Chap 47 PrepU

What cardiac risk factors are related to metabolic syndrome? (Select all that apply.)

-Central adiposity -Elevated triglycerides -Reduced high density lipoprotein cholesterol

A nurse should be aware that use of statin drugs is contraindicated in clients with which conditions? (Select all that apply.)

-Lactation. -Serious hepatic disease. -Pregnancy.

The patient 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 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 would be classified as a bile acid sequestrant?

Cholestyramine

Bile acid resins can decrease serum levels of several medications, primarily via this mechanism?

Decreased gastrointestinal absorption

Which of the following best reflects the action of ezetimibe?

Decreases the absorption of dietary cholesterol from the small intestine

The nurse is teaching a client about nicotinic acid, which the physician has prescribed for treatment of hyperlipidemia. What common adverse effect should the nurse mention to the client?

Flushing of the skin

The physician is caring for a client who is a 2-year kidney transplant survivor. The nurse would expect the physician to order what drug for the client's hyperlipidemia?

Fluvastatin

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

Frequently monitor blood cholesterol.

Which medication is classified as a fibric acid derivative (fibrate)?

Gemfibrozil (Lopid)

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 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

Which lipid level would the nurse interpret as being high?

LDL cholesterol of 190 mg/dL

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

Pregnancy Category X

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

Smoking cessation

A patient is taking cholestyramine (Questran) and ezetimibe (Zetia). What administration guideline is most important to teach this patient?

The administration of ezetimibe (Zetia) is 2 hours before cholestyramine.

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.

The client has been taking rosuvastatin for hyperlipidemia. The client now presents with severe weakness. The client states barely being able to move the extremities because of weakness. The nurse suspects the client has:

rhabdomyolysis.

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

The administration of cholestyramine (Questran) with warfarin (Coumadin) would most likely cause a client to present with issues? (Select all that apply.)

-Subtherapeutic INR -Calf pain and warmth

What are examples of modifiable risk factors for hyperlipidemia? (Select all that apply.)

-Weight -Diet

A patient with primary hypercholesterolemia has been prescribed 10 mg of ezetimibe per day by a physician. The physician has instructed the nurse to continue the drug therapy for 3 days. The drug is available in 10 mg capsules. How many capsules of the drug should the nurse administer to the patient during the entire therapy?

3 capsules

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

A patient who has been taking lovastatin (Mevacor) 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 (Questran)

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

As part of a routine physical examination, a 60-year-old patient's primary care provider has ordered blood work that includes cholesterol levels. What result would most strongly suggest the need for treatment with an antihyperlipidemic drug?

Elevated LDL levels

Increased levels of low-density lipoprotein (LDL) combined with certain risk factors can lead to the development of which medical condition?

Heart disease

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 patient who is receiving cholestyramine also takes digoxin. The nurse teaches the patient about the drug and administration. The patient demonstrates understanding of the teaching when stating:

"I will take the digoxin about an hour before the cholestyramine."

A nurse who provides care in a busy clinic is aware of the high incidence and prevalence of hyperlipidemia and the consequent need for antihyperlipidemics in many patients. Treatment of high cholesterol using statins would be contraindicated in which patient?

An obese male client who is a heavy alcohol user and who has cirrhosis of the liver

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

At bedtime

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

Bile acids

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

Which of the following adverse effects would a nurse expect to assess in a patient taking ezetimibe?

Mild abdominal pain

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

Nausea, flatulence, and constipation

The nurse is reviewing the results of a client's lipid profile. Which of the following would the nurse identify as borderline high?

Triglycerides 180 mg/dL

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

True

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

Bleeding

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

Digoxin (Lanoxin)

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

Which drug will be most effective in reducing the major types of dyslipidemia?

HMG-CoA reductase inhibitors

A patient who has an elevated triglyceride level and reduced high-density lipoprotein cholesterol is seen by her primary care physician. What do these laboratory tests indicate in this patient?

The development of metabolic syndrome

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

True

A nurse is caring for a patient who has been prescribed lovastatin to control blood lipid levels. While teaching the patient about the medication, the nurse should caution the patient against consuming large amounts of:

grapefruit juice.

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

The most common adverse effects of lovastatin include:

headache and flatulence.