as well as the response to treatment and prevention strategies.

However, genetics is not the sole determinant of health and disease, as environmental and behavioural factors also play a significant role in modulating gene expression and function.