PREP U 10

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."

The 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."

Which activity increases high-density lipoproteins?

All of these

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

Which substance would a group of students identify as being responsible for breaking up dietary fats into smaller units?

Bile acids

Which of the following are true with regards to bile? Select all that apply:

Bile emulsifies fat and lipids. Bile is secreted by the liver.

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?

Decrease the dosage of his medication

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

Diet

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

A nurse is caring for a client who has been prescribed cholestyramine powder for pruritus treatment. What instructions should the nurse include in the teaching plan for the client? Select all that apply.

Mix the drug in 2 to 6 fluid ounces of water. Mix the drug with fluid soups or pulpy fruits. Do not ingest the drug in the dry form.

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?

Niacin

Which of the following should be included by the nurse during client teaching to improve outcome? Select all that apply:

Reviews measures to minimize gastrointestinal upset. Contacts dietitian for assistance with diet teaching. Stresses importance of taking drug exactly as prescribed. Instructs in possible adverse reactions and signs and symptoms to report to primary health care provider.

What should the nurse suggest to assist a client to improve his cholesterol levels?

Smoking cessation

A patient presents at the clinic after one week of taking pravastatin (Pravacol) with reports of "just not feeling well." The nurse asks what liquid the patient has been taking their medication with, and the patient reports drinking a lot of grapefruit juice. The nurse should know that grapefruit juice increases the risk of which adverse effect?

Toxicity

Cholesterol is the base unit for the formation of steroid hormones.

True

What is HMG-CoA reductase?

An enzyme that controls the final step in production of cellular cholesterol

Which would be classified as a bile acid sequestrant?

Cholestyramine

A nurse is caring for a client receiving cholestyramine to improve his blood lipid profile at a home care setting. What adverse reactions to cholestyramine should the nurse monitor in the client?

Constipation

What intervention may help the client increase HDL levels?

Exercise

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 Vomiting

A patient with hyperlipidemia is prescribed ezetimibe. Which ongoing assessment should the nurse perform during treatment?

Frequently monitor blood cholesterol.

Which of the following would the nurse suggest to use when administering cholestyramine? Select all that apply.

Fruit juices Soups Cereals Water

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?

Gallbladder

A patient has been prescribed atorvastatin (Lipitor) comes to the clinic with acute muscle pain not associated with exercise or injury, which indicates potential rhabdomyolysis. The nurse knows that the use of atorvastatin with which products places the patient at risk for rhabdomyolysis?

Grapefruit juice consumption

The pharmacology instructor is discussing medications used in the treatment of dyslipidemia. Which drug class would the instructor identify as the most widely used dyslipidemia drugs?

HMG-CoA reductase inhibitors

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

A 54-year-old client has a cholesterol level of 240 mg/dL (6.2064 mmol/L). What serum concentration of cholesterol would this client have?

High

Which lipid level would the nurse interpret as being high?

LDL cholesterol of 190 mg/dL

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 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 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:

inhibits the production of cholesterol.

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 Diet

A student asks the nursing instructor what the most common adverse effects of ezetimibe (Zetia) are. What would be the instructor's best response?

Mild abdominal pain and diarrhea

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