Pharmacology II Prep U Chapter 47: Lipid-Lowering Agents

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

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

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

• Headache • Insomnia • Constipation

The clinic nurse has been assigned to a 43-year-old client who is obese and loves to eat. The client has been diagnosed with hyperlipidemia and has been prescribed lovastatin. Which dietary instruction would be a priority for the nurse to discuss with the client?

Avoid drinking grapefruit juice

A nurse is caring for a patient who is receiving lovastatin. Which assessment by the nurse would indicate that there is possible damage to the patient's skeletal muscle as a result of the drug therapy?

Brownish colored urine

To effectively prevent or manage metabolic syndrome, what should the desired blood lipid profile include? (Select all that apply.)

• Low triglycerides • High HDL cholesterol • Low LDL cholesterol

What should the nurse review about an antihyperlipidemic medication with the client when completing discharge counseling? (Select all that apply.)

• Reason for taking the prescribed drug • Drug name • Correct dose • Frequency of administration • Dosage form

A 58-year-old man has recently been prescribed atorvastatin (Lipitor) 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 a good idea to keep your intake of saturated fat to a bare minimum."

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

Frequently monitor blood cholesterol

Which lipid level would the nurse interpret as being high?

LDL cholesterol of 190 mg/dL

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

Nausea, flatulence, and constipation

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

Pregnancy Category X

What is the most serious side effect of lovastatin?

Rhabdomyolysis

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

Smoking cessation

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

statins

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 female client 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 has been prescribed lovastatin to treat mixed lipidemia. In addition to monitoring cholesterol levels, what other laboratory test value needs to be monitored on a routine basis during therapy?

AST and ALT

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

Bleeding

When describing the action of atorvastatin, which would the nurse include?

Blocking the enzyme that is involved in cholesterol synthesis

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

Blood lipids are a category of fatty acids, which are substances used within the body to perform essential functions. Which category of blood lipids is involved in the formation of atherosclerotic plaques?

Cholesterol

Which would be classified as a bile acid sequestrant?

Cholestyramine

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

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 male client presents to the health care provider's office for his annual visit. He takes statins to control his hyperlipidemia. When the provider reviews the client's laboratory results and notes that there is an unexplained elevation in the serum aspartate, what would the nurse expect the provider to do?

Discontinue the statin

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

The nurse instructs a patient to take his prescribed simvastatin at bedtime to promote:

Enhanced drug effectiveness

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 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

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 nurse instructs a client to take the prescribed pravastatin at bedtime based on understanding that:

Greater drug effectiveness is achieved at this time.

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

It decreases the absorption of cholesterol in the small intestine.

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

Liver disease

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.

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.

After teaching a group of students about metabolic syndrome, the instructor determines that the teaching was successful when the students identify which characteristic?

Triglyceride level above 150 mg/dL

A 62-year-old man has been prescribed extended-release lovastatin. The nurse will instruct the patient to take the medication:

at bedtime

Which category of blood lipids is involved in the formation of atherosclerotic plaques?

cholesterol

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

A client has had cholestyramine added to his or her treatment plan for dyslipidemia. What effect will cholestyramine have on the pharmacokinetics of the thiazide diuretic that the client is currently prescribed?

decreased absorption

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

headache and flatulence

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 client with a diagnosis of cardiovascular disease is taking atorvastatin calcium to reduce serum cholesterol. What is the goal of therapy for LDL cholesterol for a client taking atorvastatin calcium?

less than 130 mg/dL (3.37 mmol/L)

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

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

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.

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

The nurse knows that part of the education plan for a client with the diagnosis of hyperlipidemia needs to include which lifestyle changes? (Select all that apply.)

• Reduction of the intake of saturated fats • Weight loss • Increased physical activity

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

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

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

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

His dietary intake of saturated fat

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

True

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

True

What information would be included in a lipoprotein profile? Select all that apply:

• Total cholesterol • Triglycerides • LDL

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

digoxin

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

Bile acids

In addition to being synthesized in the liver and intestine, from where are blood lipids derived?

diet

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 • Gemfibrozil

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