Chapter 47

True

A patient with metabolic syndrome usually has increased plasminogen activator levels.

Gemfibrozil

The three major classes of drugs used to control blood lipids are statins, bile acid resins (or sequestrants), and fibrates. Which is a fibrate?

Central adiposity Elevated triglycerides Reduced high density lipoprotein cholesterol

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

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

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?

High

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?

Decrease in serum cholesterol and LDL levels

A client asks the nurse what the atorvastatin (Lipitor) prescribed for the client will do. What is an expected outcome for this client?

Digoxin

A client is taking cholestyramine to reduce LDL cholesterol. Cholestyramine will cause a decrease in absorption of which medication?

Heart disease

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?

Elevated LDL levels

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?

Diet

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

Pregnancy Category X

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

diet

In addition to being synthesized in the liver and intestine, from where are blood lipids derived?

rhabdomyolysis.

The client has been taking rosuvastatin for hyperlipidemia. The client now presents with severe weakness and states barely being able to move the extremities. The nurse suspects the client has which?

headache and flatulence.

The client is diagnosed with hyperlipidemia and prescribed lovastatin. Which is the most common adverse effects of lovastatin?

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

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?

Reduced high density lipoprotein cholesterol Elevated triglycerides Central adiposity

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

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

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?

His dietary intake of saturated fat

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

Stop smoking.

A client has an elevated total serum cholesterol of 260 mg/dL (14.4 mmol/L). Which aspect of client teaching of lifestyle changes is most important for the client?

Nausea, flatulence, and constipation

A client is taking lovastatin. Which are noted as the most common adverse effects?

Cholestyramine

A client who has been taking a statin has seen an improvement in his cholesterol laboratory values; however, the low-density lipoprotein remains elevated. What medication will be added to the medical regime?

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

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:

muscle pain.

A client will begin taking atorvastatin, and the nurse is conducting relevant health education. The nurse should emphasize the need to report any new onset of:

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

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?

a 62-year-old White client with total cholesterol of 260 mg/dl

A nurse is caring for several clients. Which client would have the greatest chance of developing CAD as determined by total cholesterol?

Diet Weight

A nurse is conducting a presentation for a local community group about hyperlipidemia. When discussing the factors that individuals can work on to reduce their risk, which information would the nurse include? Select all that apply.

Frequently monitor blood cholesterol.

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

Gemfibrozil

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

Liver disease

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?

"I can take the drug with grapefruit juice."

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

HDL 58 LDL 96 Cholesterol 178

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

Triglyceride level above 150 mg/dL

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

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

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?

HMG-CoA reductase inhibitors

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?

Smoking cessation

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

HMG-CoA reductase inhibitors

Which drug is most effective in reducing most major types of dyslipidemia in patients at risk or who have already developed CAD?

Statins

Which single class drug is known to be most effective in reducing the major types of dyslipidemia?

Cholestyramine

Which would be classified as a bile acid sequestrant?

Liver panel

An elderly client with dyslipidemia has had fenofibrate added to the existing medication regimen. In addition to having the lipid profile drawn on a regular basis, the nurse should educate the client about the need for what ongoing laboratory testing during therapy?