Chapter 10 Drugs for Dyslipidemia Prep U

The nurse is taking a health history on a 58-year-old client who is taking atorvastatin for high cholesterol. What assessment question should the nurse prioritize related to the safe use of this drug?

"How many alcoholic drinks do you have in a typical day or week?"

After teaching a client about prescribed statin therapy, the nurse determines that additional teaching is needed when the client makes which statement?

"I can take the drug with grapefruit juice."

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."

Which would be classified as a bile acid sequestrant?

Cholestyramine

A nurse is caring for a client prescribed nicotinic acid for hyperlipidemia. The nurse would assess the client for which findings as a possibility?

Flushing of the skin

A patient with hyperlipidemia is prescribed ezetimibe. Which ongoing assessment should the nurse perform during treatment?

Frequently monitor blood cholesterol.

After teaching a group of students about fats and biotransformation, the instructor determines that the teaching was successful when the students identify what as the storage location of bile acids?

Gallbladder

The nurse is teaching a 45-year-old client about ways to lower cholesterol level. What effects of exercise does the nurse describe?

Increases high-density lipoproteins (HDLs) and decreases low-density lipoproteins (LDL)

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

Increasing fiber intake

A client recently began taking lovastatin. The nurse should assess the client for what potential adverse effects?

Nausea, flatulence, and constipation

Which agent would the nurse identify as inhibiting the release of free fatty acids from adipose tissue?

Niacin

What information would be included in a lipoprotein profile? Select all that apply:

Total cholesterol Triglycerides LDL

The client receives a prescription for niacin. The nurse is providing education about the medication and possible adverse effects. Which adverse affect would the nurse include?

"Some people get very flushed skin when they take this medication."

The nurse is providing education to an older adult client who has been prescribed atorvastatin. How should the nurse describe the common adverse effects of the drug?

"The most common side effects of atorvastatin include some mild gastrointestinal upset."

What should the nurse review about an antihyperlipidemic medication with the client when completing discharge counseling? (Select all that apply.)

- Reason for taking the prescribed drug - Drug name - Correct dose - Frequency of administration - Dosage form

To effectively prevent or manage metabolic syndrome, what should the desired blood lipid profile include? Select all that apply.

- low triglycerides - high HDL cholesterol - low LDL cholesterol - low total cholesterol

The nurse has completed a comprehensive assessment of a new client. What assessment findings would support a diagnosis of metabolic syndrome? Select all that apply.

- waist measurement 107 cm (42 in) - high-density lipoprotein (HDL) 1.29 mmol/L (50 mg/dL) - blood pressure 148/93 mm Hg - fasting blood glucose 7.2 mmol/L (121 mg/dL

A male client presents to the health care provider's office with symptoms of hyperglycemia. He is taking his oral antidiabetic medication and has not modified his diet or exercise program in any way. When the nurse interviews the client, he states that he now takes flax seed to reduce his cholesterol level. What may occur as a result of taking flax seed?

Decreased absorption of his drugs

The nurse is assessing a client who reports taking cholestyramine mixed with diet cola twice per day. What is the most appropriate nursing diagnosis for this client?

Deficient knowledge regarding drug therapy

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

A client taking atorvastatin presents to the clinic reporting acute muscle pain not associated with exercise or injury. The nurse asks questions to determine if this client has been taking what contraindicated substance?

Grapefruit juice

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 pharmacology instructor is discussing medications used in the treatment of dyslipidemia. Which drug class would the instructor identify as the most widely used dyslipidemia drugs?

HMG-CoA reductase inhibitors

A 54-year-old client has a cholesterol level of 240 mg/dL (6.2064 mmol/L). What serum concentration of cholesterol would this client have?

High

Which lipid level would the nurse interpret as being high?

LDL cholesterol of 190 mg/dL

A client diagnosed with hyperlipidemia is prescribed a statin. The nurse is reviewing the client's history and would notify the client's health care provider if which condition was noted in the client's history?

Liver disease

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

Pregnancy Category X

The nurse is caring for a client with high serum cholesterol and triglyceride levels. In teaching the client about therapeutic lifestyle changes and the use of medications, the nurse explains that the desired goal for cholesterol levels is what?

Reduced low-density lipoprotein (LDL) values and increased HDL values

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

Reviewing the client's laboratory blood work results

The nurse should discuss the benefit of adding a statin drug to a client's medication regimen. Statin drugs can reduce the risk of death from which of the following? Select all that apply:

Stroke Transient ischemic attack

A client with moderately elevated lipid levels requests immediate pharmacotherapy for dyslipidemia. The nurse explains that a period of intensive diet therapy and lifestyle modification will be utilized before drug therapy is considered based on what rationale?

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

After teaching a group of students about metabolic syndrome, the instructor determines that the teaching was successful when the students identify which characteristic?

Triglyceride level above 150 mg/dL

Elevated blood lipids are a major risk factor for atherosclerosis and vascular disorders. From where are blood lipids derived?

diet

The nurse explains to a client the action of a hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor. What enzyme does the nurse state this drug inhibits?

An enzyme that controls the production of cellular cholesterol

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

The nurse cares for a 10-year-old child who has been diagnosed with hypercholesterolemia. What is the most common cause of hypercholesterolemia in children

Familial connection

A nurse is providing care to a client who has elevated levels of low-density lipoprotein (LDL). A review of the client's history reveals a sedentary lifestyle and a history of being overweight. The nurse understands that this combination of factors places the client at risk for which condition?

Heart disease

What is the most common reason for an elevated cholesterol level in a client who does not have a genetic disorder of lipid metabolism?

His dietary intake of saturated fat

After reviewing information about antihyperlipidemic drugs, a group of nursing students demonstrate understanding when they identify which medication as a fibric acid derivative (fibrate)?

Gemfibrozil

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