Chapter 10: Drug Therapy for Dyslipidemia

A 39-year-old nulliparous woman has been taking atorvastatin for 2 years and has now decided that she would like to become pregnant. What health education should the nurse provide to this client?

"It's important that you stop taking atorvastatin before you stop using contraception."

What cardiac risk factors are related to metabolic syndrome? (Select all that apply.)

Central adiposity Elevated triglycerides Reduced high density lipoprotein cholesterol

A nurse is preparing a teaching plan for a client who is prescribed cholestyramine. Which information would the nurse include as a possible adverse reaction associated with this drug? Select all that apply.

Constipation Abdominal cramping Bruising

A male client takes cholesterol absorption inhibitors as a monotherapy without statins. He develops mild hepatic insufficiency. What would the nurse expect the health care provider to do?

Decrease the dosage of his medication

Which of the following best reflects the action of ezetimibe?

Decreases the absorption of dietary cholesterol from the small intestine

Prior to administering an antihyperlipidemic to a client, what information does the nurse need to gather? (Select all that apply.)

Dietary history Vital signs Weight

As part of a routine physical examination, a 60-year-old client's primary care provider has ordered blood work that includes cholesterol levels. What result would strongly suggest the need for an antihyperlipidemic drug?

Elevated LDL levels

Statin drugs help lower cholesterol, LDL, and triglycerides by which mechanisms? (Select all that apply.)

Promoting the breakdown of cholesterol Inhibiting the manufacturing of cholesterol

What is the most serious side effect of lovastatin?

Rhabdomyolysis

What should the nurse suggest to assist a client to improve his cholesterol levels?

Smoking cessation

What is the basis for a nurse's recommendation of a period of intensive diet therapy and lifestyle modification before initiation of drug therapy for a client newly diagnosed with dyslipidemia?

Therapeutic lifestyle changes are the preferred method for lowering blood lipids.

The nurse is taking a health history on a 38-year-old male who is taking atorvastatin (Lipitor) for high cholesterol. The nurse will be sure to ask a specific group of questions regarding the client's use of:

alcohol.

A client has been prescribed lovastatin for high cholesterol. The nurse's teaching plan will include a basic explanation of how the drug produces its therapeutic effect. The nurse will explain that lovastatin lowers cholesterol levels in which manner?

inhibits cholesterol syntheses.

A client with hyperlipidemia has been taking atorvastatin for several months. The therapeutic effect of the medication can be best determined by:

reviewing the client's laboratory blood work results.

A nurse is caring for a client receiving cholestyramine to improve his blood lipid profile at a home care setting. What adverse reactions to cholestyramine should the nurse monitor in the client?

Constipation

A client asks the nurse about herbal products that can help to lower serum cholesterol and triglycerides. Which herbal product would the nurse include in the response?

Garlic

A patient begins a gemfibrozil medication regimen to lower triglyceride levels. What effect does gemfibrozil have on lovastatin?

Increases the blood level of lovastatin

The nurse is preparing to teach the client about bile sequestrant medication to lower lipid levels, and diet therapy. What important instruction will the nurse include in the teaching plan?

Increasing fiber intake

The nurse is discharging a client home on HMG-CoA inhibitor therapy. What statement by the client demonstrates that they have a clear understanding of the teaching?

"I should take this drug at bedtime, since my body makes lipids mostly at night."

A client who is receiving cholestyramine also takes digoxin. The nurse teaches the client about the drug and administration. The client demonstrates understanding of the teaching when stating:

"I will take the digoxin about an hour before the cholestyramine."

A nurse is aware of the high incidence and prevalence of hyperlipidemia and the consequent need for antihyperlipidemics. Treatment of high cholesterol using statins would be contraindicated in which client?

An obese male client who is a heavy alcohol user and who has cirrhosis of the liver

When describing the action of atorvastatin, which would the nurse include?

Blocking the enzyme that is involved in cholesterol synthesis

A nurse is caring for a client who has been prescribed cholestyramine powder for pruritus treatment. What instructions should the nurse include in the teaching plan for the client? Select all that apply.

Mix the drug in 2 to 6 fluid ounces of water. Mix the drug with fluid soups or pulpy fruits. Do not ingest the drug in the dry form.

A nurse in a health care facility is caring for patients receiving the bile acid sequestrant colesevelam. In which category of patients is colesevelam administered with caution?

Patients with liver disease

A patient with very high serum triglyceride levels is prescribed the fibric acid derivative clofibrate. In which of the following categories of patients is the use of clofibrate contraindicated?

Patients with primary biliary cirrhosis

HMG-CoA reductase inhibitors (statins) are classified as which pregnancy category?

Pregnancy Category X

When providing teaching to a client beginning therapy with a beta-hydroxy-beta-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor, the nurse will explain the need for regular monitoring of which laboratory studies? Select all that apply.

Renal function tests Liver function tests Lipid panel

Which might occur in a client receiving colestipol?

Vitamin A deficiency

A 62-year-old man has been prescribed extended-release lovastatin. The nurse will instruct the patient to take the medication:

at bedtime.

The nurse should be cognizant that niacin therapy is the most effective method of achieving which cardiac-related goal?

increased concentration of HDL cholesterol

The most common adverse effects of lovastatin (Mevacor) include:

nausea, flatulence, and constipation.

Blood lipids are a category of fatty acids, which are substances used within the body to perform essential functions. Which category of blood lipids is involved in the formation of atherosclerotic plaques?

Cholesterol

The nurse is doing teaching about cholesterol and its role in cardiovascular disease. In addition to promoting cessation of cigarette smoking and a healthy lifestyle with diet and exercise to correct cholesterol abnormalities, the nurse explains that there are two modifiable conditions that have been cited as major risk factors for CAD and its complications. What are these two conditions?

Cholesterol abnormalities and hypertension

The nurse is evaluating the effectiveness of drug therapy in a client with hyperlipidemia. Effective therapy is best demonstrated by which laboratory values?

HDL 58 LDL 96 Cholesterol 178

The health care provider prescribes fibrate for a client with elevated triglycerides. The client begins to self-administer niacin approximately 3 mg daily. What would the nurse expect the provider to order?

LFTs

An 8-year-old male client requires treatment for dyslipidemia. What would the nurse expect the health care provider to order?

Pravastatin