Exam #2 Pharmacology Chapter 50
The healthcare provider prescribes lovastatin [Mevacor] for a patient discharged from the hospital post-myocardial infarction. Which instructions are most appropriate for the nurse to include in the patient's teaching plan?
"Do not start any new medications without first talking to your healthcare provider." "Before starting this medication a blood test will be done to check your total cholesterol level and to measure liver enzymes." "Lower the total fat and saturated fat in your diet by increasing your intake of fresh fruits and vegetables and whole grains."
The nurse is teaching a group of patients about dietary approaches to reduce cholesterol levels. Which statement is most important to include in the teaching?
"Read food labels and reduce your intake of saturated fats."
The nurse is caring for a patient prescribed gemfibrozil [Lopid]. For which patient should the nurse question the use of this drug?
A patient with history of gallstones and elevated triglycerides Gemfibrozil is indicated to reduce elevated triglycerides and very-low-density lipoprotein levels primarily in patients who have not responded adequately to diet modification. It can also raise HDL but does not reduce LDL to a significant degree. Gemfibrozil increases the risk of gallstone formation and should not be used in patients with preexisting gallbladder disease.
A patient with an elevated triglyceride level is prescribed a sustained-release form of nicotinic acid [Slo-Niacin]. Which laboratory value is most important for the nurse to monitor for in this patient?
Alanine aminotransferase (ALT)
Which drug is the most effective for lowering LDL cholesterol?
Atorvastatin [Lipitor] The statin drugs, such as atorvastatin, are the most effective drugs for lowering LDL cholesterol. They are better tolerated, have fewer adverse effects, and produce better clinical outcomes than any other agents available for lowering LDL.
The nurse is caring for a patient prescribed a cholesterol-lowering drug. Which drug is least likely to cause systemic side effects?
Colesevelam [Welchol]
The nurse understands that cholesterol is carried through the blood by lipoproteins. Which lipoprotein is most closely associated with coronary atherosclerosis?
Low-density lipoprotein (LDL) Cholesterol is the primary core lipid of LDLs, which are responsible for carrying cholesterol to tissues outside the liver.
Which discharge instructions should the nurse include for a patient prescribed cholestyramine [Questran]?
Mix the drug with water or juice. Cholestyramine [Questran] is supplied in powdered form. Mix the powder with liquids that include water, fruit juices, and soups because swallowing it can cause esophageal irritation.
A patient with cardiovascular disease is taking rosuvastatin [Crestor]. The nurse is monitoring for potential adverse effects. Which finding indicates a potential adverse effect of this drug?
Muscle pain and tenderness
Which are beneficial effects that can be derived from simvastatin [Zocor] and other drugs in this class?
Reduction of LDLs Elevation of HDLs Stabilization of the plaque in coronary arteries Reduction of risk of cardiovascular events