Antihyperlipidemics

Optimal low density lipoprotien (LDL) cholesterol is now defines in ATP III as less than ____________ mg/dL

100

The __________ is the primary source of endogenous cholesterol in the body

Liver

Which drug is approved for hyperlipidemia and to help control hyperglycemia in patients with type 2 diabetes? A. Ezetimibe B. Colesevelam C. Cholestyramin D. Niacin

B. Colesevelam Colesevelam is approved for adjunct therapy of hyperglycemia in patients with type 2 diabetes.

The recommendation for regular physical activity is ______________ to ____________ minutes on most days.

30, 60

Optimal high density lipoprotein (HDL) cholesterol is now defined in ATP III as at least ______________ mg/dL

40

The nurse is caring for a patient prescribed gemfibrozil. For which patient should the nurse question the use of this drug? A. A patient with history of gallstones B. A patient with elevated triglycerides C. A patient with cardiovascular disease D. A patient with elevated very low density lipoprotein levels.

A. A patient with history of gallstones. Gemfibrozil is indicated for people with elevated vldl's, cardiovascular disease and triglycerides.

Which therapeutic lifestyle changes are shown to reduce low density lipoprotein (LDL) cholesterol? Select All. A. Active exercise for 30-60 minutes five days a week. B, Reduction of tobacco to occasional use C. Active exercise for 15 minutes two to three days a week D. Reduction of saturated fat intake E. Wight loss with metabolic syndrome

A. Active exercise for 30-60 minutes 5 days a week D. Reduction of saturated fat intake E. Weight loss with metabolic syndrome The most helpful way to lower LDLs is to actively exercise atleast an hour for 5 days a week. The reduction of saturated fats also helps with this. Those who have metabolic syndrome need to lose weight to lower LDLs

Which are positive risk factors for atherosclerotic cardiovascular disease (ASCVD)? Select all A. African American race B. Blood pressure of 130/85 mm Hg C. Blood pressure higher than 140/90 D. High density lipoprotein is 60 mg/dL or higher E. Serum triglyceride level of 150 mg/dL

A. African American race C. Blood pressure higher than 140/90 mm/hg ??

The nursing instructor is teaching nursing students about niacin therapy for treatment of different types of hyperlipidemia. What will the nursing instructor include in this teaching? Select All. A. Always check the patient's medical history for gout B. Always check the patient's medical history for diabetes C. Always check the patients white blood cell count before adminstering the drug D. It is preferable to give the extended release dosage form of the drug to the patient E. It is preferable to give the sustained release dosage form of the drug to the patient.

A. Always check the patient's medical history for gout B. Always check the patients medical history for diabetes D. It is preferable to give the extended release dosage of the drug to the patient. p 583 lol

A patient with serum cholesterol level of 275 mg/dL is prescribed simvastatin. What instructions should the nurse provide to the patient? select all that apply. A. Avoid taking the drug with grapefruit juice. B. Notify the healthcare provider if your urine becomes discolored C. Notify your healthcare provider if muscle pain occurs within 1 day D. Notify your healthcare provider if muscle pain occurs after 3 days E. take aspirin 30 minutes before taking simvastatin.

A. Avoid taking the drug with grapefruit juice B. Notify the healthcare provider if your urine becomes discolored D. Notify your healthcare provider if muscle pain occurs after 3 days. Simvastatin causes rnhabdomylosis, which can cause the urine to change color. Simvastatin starts working THREE days after administration because it is given ORALLY. Grapefruit juice will increase the levels of statins in the body and further cause rhabdomyolysis.

When teaching the nursing student about coronary heart disease, which statement will the nurse include in the session? A. Coronary heart disease occurs because of the formation of atherosclerotic plaques B. Coronary heart disease is nonlethal and cannot be prevented by antilipemic medications. C. Coronary heart disease cannot be prevented by changing lifestyle modifications D. Coronary heart disease is due to diseases in the cholesterol levels to below 200 mg/dL

A. Coronary heart disease occurs because of the formation of atherosclerotic plaques Coronary heart disease occurs because of the formation of atherosclerotic plaques inside the walls of the coronary arteries.

The nurse is caring for a patient who has coronary heart disease (CHD). The nurse tells the patient, "your cholesterol levels are abnormal; you are at a high risk of having a heart attack." What did the nurse discover regarding the lipoprotein levels in the patient's blood report? A. High levels of LDL's B. High Levels of HDL's C. Low levels of VLDLs D. Low levels of intermediate density lipoproteins

A. High Levels of LDL's

A patient with cardiovascular disease is taking rosuvastatin. Which finding would indicate a potential adverse effect of this drug? A. Muscle pain and tenderness B. Platelet count of 100 x 10^3 /mm^3 C. Blood pressure of 140/90 mm hg D. Wheezing and shortness of breath

A. Muscle pain and tenderness. statins could cause rhabdomylosis, which is muscle atrophy.

A patient with hyperlipidemia has been prescribed simvastatin. While caring for the patient, the nurse unknowingly administers niacin along with simvastatin. Which complication may the patient have due to the drugs interactions? A. Myopathy B. Blurred Vision C. Bowel Obstruction D. Hepatic Dysfunction

A. Myopathy

What are the common side effects of fenofibrate, a fibric acid derivative? Select all that apply. A. Rash B. Constipation C. Cutaneous Flushing D. Nausea and abdominal pain E. Increase in gallstone formation

A. Rash D. Nausea and abdominal pain E. Increase in gallstone formation These are common Side effects of Fibrates

A patient receiving atorvastatin therapy to reduce high cholesterol levels call the clinic and reports, 'i am experiencing severe pain in both my legs." What is the nurse's best response? A. Stop taking the drug and visit the clinic immeditately B. Continue taking the drug; leg pain is a common side effect C. Stop taking the drug if the symptoms persist for another week D. Continue taking the drug along with niacin and a pain killer.

A. Stop taking the drug and visit the clinic immediately the statin drugs can cause the serious side effect of rhabdomylosis.

The nurse reviews the history for a patient taking atorvastatin. What will the nurse act on immediately? A. The patient is on an oral contraceptive B. The patient takes medications with grape juice C. The patient takes herbal therapy including kava kava D. The patient was started on penicillin for a respiratory infection.

A. The patient is on an oral contraceptive. Atorvastatin can increase the estrogen levels of oral contraceptives.

The nurse is assessing a patient who has hyperlipidemia and who is treated with antihyperlipidemic medications. This nurse realizes bile acid sequestrants may cause what interaction? Select All A. Decreased urination B. Binding with digoxin C. Binding with warfarin D. Inactivation with food E. Elevated blood pressure

B. Binding with digoxin C. Binding with warfarin

The nurse is educating a patient about the patient's prescription for simvastatin and ezetimibe in fixed dose combination tablets. What does the explain Is the primary benefit to this approach? A. The combination medication costs less than two drugs each purchased separtately. B. Each medication has a different mechanism of action so the combination works more effectively than the separate drugs alone. C. The combination can help decrease adverse outcomes of elevated cholesterol D. A combination medication means it is more convenient since it is only one pill instead of two.

B. Each medication has a different mechanism of action so the combination works more effectively than the separate drugs alone. because both meds have different modes of action, the combo lowers cholesterol more effectively by lowering it in more ways than one simultaneously.

The nurse is assessing a patient with diabetes who has hyperlipidemia. The patient asks the nurse to suggest either an herbal medication or a dietary modification to reduce cholesterol levels. Which suggestion given by the nurse would be most beneficial to the patient? A. Include flax seeds in your food B. Eat foods rich in omega 3 fatty acids C. Consume excessive amounts of garlic D. Take 20 mg of St Johns wort regularly.

B. Eat foots rich in omega 3 fatty acids - Omega 3 fatty acids are fish oil, which helps patients with diabetes and hyperlipidemia

The nurse is assessing a patient's understanding of discharge instructions regarding cholestyramine. Which response assures the nurse that the patient has learned the instructions? A. I will weigh myself weekly B. I will increase fiber in my diet C. I will have my blood pressure checked weekly. D. I will take cholestyramine 1 hour before my other medications.

B. I will increase fiber in my diet. Cholestryramine and other bile acid sequestrants cause constipation and increased fiber can mitigate that adverse effect.

A patient with hypercholesterolemia has been prescribed simvastatin. Which action should the nurse perform while caring for the patient? A. Instruct the patient to take aspirin for pain relief. B. Inform the patient that this drug may cause nausea C. Inform the patient that allergies are a side effect of the drug D. Instruct the patient to discontinue the drug in case of muscle pain.

B. Inform the patient that this drug may cause nausea. nausea is a known side effect of simvastatin.

Which are beneficial effects that can be derived from simvastatin and other drugs in this class? Select All. A. Improvement of liver function B. reduction of risk of cardiovascular events C. Reduction of LDL's D. Elevation of HDL's E. Stabilization of the plaque in coronary arteries.

B. Reduction of risk of cardiovascular events C. Reduction of LDL's D. Elevation of HDL's E. Stabilization of the plaque in coronary arteries. These are all the beneficial effects of the statin class drugs

The nurse is assessing a patient who has hyperlipidemia and who is prescribed gemfibrozil. Which conditions will the nurse assess in the patients before administering the drug? Select all that apply. A. Muscle reflexes B. Renal dysfunction C. Gallbladder disease D. Hepatic Dysfunction E. Level of consciousness.

B. Renal Dysfunction C. Gallbladder disease D. Hepatic Dysfunction Fibrates are contraindicated in these situations as they can worsen these conditions.

The nurse is assessing a patient who has been prescribed atorvastatin. What instruction should ensure proper administration of the medication? A. Take the drug after breakfast B. Take the drug in the evening C. Take the drug with an antacid D. Take the drug on an empty stomach

B. Take the drug in the evening Cholesterol production by the liver usually occurs at night.

The nurse is caring for a patient who has elevated triglyceride levels and is unresponsive to HMG-CoA reductase inhibitors. What does the nurse expect the primary health care provider to prescribe to the patient? A. Colestipol B. Gemfibrozil C. Simvastatin D. Cholestyramine

B. gemfibrozil Gemfibrozil is a fibrate, so it can lower TG and raise HDLs and is the third line drug for lowering LDL's.

Which drug is the most effective for lowering LDL cholesterol? A. Gemfibrozil B. Ezetimibe C. Atorvastatin D. Cholesterol

C. Atorvastain

The nurse is caring for a patient who takes multiple cholesterol lowering drugs. Which drug is least likely to cause systemic side effects? A. Gemfibrozil B. Simvastatin C. Colesevelam D. Nicotinic acid.

C. Colesevelam Bile acid sequestrants are the least likely out of all the antilipidemics to cause systemic side effects.

The nurse is caring for a patient who has undergone kidney transplantation. The patient's laboratory reports show hyperlipidemia. Which antihyperlipidemia drug would be most beneficial for the patient? A. Fluvastatin B. Cyclosporin C. colesevelam D. Cholestyramine

C. Colesevelam This drug is better tolerated by high risk patients who have intolerance to other antilipidemic medications.

The nurse provides teaching to a patient who will take atorvastatin at home. Which teaching is most likely to help maintain the antilipemic medication dosage at the lowest level possible? A. Take atorvastatin at bedtime B. Avoid all alcoholic beverages C. Engage in moderate exercise D. Adhere to the blood test schedule

C. Engage in moderate exercise Exercise is more effective at lowering cholesterol than any drug therapy.

Which statement indicates the patient understands discharge instructions regarding cholestyramine? A. I will weigh myself weekly. B. I will have my blood pressure checked weekly C. I will take cholestyramine with water. D. I will take cholestyramine 1 hour before my other medications.

C. I will take cholestyramine with water. -

The nurse is providing care for a patient receiving a statin to manage cholesterol levels. For which adverse effect will the nurse monitor in this patient? Select All A. Gallstone development B. Nonalcoholic fatty liver disease C. Increased serum transaminase levels D. Unexplained muscle pain or tenderness E. Elevated creatinine kinase (CK) level with muscle pain

C. Increased serum transaminase levels D. Unexplained muscle pain or tenderness E. Elevated creatinine kinase (CK) level with muscle pain. Along with causing rhabdomylosis, liver injury can increase transaminase levels.

What is the mechanism of action of ezetimibe? A. it inhibits the biosynthesis of cholesterol in the liver B. It decreases adhesion of cholesterol on the arterial walls. C. It inhibits absorption of dietary and biliary cholesterol in the small intestine. D. It inhibits the absorption of bile, thus causing the liver to produce bile from cholesterol.

C. It inhibits absorption of dietary and biliary cholesterol in the small intestine. Ezetimibe works by selectively inhibiting the absorption of cholesterol and related sterols in the small intestine. The mechanism of action of ezetimibe does not involve the liver or arterial walls.

A 45 year old female smoker with a family history of coronary heart disease (CHD) has been prescribed a lipid lowering medication. Which outcome would be most important for this patient? A. Cholesterol total less than 200 mg/Dl B. HDL greater than 40 mg/dL C. LDL less than 100 mg/dL D. Triglycerides less than 150 mg/dL

C. LDL less than 100 mg/dL

Before the nurse administers simvastatin, which base data are collected to help prevent adverse effects of therapy? Select All that apply A. Uric Acid B. Potassium C. Muscle pain D. Liver Enzymes E. Renal function F. Gastric distress

C. Muscle Pain D. Liver Enzymes E. Renal function F. Gastric distress. The nurse checks the patient for muscle pain, and assess the liver enzymes because adverse effects includes myositis, rnhabdomylosis, and liver dysfunction. Renal function is assesses bc of adverse effects of therapy. Gastric distress is assessed bc of the risk of nausea and vomiting.

A patient with hypercholesterolemia is prescribed lovastatin. After reviewing the patient's medical history, the nurse discovers that the medication is not safe to prescribe for the patient and reports this finding to the health care provider. What did the nurse find in the patient's medical history? A. The patient has leukemia. B. The patient has renal disease C. the patient has hepatic disease. D. The patient has chronic pulmonary disease.

C. The patient has hepatic disease.

A patient with hyperlipidemia is treated with atorvastatin. On the follow-up visit, the nurse discovers that the patient has had no improvement in cholesterol levels. What could be the reason for this? A. The patient has a history of rhabdomylosis B. The patient took atorvastatin with gemfibrozil C.. The patient is taking the medication in the morning D. The patient consumed more than 8 ounces of grapefruit juice per day.

C. The patient is taking the medication in the morning Taking a statin in the morning is almost useless since the synthesis and creation of LDL's

The nurse teaches the nursing student about statin drugs. Which statements by the student indicates effective learning? Select All A. Statins can be used along with gemfibrozil B. Simvastatin is the less potent inhibitor of CYP3A4 C. Fluvastatin with warfarin increases the risk of bleeding. D. Pravastatin is not as effective as simvastatin for the inhibition of CYP3A4 D. Atorvastatin with cyclosporine decreases the risk of rhabdomylosis.

C. fluvastatin with warfarin increases the risk of bleeding D. Pravastatin is not as effective as simvastatin for the inhibition of CYP3A4

A patient diagnosed with hypercholesterolemia is prescribed lovastatin. Based on this medication order, the nurse will contact the health care provider about which reported condition in the patient's history? A. Leukemia B. Renal disease C. Hepatic disease D. Chronic pulmonary disease

C. hepatic disease

A patient with hyperlipidemia is prescribed atorvastatin; however, the patient does not want to take a pill and prefers powder form. What alternative medication available in powder form would be the most beneficial for the patient? A. Ezetimibe B. Fluvastatin C. Simvastatin D. Colesevelam

D. Colesevelam Bile Acid Sequestrants are the only antilipidemics to be administered orally with powder.

The nurse is reviewing medication orders for a patient with type 2 diabetes and hypertension. In accordance with the American College of Physicians recommendations, which additional medication does the nurse expect to be ordered even if the patient does not have high cholesterol? A. Niacins B. Fibrate C. Bile Acid Sequestrants D. HMG co-A reductase inhibitor

D. HMG co-A reductase inhibitors Statins are recommended for type 2 diabetes patients even if they do not have high cholesterol.

Which patient's statement indicated a need for further medication instruction about colestipol? A. I might need to take fat soluble vitamins to supplement my diet B. The medication may cause constipation, so I will increase fluid and fiber in my diet C. I should take this medication 1 hour after or 4 hours before my other medications. D. I should stir the powder in as small an amount of fluid as possible to maintain the potency of the medication

D. I should stir the powder in as small an amount of fluid as possible to maintain the potency of the medication. bile acid sequestrants should be diluted well in fluids before administration to avoid esophageal irritation

The nurse is teaching a group of nursing students about statin drugs and asks about the mechanism of action of lovastatin. Which response from the student indicates understanding? A. it stimulates the biliary system to increase the excretion of dietary cholesterol B. It inhibits the absorption of dietary cholesterol in the small intestine C. It binds to bile in the intestinal tract forming an insoluble complex that is excreted in feces. D. It inhibits HMG-COA reductase to reduce the biosynthesis of cholesterol in the liver.

D. It inhibits HMG-COA reductase to reduce the biosynthesis of cholesterol in the liver. This is the mechanism of action for lovastatin and other statins

The nurse is teaching a medication regimen to a patient who has type 2 hyperlipoproteinemia and who has been prescribed cholestyramine. Of what will the nurse inform the patient during the teaching? A. Include milk in the diet while taking this medication. B. Avoid taking vitamin A supplements while taking the medication. C. Avoid doing deep breathing exercises after taking the medication D. Take other medications 1 hour before or 4 hours after the administration of cholestryramine.

D. Take other medications 1 hr before or 4 hours after the administration of cholestyramine.

Estrogen, progesterone, and testosterone are _______________ that require cholesterol for formation

hormones

_____________ serve as carriers for transporting lipids in the blood

lipoprotiens

When trying to lower blood cholesterol, it is important to reduce intake of _______________ fats

saturated

Hydrophyllic means ________________ and hydrophobic means ______________.

water soluble/loving, water insoluble/ hating