Pharm 201 Chapter 34 Q & A's

The nurse is caring for a client newly prescribed rosuvastatin. The nurse should perform which preadministration or ongoing assessments? Select all that apply.

Check the aspartate aminotransferease (AST), and if it is three times the normal, notify the primary care provider. Evaluate for development of fever, muscle weakness or tenderness, or extreme fatigue and report to primary care provider. Inspect the skin and eyelids for flat or elevated yellow deposits (xanthomas) and chart, if present. Determine if dizziness and unsteadiness of gait occurs after administering first dose of rosuvastatin.

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.

The most common adverse effects of lovastatin (Mevacor) include:

nausea, flatulence, and constipation

A 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?

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

What should the nurse teach an older adult client about the potential adverse effects of atorvastatin?

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

The client with a new diagnosis of hyperlipidemia states that he is concerned because the physician believes he has vision changes. He tells the nurse the physician checked both of his eyes. What is the nurse's best response?

"Yellow deposits on the eyelids can indicate severe hyperlipidemia."

An older adult client's most recent physical assessment and diagnostic workup reveal the presence of dyslipidemia. The woman is a candidate for monotherapy with a statin, and she will soon begin treatment with atorvastatin. The nurse should anticipate what prescription from the health care provider?

"atorvastatin 10 mg PO OD"

The client admitted with hyperglycemia. The nurse evaluates the client for which medications?

Atorvastatin

What health problems contraindicate the use of vibrates for the treatment of dyslipidemia? Select all that apply.

Chronic renal failure Liver disease

What intervention may help the client increase HDL levels?

Exercise

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

HDL 58 LDL96 Cholesterol 178

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

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

Headache and flatulence

A nurse is providing care to a client who has elevated levels of low-density lipoprotein (LDL). A review of the client's history reveal's 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

A 54-year-old client has a cholesterol level of 240 mg/dL. What serum concentration of cholesterol would this client have?

High

What factor determines the "preferred density of the cholesterol?

Higher amount of protein

The nurse is preparing to teach the client about bile sequestrant medication to lower lipid levels, and diet therapy. What important instruction will the nurse include in the teaching plan?

Increasing fiber intake

A client is taking lovastatin (Mevacor) which are noted as the most common adverse effects?

Nausea, flatulence, and constipation

An older adult client is being treated in the hospital for a stroke and is undergoing an extended stay on a rehabilitation unit. The client's spouse has been participating actively in the client's care and performs much of the feeding and hygiene needs. This evening, the client's spouse has brought in a nu,her of healthy snacks to keep at the client's bedside. Knowing that the client's medication regimen includes simvastatin, the nurse would remove which item?

grapefruit juice

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

headache and flatulence.

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?

liver panel

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?

rhaabdomyolysis

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 my grapefruit juice."

A 58-year-old man has recently been prescribed atorvastatin (Liptor) in an effort to reduce his cholesterol levels. The man has acknowledged the potentially harmful effects of hyperlipidemia and is motivated to make changes to resolve this health problem. What advice should the nurse give to this client?

"It's good idea to your intake of saturated fat to a bare Minimum."

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?

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

A client with primary hypercholesterolemia has been prescribed 10 mg of ezetimibe per day by a health care provider. The provider has instructed the nurse to continue the drug therapy for 3 days. The drug is available in 10-mg capsules. How many capsules of the drug should the nurse administer to the client during the entire therapy?

3 Capsules

Some populations/ethnicities have a higher incidence of hyperlipidemia than others. The nurse knows that which client's would have the greatest chance of developing hyperlipidemia as determined by total cholesterol?

A white 62 years of age with total cholesterol of 260 mg/dL

A client is taking cholestyramine 4 g by mouth once daily in the morning and is to begin taking glipzide 5 mg one daily for diabetes. Which intervention would be appropriate for administering both drugs? Select all that apply.

Administer the glipzide in the evening Administer the glipzide 4 hours after the cholstyramine Administer the glipzide 4 hours after the cholestyramine

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?

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

A client is taking atorvastatin calcium to reduce serum cholesterol. Which aspect of client teaching is most important?

Call the health care provider if muscle pain develops.

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

Cholestyramine

A nurse is preparing to adminster a prescribed bile acid resin to a client with hyperlipidemia. The nurse understands that this class of drugs can decrease serum levels of several medications, primarily via which mechanism?

Decreased gastrointestinal absorption

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

Decreased in serum cholesterol and 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?

Elevated LDL levels

After reviewing the various agents used to lower lipid levels, the students demonstrate understanding of the information when they identify which agents as stimulating the breakdown of lipoproteins from the tissues and their removal from the plasma? (Select all that apply.)

Fenofibrate Gemfribrozil

A nurse is caring fora a client prescribed nicotinic acid for hyperlipidemia. The nurse would assess the client for which findings as a possibility?

Flushing of the skin

The client has been prescribed nicotinic acid for treatment of hyperlipidemia. The nurse should teach about which common side effects with this medication?

Flushing of the skin

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

The client has been prescribed pravastatin (Pravachol). The nurse also notes that the client takes warfarin daily. The nurse evaluates the client for which of the following?

Increased anticoagulant effect

A client diagnosed with hyperlipidemia is prescribed a statin. The nurse is reviewing the client's history and would notify the clients health care provider if which condition was noted in the client's history?

Liver disease

Which adverse effect would a nurse expect to assess in a client taking ezetimibe?

Mild abdominal pain

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

Nausea Vomiting Flushing of the face

The client presents to the physicain's office complaining of ringing in her ears. Upon review of the client's medication list, the nurse identifies that it may be caused by which of the following medications?

Niacin

A client has an elevated total serum cholesterol of 260 mg/mL (14.4 mol/L) Which aspects of client teaching of lifestyle changes is most important for the client?

Stop smoking.

A client is diagnosed with hyperlipidemia and is to receive drug therapy as part of the treatment plan. When reviewing the client's laboratory test results, which findings would the nurse identify as supporting the client's diagnosis? Select all that apply.

Total cholesterol 250 mg/dL LDL cholesterol 165 mg/Dl

The nurse should be cognizant that niacin therapy is the most effective method of achieving which cardiac-related goal?

increased concentration of HDL cholesterol

The nurse is teaching a 45-year-old client about ways to lower elevated cholesterol levels. One method to lower cholesterol levels is to exercise, which:

increases HDL and decreases triglycerides

A client has been prescribed lovastatin for high cholesterol. 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 in which manner?

inhibits cholesterol syntheses.

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

inhiibits the production of cholesterol.

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:

muscle pain.

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

Gemfibrozil

The nurse is providing care for a client who has been prescribed cholestryamine for the treatment of hyperlipidemia. During the client's latest clinic visit, the client states, "It seems like i bruise from the lightest little bumps of scrapes. What is the nurse's best action?

Inform the care provider so laboratory testing can be preformed

A client asks how ezetimibe will help to treat high lipid levels. The nurse explains that:

It decreases the absorption of cholesterol in the small intestine.

The nurse is discharged a client home on HMG-CoA inhibitor therapy. What statement by the client demonstrates that they have a clear understanding of the teaching?

"I should take this drug at bedtime, since my body makes lipids mostly at night."

A client who is receiving cholestryamine 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."

A 58-year-old man has recently been prescribed atorvastatin (Lipitor) in an effect to reduce his cholesterol levels. The man has acknowledged his potentially harmful effects of hyperlipidemia and is motivated to make changes to resolve this health problem. What advice should the nurse give to this client?

"It's a good idea to keep your intake of saturated fat to a bare minimum ."

Which activity increases high-density lipoproteins?

All of these

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

Gemfibrozil

The nurse is caring for a client who has high levels of total cholesterol and triglycerides. When discussing management of dysipidemia with the client, the nurse will describe the desired blood lipid profile as:

High HDL cholesterol, low LDL cholesterol, Low total cholesterol, and low triglyceride

The nurse is taking care of a client with high cholesterol and triglyceride values. In teaching the client about therapeutic lifestyle changes such as diet and exercise, the nurse realizes that the dissuader goal for cholesterol level is:

Low LDL values and high HDL values

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

Pregnancy Category X

A 37-year-old woman with moderately elevated lipid levels requests immediate pharmacotherapy for her dyslipidemia. The nurse explains that a period of intensive diet therapy and lifestyle modification will be utilized before drug thereapy is considered. The nurse explains the rationale for this regimen as:

Therapeutic lifestyle changes are preferred method for lowering blood lipids

What is the basis for a nurse's recommendation of intensive diet therapy and lifestyle modification before initiation of drug therapy for client newly diagnosed with dyslipidemia?

Therapeutic lifestyle changes are the preferred method for lowering blood lipids

The nurse is caring for a 35-year-old woman taking a beta-hydroxy-methylglutaryl coenzyme A (HMG-CoA) reductase inbitor to lower serum lipid levels. When teaching this client about her medications, What priority teaching point will the nurse include in the teaching plan?

Use barrier contraceptives

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.

Weight Deit

The nurse is taking a health history on a 38-year-old male who is taking atorvastatin (Lipitor) for high cholesterol. The nurse will be sure to ask a specific group of questions regarding the client's use of:

alcohol

A client has begun taking cholestramine. What are noted as the most common adverse effects?

nausea, flatulence, and constipation

A 9-year-old child has received an order for pravastatin (pravachol) 40 mg/d PO for genetically linked hyperlipidemia. In preparation for client teaching concerning this drug, the nurse's initial action will be to:

question the provider concerning the order.

A client asks the nurse about herbal products that can help to lower serum cholesterol and triglycerides. Which herbal product would the nurse include in the response?

Garlic

How does the nurse providing medication education describe how the drug atorvastatin achieves its desired therapeutic effect?

reducing the amount of cholesterol synthesized by the liver

A 45-year-old client who is a construction worker has been diagnosed with hyperlipidemia and has been prescribed lovastatin. The nurse will advise the client to do which?

avoid prolonged exposure to sunlight.

A client has been largely unsuccessful in achieving adequate control of dyslipidemia through lifestyle changes and the use of a statin. As a result, the client has been prescribed cholestyramine. What change in this client's lipid profile will the nurse identify as the most likely goal of therapy?

reduction in LDL cholesterol levels

A client with hyperlipidemia has been taking atorvastatin for several months. The therapeutic effect of the medication can be best determined by:

reviewing the client's laboratory blood work results.