Week 6: Drugs for Lipid Disorders
The client states to the nurse, "My healthcare provider says I have heart disease and I need to decrease the cholesterol in my diet. I don't understand how this happened." Which response should the nurse provide the client? "The arteries around your heart are narrowed by low density lipoprotein (LDL) cholesterol buildup in them." "Low density lipoprotein (LDL) cholesterol is converted to saturated fat, which is stored in your coronary arteries." "Too much low density lipoprotein (LDL) cholesterol narrows all the arteries in your body so your heart does not receive enough blood to be healthy." "It is a good idea to decrease low density lipoprotein (LDL) cholesterol in your diet, although current research has not proven a correlation yet."
"The arteries around your heart are narrowed by low density lipoprotein (LDL) cholesterol buildup in them."
A client tells the nurse they will need a prescription for high cholesterol but does not know which would be best. Which information should the nurse provide the client? SAT "The best drugs to raise the high density lipoprotein (HDL) levels are the fibric acid drugs." "The statin drugs are good but will cause a lot of flushing if you swallow them with warm fluids." "The bile resins keep cholesterol from being absorbed but have some side effects." "The statin drugs inhibit the making of cholesterol and are considered the best choice." "Fibric acid drugs will decrease triglycerides, but your low density lipoprotein (LDL) will still be high."
- the bile resins keep cholesterol from being absorbed but have some side effects -The statin drugs inhibit the making of cholesterol and are considered the best choice -Fibric acid drugs will decrease triglycerides, but your LDL will still be high
Which information about the dietary intake of lipids should the nurse provide a client? SAT "Phospholipids will help prevent Alzheimer's disease." "Phospholipids are essential to building plasma membranes." "Cholesterol is a building block for estrogen and testosterone." "Triglycerides are the major form of fat in the body." "Cholesterol in the diet is unnecessary as the liver synthesizes it."
-phospholipids are essential to building plasma membranes -cholesterol is a building block for estrogen and testosterone -triglycerides are the major form of fat in the body -cholesterol in the diet is unnecessary as the liver synthesizes it
Which assessment is a nursing priority for a client receiving cholestyramine (Questran)? Auscultation of heart sounds Assessment of 24-hour urine output Auscultation of bowel sounds in all four abdominal quadrants Palpation for peripheral edema in the lower extremities
Auscultation of bowel sounds in all four abdominal quadrants Assessent of bowel sounds is a priority because this medication could cause obstruction of the intestines.
A patient has been prescribed gemfibrozil (Lopid). Which laboratory tests should the nurse schedule for the client on the next clinic appointment? Blood glucose Liver enzymes Potassium Hemoglobin and hematocrit Urinalysis
Blood glucose Liver enzymes Hemoglobin and hematocrit
The educator is reviewing the classifications of prescriptions used to decrease blood cholesterol levels with a nurse. Which prescriptions should the educator include in the discussion of fibric acid agents? SAT Tricor Zetia. Lopid Colestid Zocor
Tricor Lopid
Which type of lipid serves as fuel for the body when energy is needed? Steroids Triglycerides Lecithins Phospholipids
Triglycerides Triglycerides are the major storage form of fat in the body and the only type of lipid that serves as an important energy source.
The patient is receiving cholestyramine (Questran) and complains of constipation. The physician orders bisacodyl (Dulcolax) tablets. When is the best time for the nurse to administer the bisacodyl (Dulcolax) tablets? One hour after administration of cholestyramine (Questran). The drugs can be administered together. Bisacodyl (Dulcolax) can be given any time but must be taken with food. Four hours after administration of cholestyramine (Questran).
Four hours after administration of cholestyramine (Questran)
The nurse has completed nutritional teaching for a client with a high low density lipoprotein (LDL) level. Which menu choice made by the client indicates an understanding of the teaching? Beef tenderloin with gravy and noodles, fruit salad with apples and grapefruit, slice of rye bread, and apple pie Grilled chicken with rice and broccoli, tossed salad with walnuts and sliced apples, slice of whole-wheat bread, and low-fat chocolate pudding Grilled chicken salad with strawberries and pecans, baked macaroni and cheese, and low-fat brownie Low-fat hamburger with whole-wheat bun, tossed salad with walnuts and olive oil, and raisin-oatmeal cookie
Grilled chicken with rice and brocolli, tossed salad with walnuts and sliced apples, slice of whole wet bread and low fat chocolate pudding
Which type of lipoprotein is often referred to as "the good type?" HDL LDL VLDL Triglycerides
HDL
The nurse is providing education about lipids for a client with hyperlipidemia. Which information should the nurse include in the education? High density lipoprotein (HDL) is called good cholesterol because it increases the oxygen content in the arteries and reduces the amount of plaque buildup. High density lipoprotein (HDL) is called good cholesterol because it removes cholesterol from the body and gets rid of it in the liver. High density lipoprotein (HDL) decreases low density lipoprotein (LDL) and prevents it from converting to very low density lipoprotein (VDRL), which is the worst kind of cholesterol in the body. High density lipoprotein (HDL) decreases the bad cholesterol (low density lipoprotein [LDL]), and promotes excretion of it through the kidneys.
High density lipoprotein is called good cholesterol because it removes cholesterol from the body and gets rid of it in the liver High density lipoprotein (HDL) assists in the transport of cholesterol away from body tissues and back to the liver in a process called reverse cholesterol transport.
Which is the priority action of the nurse when caring for a client receiving a statin with elevated creatine kinase (CK) levels? Administer the prescription and continue to assess for muscle pain. Hold the prescription and obtain another creatine kinase (CK) level in 6 hours. Administer the prescription and obtain another creatine kinase (CK) level in 6 hours. Hold the prescription and notify the healthcare provider.
Hold the prescription and notify the healthcare provider Elevated creatine kinase levels could indicate myopathy if this is suspected the prescription is held and the healthcare provider is notified
The nurse has completed the education for a client prescribed gemfibrozil (Lopid). Which statement made by the client indicates an understanding of the information? "My physician said it really doesn't matter how I take this medication." "I must take this medication with food or I can have heartburn.". "Taking this medication with yogurt will help it to absorb better." "I should take this medication on an empty stomach to help it absorb better."
I must take this medication with food or I can have heartburn Gemfibrozil should be administered with food to decrease gastrointestinal distress.
The nurse has provided education for a client prescribed fenofibrate (Lofibra). Which statement made by the client indicates an understanding of the information? "I will take my prescription with food." "I will report nausea and vomiting to my healthcare provider." "I will monitor myself for bruising." "I will expect to see a change in color of my stool."
I will expect to see a change in color of my stool Fenofibrate increases the risk of bleeding. A change in color of the stool should be reported. Fenofibrate should be taken with meals to avoid adverse gastrointestinal symptoms. Fenofibrate is a fibric acid drug with a risk of bruising and bleeding. Nausea and vomiting are adverse effects of fenofibrate and should be reported to the healthcare provider to avoid dehydration.
The nurse has provided client education regarding therapeutic lifestyle changes to help control cholesterol levels. Which statement made by the client indicates an understanding of the information?SAT I will maintain an optimal weight." "I will implement a medically supervised exercise plan." "I will increase saturated fat in my diet." "I will increase insoluble fiber in my diet." "I will eliminate tobacco use."
I will maintain an optimal weight." "I will implement a medically supervised exercise plan." I will eliminate tobacco use."
Which describes the mechanism of atorvastatin's (Lipitor) ability to lower blood cholesterol levels? Prevents dietary absorption within the GI tract. Increases excretion by activating enzymes within the hepatic system. Binds exogenous cholesterol and excreting it in the feces. Inhibits an enzyme that is essential for cholesterol synthesis.
Inhibits an enzyme that is essential for cholesterol synthesis This medication is a statin, statins inhibit an enzyme in the liver and we make less LDL because it's not metabolized/produced
Which anatomical location is Ezetimibe (Zetia) effective in blocking the absorption of cholesterol? Gallbladder Liver Stomach Jejunum
Jejunum
The nurse reviewing a client's serum cholesterol levels notes the following: Low density lipoprotein (LDL) = 105 mg/dl High density lipoprotein (HDL) = 37 mg/dl Low density lipoprotein (LDL)/high density lipoprotein (HDL) ratio = 4.1 Which should the nurse identify as the priority outcome in the client's plan of care? Validate that the client understands the importance of lifestyle changes. Maintenance of normal lipid levels without the use of pharmacotherapy. Education about diet and exercise. The client's achievement of normal lipid levels through compliance with medications.
Maintenance of normal lipid levels without the use of pharmacotherapy The client has borderline lab values. Clients with borderline lab values can control their dyslipidemia through nonpharmacological interventions.
Which assessment data obtained from a client receiving a statin is a priority for the nurse to report to the healthcare provider? "My calves hurt, and I had a hard time walking to the bathroom." "My heart rate really went up this morning." "I know I just started this medicine yesterday, but my stomach really is upset." "Will you call my healthcare provider? I have a really bad headache."
My calves hurt and I had a hard time walking to the bathroom The nurse must asses for complaints of muscle pain, tenderness, and weakness as this could indicate a type of myopathy known as rhabdomyolysis.
The nurse is preparing to provide education for a client prescribed a statin. Which adverse effects should the nurse include in the teaching?SAT Headache Abdominal pain Myopathy Muscle or joint pain Rhabdomyolysis
Myopathy Rhabdomyolysis Severe myopathy is a rare but serious adverse effect associated with statins. Rhabdomyolysis is an example of a rare but serious adverse effect associated with statins. Headache, abdominal pain, and muscle or joint pain are examples of minor adverse effects associated with statins.
Which statement is accurate regarding the use of nicotinic acid (Niacin) for lowering blood cholesterol levels? Due to adverse effects, niacin should not be used with statins. High doses of 25-30 mg per day are often necessary. Works primarily by lowering LDL and HDL levels. Niacin may also reduce triglyceride levels.
Niacin may also reduce triglyceride levels
The nurse is discussing with a client, the dietary intake of omega-3 and CoQ10-rich foods to control lipid levels. Which foods should the nurse include in the discussion?SAT Sardines Shrimp Almonds Olive oil Carrots
Sardines Almonds Olive oil
Which lipid type is associated with the highest risk for the development of atherosclerosis? Steroids Phospholipids Triglycerides Lecithins
Steroids
Which information should the nurse include in the education for a client prescribed niacin to lower lipid levels? "Take one aspirin 30 minutes before you take your niacin." "Be sure to take your niacin on an empty stomach as soon as you arise." "Take your niacin tablet with food and at least one full glass of water." "It may be time to ask your healthcare provider about switching to another drug."
Take one aspirin 30 minutes before you take your niacin
Which statement correctly identifies why restricting dietary intake of cholesterol generally will not result in a significant reduction of blood cholesterol? Cholesterol is found in nearly all foods, and it is not possible to eliminate it from the diet. Cholesterol is made within the body and cannot be absorbed via external sources. Most clients are not compliant with the dietary restriction. The liver reacts to a low-cholesterol diet by making more cholesterol.
The liver reacts to a low-cholesterol diet by making more cholesterol
The nurse reviewing records should determine that which client's lab values are associated with the highest risk of developing heart disease? Total 200, LDL 104, HDL 30 Total 186, LDL 125, HDL 54 Total 220, LDL 162, HDL 20 Total 210, LDL 135, HDL 58
Total 220, LDL 162, HDL 20
Which statement provides the best rationale for monitoring HDL and LDL as opposed to total cholesterol? Total cholesterol does not differentiate the amounts of "good" cholesterol and "bad" cholesterol. HDL and LDL measurements are more general and frequently used to assessed clients that are not at risk for heart disease. HDL and LDL monitoring is less expensive than measuring total cholesterol. Total cholesterol measurements are often inaccurate and not as reliable as HDL and LDL.
Total cholesterol does not differentiate the mounts of good and bad cholesterol
The educator is preparing education about the different types of lipids for a nurse. Which should the educator include in the presentation? SAT Triglycerides Phospholipids Steroids Lecithins. Bile acids
Triglycerides Phospholipids Steroids
Which assessment finding for a client receiving a statin is a priority for the nurse to report to the healthcare provider? Urine output of 20 mL/hour. Bowel sounds markedly increased in all four quadrants of the abdomen. Urine output of 200 mL/hour. Moderate elevation in liver function tests (LFTs).
Urine output of 20 mL/hour Urine output of less than 30mL/hr is considered renal failure. Renal failures occurs with rhabdomyolysis
