PrepU: Chapter 34: Antihyperlipidemic Drugs
The nurse is taking a health history on a 58-year-old client who is taking atorvastatin for high cholesterol. What assessment question should the nurse prioritize related to the safe use of this drug? "How many alcoholic drinks do you have in a typical day or week?" "How would you describe your caffeine intake?" "Do you do any physical exercise on a regular basis?" "Do you use any over-the-counter medications for headaches or colds?"
"How many alcoholic drinks do you have in a typical day or week?"
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." "I'll give you the names of some salt substitutes that you can start using to season your food." "A low-fat diet is a good idea, and the animal sources of fat are always preferable to plant sources." "Try to get most of your food energy from protein sources rather than carbohydrates."
"It's a good idea to keep your intake of saturated fat to a bare minimum."
The nurse is providing education to an older adult client who has been prescribed atorvastatin. How should the nurse describe the common adverse effects of the drug? "Some clients experience mild chest pain initially." "Most people who experience side effects from atorvastatin report stiffness in their joints." "The more serious side effects of atorvastatin involve a risk of bleeding." "The most common side effects of atorvastatin include some mild gastrointestinal upset."
"The most common side effects of atorvastatin include some mild gastrointestinal upset."
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." "Don't worry about it. I'm sure it's not really noticeable." "You need to stop taking the medication immediately. I will notify the health care provider." "You need to decide if you want to take this medication. The flushing will be present as long as you take the medication."
"This is an expected adverse effect of the drug. It should subside in time."
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? "Your medication can cause visual disturbances." "Yellow deposits on the eyelids can indicate severe hyperlipidemia." "Yellowing of your eyes is advanced hyperlipidemia." "High cholesterol can cause vision changes."
"Yellow deposits on the eyelids can indicate severe hyperlipidemia."
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? Digoxin Vitamin D Cholestyramine Calcium carbonate
Cholestyramine
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? Ginseng Feverfew Garlic Black cohosh
Garlic
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 Diabetes Glaucoma Hypertension
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? Optimal Desirable High Very high
High
The nurse is teaching a 45-year-old client about ways to lower cholesterol level. What effects of exercise does the nurse describe? Increases LDL and decreases triglycerides Decreases HDL and increases LDL Increases high-density lipoproteins (HDLs) and decreases low-density lipoproteins (LDL) Decreases both HDL and LDL
Increases high-density lipoproteins (HDLs) and decreases low-density lipoproteins (LDL)
The nurse is teaching the client how to reduce risk for coronary artery disease (CAD). What should the nurse recommend? Select all that apply. Lose weight. Manage hypertension. Eat a high-protein, low-carbohydrate diet. Increase intake of food high in antioxidants. Reduce stress levels whenever possible.
Lose weight. Manage hypertension. Reduce stress levels whenever possible.
A client is taking lovastatin. Which are noted as the most common adverse effects? Increased appetite and blood pressure Fatigue and mental disorientation Nausea, flatulence, and constipation Hiccups, nasal congestion, and dizziness
Nausea, flatulence, and constipation
The nurse is caring for a client with high serum cholesterol and triglyceride levels. In teaching the client about therapeutic lifestyle changes and the use of medications, the nurse explains that the desired goal for cholesterol levels is what? Increased high-density lipoprotein (HDL) values and increased triglyceride values 1:1:1 ratio of LDL, HDL, and total cholesterol Elevated blood lipids and fasting glucose less than 5.6 mmol/L (100 mg/dL) Reduced low-density lipoprotein (LDL) values and increased HDL values
Reduced low-density lipoprotein (LDL) values and increased HDL values
A client with moderately elevated lipid levels requests immediate pharmacotherapy for dyslipidemia. The nurse explains that a period of intensive diet therapy and lifestyle modification will be utilized before drug therapy is considered based on what rationale? Therapeutic lifestyle changes are the preferred method for lowering blood lipids. Continued therapeutic lifestyle changes during drug therapy will guarantee success. Therapeutic lifestyle changes work only when used in conjunction with medications. The needed lifestyle changes are usually easy for most people to achieve.
Therapeutic lifestyle changes are the preferred method for lowering blood lipids.
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 Phospholipids Triglycerides Nitroglycerin
cholesterol
Which category of blood lipids is involved in the formation of atherosclerotic plaques? cholesterol phospholipids triglycerides nitroglycerin
cholesterol
A nurse is caring for a female client who breastfeeds her 3-month-old infant. The client tells the nurse that she has been taking garlic to reduce serum cholesterol levels. The nurse informs the client that which adverse effects may occur? Colic in her infant Increased risk of bleeding Severe stomach upset Increased blood pressure
colic in her infant
A client is taking cholestyramine. The nurse will assess for which common adverse effect of the drug? Abdominal pain Headache Constipation Indigestion
constipation
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? Rash Vertigo Constipation Cholelithiasis
constipation
In addition to being synthesized in the liver and intestine, from where are blood lipids derived? diet exercise kidneys medications
diet
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? Asthma Liver disease Renal disease Hypertension
liver disease
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? Complete blood count (CBC) Liver panel INR and aPTT Reticulocyte count
liver panel
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. dry mouth. pruritus (itching) increased thirst.
muscle pain
HMG-CoA reductase inhibitors (statins) are classified as which pregnancy category? Pregnancy Category X Pregnancy Category A Pregnancy Category B Pregnancy Category C
pregnancy category X
After teaching a client about prescribed statin therapy, the nurse determines that additional teaching is needed when the client makes which statement? "I should take the dose around bedtime." "I need to be careful when I'm out in the sun." "I can take the drug with grapefruit juice." "I should report any problems with muscle pain or weakness."
"I can take the drug with grapefruit juice."
A client calls the clinic and talks to the nurse. The client tells the nurse the client has been taking colesevelam (Welchol) for six months and that the client is having small amounts of bright red rectal bleeding and is concerned. What would an appropriate response from the nurse be? "I should let your physician know immediately!" "Don't worry about it. This can happen some time." "Stop taking the medication now! This is a serious adverse effect." "The bleeding may be coming from hemorrhoids. We should check this out."
"The bleeding may be coming from hemorrhoids. We should check this out."
A client asks the nurse what the atorvastatin (Lipitor) prescribed for the client will do. What is an expected outcome for this client? Decrease in serum cholesterol only Decrease in serum cholesterol and LDL levels Decrease in sitosterol and serum cholesterol Decrease in campesterol and LDL levels
Decrease in serum cholesterol and 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 Atorvastatin Cholestyramine Gemfibrozil Niacin
Fenofibrate Gemfibrozil
After reviewing information about antihyperlipidemic drugs, a group of nursing students demonstrate understanding when they identify which medication as a fibric acid derivative (fibrate)? Colesevelam Niacin Ezetimibe Gemfibrozil
Gemfibrozil
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 Colesevelam Niacin Ezetimibe
Gemfibrozil
A client has had an exacerbation of hemorrhoidal irritation. What drug should the nurse suspect as most likely to contribute to this adverse effect? hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors cholesterol absorption inhibitor fibrates bile acid sequestrants
bile acid sequestrants
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? increased first-pass effect increased metabolism decreased absorption faster excretion
decreased absorption
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. promotes the breakdown of HDL. promotes excretion of cholesterol in the feces. decreases absorption of cholesterol.
inhibits the production of cholesterol.
Which herbal and dietary supplement has shown proven success in lowering LDL and total cholesterol in research studies? Soy Flaxseed oil Red yeast rice Garlic
red yeast rice
A nurse is conducting a presentation for a local community group about hyperlipidemia. When discussing the modifiable factors that individuals can work on to reduce their risk, which information would the nurse include? Select all that apply. Weight Diet Gender Age Family history
weight diet
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 need to take both drugs at the same time of the day." "I'll take the cholestyramine at 8 AM and the digoxin at 9 AM." "I will take the digoxin about an hour before the cholestyramine." "I'll take the digoxin about 15 minutes before the cholestyramine."
"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." "Atorvastatin can be taken safely throughout your pregnancy since it does not cross through the placenta." "Atorvastatin is approved to be taken during pregnancy, but you would have to stop taking it if you chose to breastfeed." "There's no evidence that atorvastatin is either safe or unsafe during pregnancy, so it's best to err on the side of caution."
"It's important that you stop taking atorvastatin before you stop using contraception."
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? "Sometimes this causes a full body rash when you first take it, but that doesn't necessarily mean you're allergic to it." "Some people get very flushed skin when they take this medication." "You're likely to have some nausea when you begin taking the drug, but this will dissipate with time." "It's important to avoid eating shellfish and to tell your care provider before having any diagnostic imaging tests."
"Some people get very flushed skin when they take this medication."
The nurse is providing medication teaching to a client who will begin taking niacin with a bile acid sequestrant. How should the nurse instruct the client to take these two medications? "Both medications should be taken in the morning." "One medication should be taken in the morning, but the other is taken at bedtime." "The medications should be taken 4 to 6 hours apart." "Both medications can be taken at once just before going to bed."
"The medications should be taken 4 to 6 hours apart."
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 115 Cholesterol 210 HDL 78 LDL 115 Cholesterol 189 HDL 58 LDL 96 Cholesterol 178 HDL 82 LDL 96 Cholesterol 240
HDL 58 LDL 96 Cholesterol 178
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? Hyperlipidemia Increased anticoagulant effect Decreased anticoagulant effect Elevated plasma levels of statins
Increased anticoagulant effect
The nurse is preparing to teach the client about diet therapy when beginning bile sequestrant medication to lower lipid levels. What important point will the nurse include in the teaching plan? Increasing carbohydrate intake Reducing protein intake Increasing fiber intake Reducing fluid intake
Increasing fiber intake
A client asks how ezetimibe will help to treat high lipid levels. The nurse explains that: Its mechanism of action is not understood. It decreases the absorption of cholesterol in the small intestine. It stimulates the breakdown of triglycerides. It reduces the production of triglycerides by the liver.
It decreases the absorption of cholesterol in the small intestine.
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 triglycerides Reduction in total serum cholesterol levels Increase in HDL levels Reduction in LDL cholesterol levels
Reduction in LDL cholesterol levels
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 in the intake of carbohydrates Reduction of the intake of saturated fats Weight loss Increased physical activity
Reduction of the intake of saturated fats Weight loss Increased physical activity
A client with hyperlipidemia has been taking atorvastatin for several months. How can the therapeutic effect of the medication be best determined? Assessing the client's resting heart rate and postural blood pressures Reviewing the client's laboratory blood work results Assessing the client's exercise tolerance and activities of daily living Performing a focused cardiac assessment
Reviewing the client's laboratory blood work results
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 HDL cholesterol 60 mg/dL Total cholesterol 150 mg/dL LDL cholesterol 90 mg/dL
Total cholesterol 250 mg/dL LDL cholesterol 165 mg/dL
The nurse is caring for a 35-year-old client taking a beta-hydroxy-beta-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor to lower serum lipid levels. When teaching this client about the medication, what priority teaching point will the nurse include in the teaching plan? Need for frequent ophthalmic examinations Information about a cholesterol-lowering diet Use of barrier contraceptives Calling her doctor with any respiratory symptoms
Use of barrier contraceptives
Recommended treatments for clients with dyslipidemia are made according to their blood levels of total and low-density lipoproteins (LDL) cholesterol and risk factors for cardiovascular disease. What does the impact of existing cardiovascular disease have on recommendations? decreases target serum LDL level increases target serum high-density lipoproteins (HDL) level has no effect on either LDL or HDL levels decreases target serum triglyceride level
decreases target serum LDL level
The client has been prescribed nicotinic acid for treatment of hyperlipidemia. The nurse should teach about which common side effects with this medication? Drowsiness Flushing of the skin Facial tics Fever
flushing of the skin
The client is diagnosed with hyperlipidemia and prescribed lovastatin. Which is the most common adverse effects of lovastatin? headache and flatulence. increased appetite and blood pressure. fatigue and mental disorientation. hiccups, sinus congestion, and dizziness.
headache and flatulence.
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? is a hormone. is a bile-acid resin. inhibits cholesterol syntheses. consists of a fibric acid derivative.
inhibits cholesterol syntheses.
