Chapter 47: Lipid-Lowering Agents

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 thiazide diuretic about 1 hour before the colestipol."

A female patient 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."

The client wants to know the difference between triglycerides and cholesterol. Which response by the nurse would be correct?

"Triglycerides and cholesterol are fatlike substances found in your blood."

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

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

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

Central adiposity Elevated triglycerides Reduced high density lipoprotein cholesterol

Which would a nurse identify as a carrier for small units of fats?

Chylomicrons

A male client takes cholesterol absorption inhibitors as a monotherapy without statins. He develops mild hepatic insufficiency. What would the nurse expect the physician to do?

Decrease the dosage of his medication

Which of the following best reflects the action of ezetimibe?

Decreases the absorption of dietary cholesterol from the small intestine

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

Diet

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

Digoxin (Lanoxin)

A 57-year-old female client is postmenopausal. Lifestyle changes have not made a significant impact on her lipids. What would the nurse expect the physician to suggest?

Estrogen replacement therapy

A male client's triglycerides are still elevated despite lifestyle changes. What does the nurse expect the physician to order for this client?

Fenofibrate

Niacin is prescribed to a patient to increase HDL levels. What are the most common adverse effects of this therapy? (Select all that apply.)

Flushing of the face Nausea and stomach upset

Which medication is classified as a fibric acid derivative (fibrate)?

Gemfibrozil (Lopid)

Which drug will be most effective in reducing the major types of dyslipidemia?

HMG-CoA reductase inhibitors

What might a client report of during treatment with an atorvastatin (Lipitor)? (Select all that apply.)

Headache Insomnia Constipation

A patient who is receiving cholestyramine also takes digoxin. The nurse teaches the patient about the drug and administration. The patient demonstrates understanding of the teaching when stating:

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

Which lipid level would the nurse interpret as being high?

LDL cholesterol of 190 mg/dL

Which of the following adverse effects would a nurse expect to assess in a patient taking ezetimibe?

Mild abdominal pain

An 8-year-old male client requires treatment for dyslipidemia. What would the nurse expect the physician to order?

Pravastatin

Statin drugs help lower cholesterol, LDL, and triglycerides by which mechanisms? (Select all that apply.)

Promoting the breakdown of cholesterol Inhibiting the manufacturing of cholesterol

A client is taking cholestyramine (Questran) and ezetimibe (Zetia). What administration guideline is most important to teach this client?

The administration of ezetimibe (Zetia) is four hours after cholestyramine.

The nurse is reviewing the results of a client's lipid profile. Which of the following would the nurse identify as borderline high?

Triglycerides 180 mg/dL

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

True

During ongoing assessment of a client receiving an antihyperlipidemic drug, what should the nurse collect? (Select all that apply.)

Vital signs Assessment of bowel function

How should the nurse instruct the client to take his lovastatin?

With food

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

before a meal.

A client with atrial fibrillation who is receiving oral anticoagulant therapy is receiving atorvastatin. The nurse would monitor this client for:

bleeding

A nurse is caring for a male patient who has a diagnosis of coronary artery disease (CAD). His drug therapy includes lovastatin. Because the patient has a history of severe renal disease, the nurse will assess for a(n):

increase in plasma concentration of lovastatin.

A patient has been prescribed lovastatin for a high cholesterol level. The nurse's teaching plan will include a basic explanation of how the drug produces its therapeutic effect. The nurse will explain that lovastatin lowers cholesterol levels because it:

inhibits cholesterol syntheses.

Several months of treatment with a statin accompanied by lifestyle modifications have failed to appreciably improve a patient's cholesterol levels. Consequently, the patient has been prescribed cholestyramine. The nurse should recognize that this drug achieves its therapeutic effect by:

oxidizing cholesterol to bile acids.

A patient is taking cholestyramine. The nurse will assess for which common adverse effect of the drug?

Constipation