Pharm Ch. 47 PrepU

Which of the following would the nurse suggest to use when administering cholestyramine? Select all that apply.

- Fruit juices -Soups -Cereals - Water

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

Which activity increases high-density lipoproteins?

All of these

Which would be classified as a bile acid sequestrant?

Cholestyramine

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)

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

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

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

Nausea, flatulence, and constipation

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 has an elevated total serum cholesterol of 260. Which aspect of patient teaching of lifestyle changes is most important for the patient?

Stop smoking

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 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

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

True

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

True

Strong evidence exists that atheroma development occurs more quickly in patients with elevated cholesterol and lipid levels.

True

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

Weight Diet

A patient has been prescribed lovastatin for a high cholesterol level. 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 because it:

inhibits cholesterol syntheses.

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. *An adverse reaction of rosuvastatin is muscle toxicity, which may cause rhabdomyolysis. Rhabdomyolysis is the breakdown of muscle that can cause pain, weakness, nausea, and even kidney damage. Gallbladder disorders are related to the use of fibric acid derivatives.

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

-Total cholesterol -LDL -Triglycerides

An instructor is describing the characteristics associated with metabolic syndrome. Which of the following would the instructor include in the description? (Select all that apply.)

-Waist measurement over 40 inches in men -Triglyceride levels greater than 150 mg/dL

A client is being prescribed fluvastatin. The nurse reviews the client's medical record to ensure that the client has attempted lifestyle changes for at least a minimum of which amount of time?

12 weeks

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

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

Bile acids

A patient is taking cholestyramine. The nurse will assess for which common adverse effect of the drug?

Constipation

A male client takes cholesterol absorption inhibitors as a monotherapy without statins. He develops mild hepatic insufficiency. What would the nurse expect the physician to do?

Decrease the dosage of his medication

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

Digoxin (Lanoxin)

A nurse is caring for a patient prescribed nicotinic acid for hyperlipidemia. What is experienced by patients taking nicotinic acid?

Flushing of the skin

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

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 *Gemfibrozil is a fibrate. Colestipol, colesevelam, and cholestyramine are bile acid resins.

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

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

HMG-CoA reductase inhibitors

The nurse is developing a plan of care for a male patient who has been admitted to the hospital after a myocardial infarction. The patient begins lovastatin to lower his LDL levels and increase his HDL levels. Based on the adverse reaction of this medication, what would be the most appropriate nursing diagnosis?

Risk for injury to skeletal muscles related to adverse effects of drug therapy

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 most common adverse effects of lovastatin include:

headache and flatulence.