Chapter 23
The nurse has provided client education regarding therapeutic lifestyle changes to help control cholesterol levels. Which statement made by the client indicates an understanding of the information?
"- I will maintain an optimal weight." - "I will implement a medically supervised exercise plan." - "I will eliminate tobacco use."
Which information about the dietary intake of lipids should the nurse provide a client?
- "Phospholipids are essential to building plasma membranes." - "Cholesterol is a building block for estrogen and testosterone." - "Triglycerides are the major form of fat in the body." - "Cholesterol in the diet is unnecessary as the liver synthesizes it."
A patient has been prescribed gemfibrozil (Lopid). Which laboratory tests should the nurse schedule for the client on the next clinic appointment?
- Blood glucose - Liver enzymes - Hemoglobin and hematocrit
The nurse is preparing to provide education for a client prescribed a statin. Which adverse effects should the nurse include in the teaching?
- Myopathy - Rhabdomyolysis
The nurse is discussing with a client, the dietary intake of omega-3 and CoQ10-rich foods to control lipid levels. Which foods should the nurse include in the discussion?
- Sardines - Almonds - Olive oil
The educator is reviewing the classifications of prescriptions used to decrease blood cholesterol levels with a nurse. Which prescriptions should the educator include in the discussion of fibric acid agents?
- Tricor - Lopid
The educator is preparing education about the different types of lipids for a nurse. Which should the educator include in the presentation?
- Triglycerides - Phospholipids - Steroids
A client tells the nurse they will need a prescription for high cholesterol but does not know which would be best. Which information should the nurse provide the client?
- "The bile resins keep cholesterol from being absorbed but have some side effects." - "The statin drugs inhibit the making of cholesterol and are considered the best choice." - "Fibric acid drugs will decrease triglycerides, but your low density lipoprotein (LDL) will still be high."
Which assessment is a nursing priority for a client receiving cholestyramine (Questran)?
Auscultation of bowel sounds in all four abdominal quadrants
The patient is receiving cholestyramine (Questran) and complains of constipation. The physician orders bisacodyl (Dulcolax) tablets. When is the best time for the nurse to administer the bisacodyl (Dulcolax) tablets?
Four hours after administration of cholestyramine (Questran).
The nurse has completed nutritional teaching for a client with a high low density lipoprotein (LDL) level. Which menu choice made by the client indicates an understanding of the teaching?
Grilled chicken with rice and broccoli, tossed salad with walnuts and sliced apples, slice of whole-wheat bread, and low-fat chocolate pudding
Which type of lipoprotein is often referred to as "the good type?"
HDL
The nurse is providing education about lipids for a client with hyperlipidemia. Which information should the nurse include in the education?
High density lipoprotein (HDL) is called good cholesterol because it removes cholesterol from the body and gets rid of it in the liver.
Which is the priority action of the nurse when caring for a client receiving a statin with elevated creatine kinase (CK) levels?
Hold the prescription and notify the healthcare provider.
Which describes the mechanism of atorvastatin's (Lipitor) ability to lower blood cholesterol levels?
Inhibits an enzyme that is essential for cholesterol synthesis.
Which anatomical location is Ezetimibe (Zetia) effective in blocking the absorption of cholesterol?
Jejunum
The nurse reviewing a client's serum cholesterol levels notes the following: Low density lipoprotein (LDL) = 105 mg/dl High density lipoprotein (HDL) = 37 mg/dl Low density lipoprotein (LDL)/high density lipoprotein (HDL) ratio = 4.1 Which should the nurse identify as the priority outcome in the client's plan of care?
Maintenance of normal lipid levels without the use of pharmacotherapy.
Which statement is accurate regarding the use of nicotinic acid (Niacin) for lowering blood cholesterol levels?
Niacin may also reduce triglyceride levels.
Which lipid type is associated with the highest risk for the development of atherosclerosis?
Steroids
Which statement correctly identifies why restricting dietary intake of cholesterol generally will not result in a significant reduction of blood cholesterol?
The liver reacts to a low-cholesterol diet by making more cholesterol.
Which statement provides the best rationale for monitoring HDL and LDL as opposed to total cholesterol?
Total cholesterol does not differentiate the amounts of "good" cholesterol and "bad" cholesterol.
The nurse reviewing records should determine that which client's lab values are associated with the highest risk of developing heart disease?
Total 220, LDL 162, HDL 20
Which type of lipid serves as fuel for the body when energy is needed?
Triglycerides
Which assessment finding for a client receiving a statin is a priority for the nurse to report to the healthcare provider?
Urine output of 20 mL/hour.
A client asks the nurse how fat is carried in the blood. Which response should the nurse provide?
"Fats travel in the blood on little proteins called lipoproteins."
The nurse has completed the education for a client prescribed gemfibrozil (Lopid). Which statement made by the client indicates an understanding of the information?
"I must take this medication with food or I can have heartburn."
The nurse has provided education for a client prescribed fenofibrate (Lofibra). Which statement made by the client indicates an understanding of the information?
"I will expect to see a change in color of my stool."
Which assessment data obtained from a client receiving a statin is a priority for the nurse to report to the healthcare provider?
"My calves hurt, and I had a hard time walking to the bathroom."
Which information should the nurse include in the education for a client prescribed niacin to lower lipid levels?
"Take one aspirin 30 minutes before you take your niacin."
The client states to the nurse, "My healthcare provider says I have heart disease and I need to decrease the cholesterol in my diet. I don't understand how this happened." Which response should the nurse provide the client?
"The arteries around your heart are narrowed by low density lipoprotein (LDL) cholesterol buildup in them."