CHAPTER 47 (LIPID-LOWERING AGENTS)
After teaching a group of students about metabolic syndrome, the instructor determines that the teaching was successful when the students identify which characteristic?
Triglyceride level above 150 mg/dL
A patient with metabolic syndrome usually has increased plasminogen activator levels.
True
A nurse is caring for several clients. Which client would have the greatest chance of developing CAD as determined by total cholesterol?
a 62-year-old White client with total cholesterol of 260 mg/dl
In addition to being synthesized in the liver and intestine, from where are blood lipids derived?
diet
A client with a diagnosis of cardiovascular disease is taking atorvastatin calcium to reduce serum cholesterol. What is the goal of therapy for LDL cholesterol for a client taking atorvastatin calcium?
less than 130 mg/dL (3.37 mmol/L)
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.
A client is taking lovastatin. The nurse will teach the client about which potential adverse effects?
nausea and constipation
The client has been taking rosuvastatin for hyperlipidemia. The client now presents with severe weakness and states barely being able to move the extremities. The nurse suspects the client has which?
rhabdomyolysis.
The nurse is preparing to teach a client with hyperlipidemia about the prescribed cholestyramine. Which instruction should the nurse prioritize for the client?
"Eat foods high in dietary fiber."
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 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."
Statin drugs help lower cholesterol, LDL, and triglycerides by which mechanisms? (Select all that apply.)
1. Inhibiting the manufacturing of cholesterol 2. Promoting the breakdown of cholesterol
Which adverse effects would the nurse include in the teaching plan for a patient receiving fenofibric acid as common? (Select all that apply.)
1. Runny nose 2. Respiratory infections
A nurse is analyzing the chemistry profile of a client diagnosed with hyperlipidemia. Which measurement(s) will the nurse prioritize on the lipid profile? Select all that apply.
1. Total cholesterol 2. Triglycerides 3. LDL
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
The nurse is doing teaching about cholesterol and its role in cardiovascular disease. In addition to promoting cessation of cigarette smoking and a healthy lifestyle with diet and exercise to correct cholesterol abnormalities, the nurse explains that there are two modifiable conditions that have been cited as major risk factors for CAD and its complications. What are these two conditions?
Cholesterol abnormalities and hypertension
A client is taking cholestyramine to reduce LDL cholesterol. Cholestyramine will cause a decrease in absorption of which medication?
Digoxin
A nurse is caring for a client prescribed nicotinic acid for hyperlipidemia. The nurse would assess the client for which findings as a possibility?
Flushing of the skin
A patient with hyperlipidemia is prescribed ezetimibe. Which ongoing assessment should the nurse perform during treatment?
Frequently monitor blood cholesterol.
The health care provider has prescribed ezetimibe for a client diagnosed with hyperlipidemia. The nurse is prepared to prioritize which assessment to evaluate the drug's effectiveness?
Frequently monitoring blood cholesterol
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
The nurse instructs a client to take the prescribed pravastatin at bedtime based on understanding that:
Greater drug effectiveness is achieved at this time.
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
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 is most effective in reducing most major types of dyslipidemia in patients at risk or who have already developed CAD?
HMG-CoA reductase inhibitors
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?
High
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 nurse is conducting a community presentation on heart disease, cholesterol, and risk factors. The nurse determines that the class has been successful when the class correctly chooses which point as true?
Physical activity raises HDL cholesterol levels.
HMG-CoA reductase inhibitors (statins) are classified as which pregnancy category?
Pregnancy Category X
What should the nurse suggest to assist a client to improve his cholesterol levels?
Smoking cessation
Which single class drug is known to be most effective in reducing the major types of dyslipidemia?
Statins
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.
A nurse is aware of the high incidence and prevalence of hyperlipidemia and the consequent need for antihyperlipidemics. Treatment of high cholesterol using statins would be contraindicated in which client?
An obese male client who is a heavy alcohol user and who has cirrhosis of the liver
What is the basis for a nurse's recommendation of a period of intensive diet therapy and lifestyle modification before initiation of drug therapy for a client newly diagnosed with dyslipidemia?
Therapeutic lifestyle changes are the preferred method for lowering blood lipids.