Drugs chapter 47

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."

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."

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."

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 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

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

Bile acids

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 the urine and stool

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?

Constapation

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 to reduce LDL cholesterol. Cholestyramine will cause a decrease in absorption of which medication?

Digoxin

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

Flushing of the skin

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

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

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

Gemfibrozil

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

After reviewing information about lipoproteins, a group of students demonstrate understanding of the information when they identify which of the following as being loosely packed?

HDLS

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

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

Headache insomnia constipation

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 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 synthesis

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

Nausea, flatulence, and constipation

Which single class drug is known to be most effective in reducing the major types of dyslipidemia?

Statins

An obese client who has an elevated triglyceride level and reduced high-density lipoprotein cholesterol is seen by the primary care provider. What do these data suggest in this client?

The development of metabolic syndrome

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 therapy is considered. The nurse explains the rationale for this regimen as:

Therapeutic lifestyle changes are the preferred method for lowering blood lipids.

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

True

Which might occur in a client receiving colestipol?

Vitamin A deficiency

A nurse would caution a client receiving cholestyramine to avoid mixing the drug with:

carbonated drinks

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?

cholestyramine

What is the most common reason for an elevated cholesterol level in a client who does not have a genetic disorder of lipid metabolism?

dietary intake of saturated fat

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

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

frequently monitor blood cholesterol

41s The client is diagnosed with hyperlipidemia and prescribed lovastatin. Which is the most common adverse effects of lovastatin?

headache and flatulence

The client is 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

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

pregnancy category x

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?

rhabdomyolysis.

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

smoking cessation

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

true