Karch's Prep U (Pharm) Ch 46: Lipid Lowering Agents

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." "I should take the dose around bedtime." "I need to be careful when I'm out in the sun." "I should report any problems with muscle pain or weakness."

"I can take the drug with grapefruit juice." Explanation: The client needs additional teaching when stating that they can take the drug with grapefruit juice. Instead, the client should choose juices other than grapefruit juice because of the risk for an enzyme reaction. The client should take the dose in the evening or at bedtime, use sunscreen and protective clothing to reduce the risk of photosensitivity reactions, and report any muscle pain, tenderness, or weakness to the primary health care provider.

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." "I need to take both drugs at the same time of the day." "I'll take the cholestyramine at 8 AM and the digoxin at 9 AM." "I'll take the digoxin about 15 minutes before the cholestyramine."

"I will take the digoxin about an hour before the cholestyramine." Explanation: The absorption of digoxin can be decreased or delayed with cholestyramine, a bile acid sequestrant. Therefore, the digoxin should be taken 1 hour before for 4 to 6 hours after the cholestyramine.

A client who is receiving colestipol is also taking a thiazide diuretic. Which instruction would be most appropriate for the nurse to give? "Take the colestipol at the same time as the thiazide diuretic." "Take the thiazide diuretic about 4 hours before the colestipol." "Take the colestipol first and then take the diuretic a half hour later." "Take the thiazide diuretic about 1 hour before the colestipol."

"Take the thiazide diuretic about 1 hour before the colestipol." Explanation: The absorption of thiazide diuretic can be decreased or delayed with colestipol, a bile acid sequestrant. Therefore, the diuretic should be taken 1 hour before or 4 to 6 hours after the colestipol.

A patient is receiving atorvastatin. The nurse would anticipate that the maximum effectiveness of the drug would occur within which time frame? 1 to 2 hours 2 to 3 hours 3 to 4 hours 4 to 5 hours

1 to 2 hours Explanation: Atorvastatin peaks in 1 to 2 hours.

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 Phospholipids Triglycerides Nitroglycerin

Cholesterol Explanation: Cholesterol is the portion of blood lipids involved in the formation of atherosclerotic plaques.

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

Digoxin Explanation: Bile acid sequestrants may decrease absorption of digoxin. Cholestyramine will not decrease the ibuprofen, aspirin, or acetaminophen.

The nurse has completed a teaching session with a client who is prescribed nicotinic acid. The nurse determines the session is successful when the client correctly chooses which reaction(s) as a normal response to this drug? Select all that apply. Flushing Sensations of warmth Tingling Urticaria Pustule formation

Flushing Sensations of warmth Tingling Explanation: Generalized skin flushing, a sensation of warmth, and severe itching and tingling can occur with the administration of nicotinic acid, especially at higher doses. These sensations are temporary but may frighten the client. Urticaria could indicate a possible hypersensitivity reaction but is uncommon with nicotinic acid. Pustule formation may indicate an infectious process.

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 HDL 58 LDL 115 Cholesterol 210 HDL 78 LDL 115 Cholesterol 189 HDL 82 LDL 96 Cholesterol 240

HDL 58 LDL 96 Cholesterol 178 Explanation: Normal HDL should be greater than 40 mg/dl, LDL should be less than 100 mg/dl, and total cholesterol should be less than 200 mg/dl.

A client asks how ezetimibe will help to treat high lipid levels. The nurse explains that: Its mechanism of action is not understood. It decreases the absorption of cholesterol in the small intestine. It stimulates the breakdown of triglycerides. It reduces the production of triglycerides by the liver.

It decreases the absorption of cholesterol in the small intestine. Explanation: Ezetimibe inhibits the absorption of cholesterol by the small intestine. Fibric acid derivatives work by stimulating catabolism of triglyceride-rich proteins. Gemfibrozil reduces the production of triglycerides by the liver.

A nurse is preparing to administer colesevelam to a client with hyperlipidemia. The nurse determines cautious administration is warranted after noting which condition in the client's history? Hypotension Acute infection Liver disease Unstable angina

Liver disease Explanation: Bile acid resins should be used cautiously in clients with diabetes, liver, peptic ulcer or kidney disease, and during pregnancy and lactation. Colesevelam is administered with caution in clients with liver disease. Niacin is used with caution in clients with unstable angina. Statins should be used cautiously in clients with hypotension and an acute infection.

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? Asthma Liver disease Renal disease Hypertension

Liver disease Explanation: Statins are contraindicated in clients with liver disorders. They are used cautiously in clients with a history of hypotension, infection, and myopathy.

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? Complete blood count (CBC) Liver panel INR and aPTT Reticulocyte count

Liver panel Explanation: Because of the risk for hepatotoxicity, clients taking fenofibrate require serial testing of liver enzyme levels. There is no specific need for follow-up with CBCs, coagulation tests, or reticulocyte counts.

A female client presents to the health care provider's office with recurrence of her "hot flashes." The nurse understands that the client is taking what drug to treat her dyslipidemia? Fenofibrate Cholestyramine Niacin Atorvastatin

Niacin Explanation: Skin flushing may occur with niacin.

HMG-CoA reductase inhibitors (statins) are classified as which pregnancy category? Pregnancy Category X Pregnancy Category A Pregnancy Category B Pregnancy Category C

Pregnancy Category X Explanation: HMG-CoA reductase inhibitors (statins) are in pregnancy category X and contraindicated during any stage of pregnancy. Medications in pregnancy category A are considered safe. Medications classified as pregnancy category B, studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women. For pregnancy category C, studies have shown adverse effects to the fetus; however, benefit may outweigh the potential harm—the risk has not been ruled out.

The health care provider has prescribed fenofibrate for a client discovered to have very high serum triglyceride levels. The nurse should question this order if the client has a history of which additional disorder? Endocrine disorder Primary biliary cirrhosis Arterial bleeding Respiratory depression

Primary biliary cirrhosis Explanation: The fibric acid derivative fenofibrate is contraindicated in clients with primary biliary cirrhosis. The HMG-CoA reductase inhibitors are used with caution in clients with a history of endocrine disorders. Niacin is contraindicated in clients with arterial bleeding. Respiratory depression is a potential adverse reaction to fenofibrate.

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

Reason for taking the prescribed drug Drug name Correct dose Frequency of administration Dosage form Explanation: The nurse should review the reasons for the drug and prescribed therapy, including drug name, form and method of preparation, correct dose, and frequency of administration as part of a client's discharge counseling.

Which single class drug is known to be most effective in reducing the major types of dyslipidemia? Statins Bile acid sequestrants Fibrates Niacin

Statins Explanation: For single-drug therapy, a statin is preferred for the treatment of dyslipidemia. To lower cholesterol and triglycerides, a statin, a cholesterol absorption inhibitor, gemfibrozil, a fibrate, or the vitamin niacin may be used. To lower triglycerides, gemfibrozil, ezetimibe, a cholesterol absorption inhibitor, or niacin may be given.

A nurse is analyzing the chemistry profile of a client diagnosed with hyperlipidemia. Which measurement(s) will the nurse prioritize on the lipid profile? Select all that apply. Total cholesterol Triglycerides LDL ALT AST

Total cholesterol Triglycerides LDL Explanation: A lipoprotein profile is a laboratory test that reports total cholesterol, LDL, HDL, and triglycerides. AST and ALT are values that would be reported from liver function tests.

A 62-year-old man has been prescribed extended-release lovastatin. The nurse will instruct the patient to take the medication: at bedtime. in the early morning. in the evening. in the afternoon.

at bedtime. Explanation: Patients who are prescribed extended-release lovastatin should take the medication at bedtime, without food, to be most effective. This is because most cholesterol synthesis occurs during this time. Immediate-release lovastatin should be taken after the evening meal. It would not be appropriate to take lovastatin in the afternoon or the early morning.

Which category of blood lipids is involved in the formation of atherosclerotic plaques? cholesterol phospholipids triglycerides nitroglycerin

cholesterol Explanation: Blood lipids are a category of fatty acids, which are substances used within the body to perform essential functions. Cholesterol is the portion of blood lipids involved in the formation of atherosclerotic plaques. Triglycerides and phospholipids are not involved in the formation of plaque. Nitroglycerin is not a blood lipid.

A nurse is caring for a client who has been prescribed lovastatin to control blood lipid levels. While teaching the client about the medication, the nurse should caution against consuming large amounts of which? water. high-fiber food. orange juice. grapefruit juice.

grapefruit juice. Explanation: Consumption of large amounts of grapefruit juice during lovastatin therapy can increase serum drug levels. Consumption of water, high-fiber food, and orange juice does not increase serum drug levels.

The client is diagnosed with hyperlipidemia and prescribed lovastatin. Which is the most common adverse effects of lovastatin? headache and flatulence. increased appetite and blood pressure. fatigue and mental disorientation. hiccups, sinus congestion, and dizziness.

headache and flatulence. Explanation: The most common adverse effects of statins include GI symptoms (including nausea, constipation, flatulence, and abdominal pain), headache, and muscle aches. These effects are usually mild and transient. Hiccups, sinus congestion, dizziness, fatigue, mental disorientation, increased appetite or hypertension are not common adverse effects of statin drugs.

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? "Some clients experience mild chest pain initially." "Most people who experience side effects from atorvastatin report stiffness in their joints." "The more serious side effects of atorvastatin involve a risk of bleeding." "The most common side effects of atorvastatin include some mild gastrointestinal upset."

"The most common side effects of atorvastatin include some mild gastrointestinal upset." Explanation: Statins like atorvastatin are usually well tolerated. The most common adverse effects (nausea, constipation, diarrhea, abdominal cramps or pain, headache, skin rash) are usually mild and transient. Chest pain, joint stiffness, and bleeding are not common adverse effects.

The client wants information about triglycerides and cholesterol. Which response by the nurse would be correct? "Triglycerides are found in your blood. Cholesterol is found in the gallbladder." "Triglycerides are found in your blood. Cholesterol is how the fat is transported." "Triglycerides and cholesterol are fatlike substances found in your blood." "Triglycerides transport cholesterol throughout the body."

"Triglycerides and cholesterol are fatlike substances found in your blood." Explanation: Triglycerides and cholesterol are lipids that are found in blood. Cholesterol is produced mostly by the liver.

Which would be classified as a bile acid sequestrant? Lovastatin Ezetimibe Cholestyramine Gemfibrozil

Cholestyramine Explanation: Cholestyramine is classified as a bile acid sequestrant. Lovastatin is a HMG-CoA reductase inhibitor. Ezetimibe is a cholesterol absorption inhibitor. Gemfibrozil is classified as a fibrate.

Which would a nurse identify as a carrier for small units of fats? Chylomicrons Micelles Bile acids Cholesterol

Chylomicrons Explanation: Chylomicrons are carriers for micelles. Micelles are the small units of broken down fats. Bile acids act like a detergent in the small intestine and break up fats into small units. High levels of cholesterol are part of bile acids.

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. Continued therapeutic lifestyle changes during drug therapy will guarantee success. Therapeutic lifestyle changes are easier to comply with than medication therapies. Nonpharmacologic interventions are cheaper than using medications.

Therapeutic lifestyle changes are the preferred method for lowering blood lipids. Explanation: Nonpharmacologic interventions are always preferred to pharmacologic ones if there is potential for success. Appropriate lifestyle changes should be maintained, but there will not assure guaranteed success. Medications are to be used only when nonpharmacologic efforts have proven unsuccessful. While nonpharmacologic interventions may be less expensive, that is not the basis for the recommendation.

A patient with atrial fibrillation is receiving warfarin therapy. The patient is also prescribed ezetimibe. The nurse would instruct the patient to watch for: Blood in urine or stool Abdominal pain Yellowing of the skin Blurred vision

Blood in urine or stool Explanation: Warfarin levels increase with ezetimibe, increasing the patient's risk for bleeding. Abdominal pain is a common adverse effect of ezetimibe and is unrelated to the combination therapy. Yellowing of the skin suggests liver dysfunction, which is not associated with the combination therapy. Blurred vision is not associated with the combination therapy.

A nurse is caring for a patient who is receiving lovastatin. Which assessment by the nurse would indicate that there is possible damage to the patient's skeletal muscle as a result of the drug therapy? Amber colored urine Brownish colored urine Tanned colored skin Reddish colored skin

Brownish colored urine Explanation: Prolonged use of lovastatin may damage skeletal muscle; the increased bilirubin from the dead cells changes the color of the urine from amber to brown. Tanned and reddish color skin indicates photosensitivities caused by the drug and are general adverse effects.

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? Digoxin Vitamin D Cholestyramine Calcium carbonate

Cholestyramine Explanation: Cholestyramine is administered to clients to reduce LDL cholesterol in clients who are already taking a statin drug. Digoxin is not given to lower LDL cholesterol. Vitamin D is not given to lower LDL cholesterol. Calcium carbonate is not given to lower LDL cholesterol.

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? Increase the dosage of his medication Decrease the dosage of his medication Maintain the current dosage of his medication Discontinue his medication

Decrease the dosage of his medication Explanation: Cholesterol absorption inhibitors as monotherapy (without statins) require dosage reduction in clients with mild hepatic impairment.

Which of the following would the nurse suggest to use when administering cholestyramine? Select all that apply. Fruit juices Soups Cereals Water Soda Seltzer water

Fruit juices Soups Cereals Water Explanation: Cholestyramine can be mixed with fluids, cereals, pulpy fruits, or water but not with carbonated fluids such as soda or seltzer water.

Niacin is prescribed to a client to increase HDL levels. What are the most common adverse effects of this therapy? Select all that apply. Flushing of the face Nausea Headache Diarrhea Vomiting

Flushing of the face Nausea Vomiting Explanation: These larger doses produce peripheral vasodilation, mostly in the cutaneous vessels of the face, neck, and chest. Vasodilation results in flushing of the skin, which is usually transient. Vasodilation and increased blood flow from niacin administration are attributable to histamine release. Other common adverse effects, which include GI irritation, nausea, and vomiting, make niacin intolerable for many clients.

A patient with hyperlipidemia is prescribed ezetimibe. Which ongoing assessment should the nurse perform during treatment? Take a dietary history of the patient. Inspect skin and eyelids for evidence of xanthomas. Obtain reports of fasting blood sugar levels. Frequently monitor blood cholesterol.

Frequently monitor blood cholesterol. Explanation: The nurse should frequently monitor blood cholesterol as part of the ongoing assessment for a patient receiving ezetimibe. Taking a dietary history of the patient and inspecting the skin and eyelids for evidence of xanthomas are the pre-administration assessments that a nurse should perform for a patient receiving ezetimibe. The nurse obtains the reports of fasting blood sugar for a diabetic patient.

A nurse is responsible for patient education for a 48-year-old woman who has been prescribed colestipol. The nurse will instruct the patient to take the medication at bedtime. before a meal. after a meal. two hours before a meal.

before a meal. Explanation: Colestipol is a bile acid sequestrant that promotes the oxidation of cholesterol to bile acids. Cholesterol is the major precursor to bile acids. Bile acids are secreted from the gallbladder and liver into the intestine during digestion. In the intestine, bile acids emulsify the fat and lipid particles from food, promoting absorption. Much of the bile acid that is secreted is reabsorbed and returned to the liver by hepatic circulation. Colestipol binds with the bile acids in the intestine to make them nonresorbable. The bile acids are then eliminated in the stool. Because of this mechanism of action, the drug should be administered before a meal.

A female client is taking a large dose of nicotinic acid to treat hyperlipidemia. She calls the clinic and reports that her face, neck, and chest are red. Which would be an appropriate response by the nurse? "This is an expected adverse effect of the drug. It should subside in time." "Don't worry about it. I'm sure it's not really noticeable." "You need to stop taking the medication immediately. I will notify the health care provider." "You need to decide if you want to take this medication. The flushing will be present as long as you take the medication."

"This is an expected adverse effect of the drug. It should subside in time." Explanation: Large doses of nicotinic acid produce peripheral vasodilation, mostly in the cutaneous vessels of the face, neck, and chest. Vasodilation results in flushing of the skin and is usually transient. The vasodilation is due to the histamine release caused by the medication. A nurse would never tell a client not to worry and to stop taking the medication, unless the prescriber told her to. The flushing should subside and will not be present for the duration of the course of the drug.

When describing the action of atorvastatin, which would the nurse include? Blocking the enzyme that is involved in cholesterol synthesis Binding with bile acids to form an insoluble complex that is excreted Stimulating the breakdown of lipoproteins from the tissues Decreasing dietary cholesterol absorption from the small intestine

Blocking the enzyme that is involved in cholesterol synthesis Explanation: HMG-CoA reductase inhibitors, such as atorvastatin, block the enzyme involved in cholesterol synthesis. Bile acid sequestrants block bile acids to form insoluble complexes for excretion in the feces. Fibrates stimulate the breakdown of lipoproteins from the tissues and their removal from the plasma. Cholesterol absorption inhibitors work in the brush border of the small intestine to decrease absorption of dietary cholesterol from the small intestine.

The nurse is caring for a client newly prescribed rosuvastatin. The nurse should perform which preadministration or ongoing assessments? Select all that apply. Assess for moderate-severe generalized flushing, warm feeling, tingling sensation, and ringing in the ears. Check the aspartate aminotransferase (AST), and if it is three times the normal, notify the primary care provider. Inspect the skin and eyelids for flat or elevated yellow deposits (xanthomas) and chart, if present. Evaluate for development of fever, muscle weakness or tenderness, or extreme fatigue and report to primary care provider. Determine if dizziness and unsteadiness of gait occurs after administering first dose of rosuvastatin.

Check the aspartate aminotransferase (AST), and if it is three times the normal, notify the primary care provider. Inspect the skin and eyelids for flat or elevated yellow deposits (xanthomas) and chart, if present. Evaluate for development of fever, muscle weakness or tenderness, or extreme fatigue and report to primary care provider. Determine if dizziness and unsteadiness of gait occurs after administering first dose of rosuvastatin. Explanation: The nurse should make the following assessments when a client begins a statin: for xanthomas, which indicate serious hyperlipidemia; dizziness or unsteady gait after administering the first dose at bedtime, a potential adverse effect. The nurse should assess for fever, malaise, muscle weakness or tenderness signaling rhabdomyolysis, a serious deterioration of muscle cells that can result in renal failure, if not caught early and treated. If the AST is three times the normal, the nurse should call the primary care provider. The provider may discontinue the drug and begin another therapy. Nicotinic acid can lead to generalized flushing of the skin, a warm feeling and tingling and tinnitus, or ringing of the ears.

Which of the following best reflects the action of ezetimibe? Blocks the enzyme involved in cholesterol synthesis Binds with bile acids to form an insoluble complex for excretion Stimulates the breakdown of lipoproteins from tissues Decreases the absorption of dietary cholesterol from the small intestine

Decreases the absorption of dietary cholesterol from the small intestine Explanation: Ezetimibe is a cholesterol absorption inhibitor that works in the brush border of the small intestine to decrease absorption of dietary cholesterol from the small intestine. HMG-CoA reductase inhibitors block the enzyme involved in cholesterol synthesis. Bile acid sequestrants block bile acids to form insoluble complexes for excretion in the feces. Fibrates stimulate the breakdown of lipoproteins from the tissues and their removal from the plasma.

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

Diet Explanation: Blood lipids, which include cholesterol, phospholipids, and triglycerides, are derived from the diet or synthesized by the liver and intestine. Medications, exercise, and the kidneys do not play a role in synthesis.

Which agent would a nurse identify as a cholesterol absorption inhibitor? Ezetimibe Simvastatin Colestipol Fenofibrate

Ezetimibe Explanation: Ezetimibe is a cholesterol absorption inhibitor. Simvastatin is a HMG-CoA reductase inhibitor. Colestipol is a bile acid sequestrant. Fenofibrate is classified as a fibrate.

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? Small intestine Stomach Gallbladder Liver

Gallbladder Explanation: The presence of fatty acids, lipids, and cholesterol in the duodenum stimulates contraction of the gallbladder and the release of bile, which contains bile acids. Once their action is completed, they are reabsorbed and recycled to the gallbladder, where they remain until the gallbladder is stimulated again.

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

Gemfibrozil Explanation: Gemfibrozil is a fibrate. Colestipol, colesevelam, and cholestyramine are bile acid resins.

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 Colesevelam Niacin Ezetimibe

Gemfibrozil Explanation: Gemfibrozil is a fibric acid derivative. Colesevelam is a bile acid resin. Niacin is classified as a miscellaneous antihyperlipidemic. Ezetimibe is a miscellaneous antihyperlipidemic.

After teaching a group of students about drugs used to treat hyperlipidemia, the instructor determines that the teaching was successful when the students identify which of the following? Select all that apply. HMG-CoA reductase inhibitors Fibric acid derivatives Bile acid resins Calcium channel blockers Angiotensin II receptor blockers

HMG-CoA reductase inhibitors Fibric acid derivatives Bile acid resins Explanation: HMG-CoA reductase inhibitors, fibric acid derivatives, and bile acid resins are classes of medications used to treat hyperlipidemia. Calcium channel blockers and angiotensin II receptor blockers are used to treat hypertension.

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 Diabetes Glaucoma Hypertension

Heart disease Explanation: Increased levels of LDL in combination with other risk factors, such as increased weight, diet high in saturated fats, and lack of physical activity, can lead to the development of atherosclerotic heart disease. In diabetes high levels of blood glucose as well as HbA1c are seen. In clients with glaucoma, increased eye pressure causes damage to the optic nerve. Clients with hypertension left untreated can lead to kidney failure and stroke.

The nurse is administering pravastatin and amiodarone to a client with cardiac issues. Which potential interaction will the nurse carefully monitor the client for? Increased anticoagulant effect Increased hypoglycemic effect Increased risk of myopathy Decreased effects of pravastatin

Increased risk of myopathy Explanation: When the HMG-CoA reductase inhibitor pravastatin is administered with amiodarone, the nurse should monitor the client for increased risk of myopathy as an effect of the interaction between the two drugs. Increased anticoagulant effect is observed in clients receiving warfarin along with pravastatin. Increased hypoglycemic effects are observed in clients receiving sulfonylureas with fibric acid derivatives. The interaction of pravastatin with amiodarone does not decrease the effect of pravastatin.

The nurse knows that part of the education plan for a client with the diagnosis of hyperlipidemia needs to include which lifestyle changes? (Select all that apply.) Reduction in the intake of carbohydrates Reduction of the intake of saturated fats Weight loss Increased physical activity

Reduction of the intake of saturated fats Weight loss Increased physical activity Explanation: The NCEP ATP IV recommends a multipronged approach in reducing LDL levels. They term this approach therapeutic lifestyle changes. These lifestyle changes include reduced intake of saturated fats, trans fats, and cholesterol; minimum intake of fatty acids; weight reduction; increased physical activity; increased intake of soluble fiber; and possibly increased intake of plant stanols and sterols.

A client's serum cholesterol is 286 mg/dL. Lovastatin (Mevacor) is prescribed. The nurse plans care based on the fact that the action of lovastatin: inhibits the production of cholesterol. promotes the breakdown of HDL. promotes excretion of cholesterol in the feces. decreases absorption of cholesterol.

inhibits the production of cholesterol. Explanation: Statin drugs inhibit the production of cholesterol and promote the breakdown of cholesterol. Bile acid resins bind to bile acids to form insoluble substances that cannot be absorbed.

The nurse is assessing a client who reports taking cholestyramine mixed with diet cola twice per day. What would the nurse assess the client for at this time? imbalanced nutrition constipation infection knowledge deficit

knowledge deficit Explanation: Cholestyramine should be mixed with water or other noncarbonated fluids, so the nurse now recognizes the need for medication teaching and assesses the client's level of knowledge deficit. Nothing in this question indicates that the client is experiencing any adverse effects from the drug, so constipation would not be assessed. This practice does not create a risk of infection or malnutrition.

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? pruritis. rhabdomyolysis. cholelithiasis. cholecystitis.

rhabdomyolysis. Explanation: An adverse reaction of rosuvastatin is muscle toxicity, which may cause rhabdomyolysis. Rhabdomyolysis is the breakdown of muscle that can cause pain, weakness, nausea, and even kidney damage. Gallbladder disorders are related to the use of fibric acid derivatives. Any medication can cause pruritis, however, it is not related to weakness manifested by the use of rosuvastatin.