PrepU Abram's CH 10 - Dyslipidemia

A 39-year-old nulliparous woman has been taking atorvastatin for 2 years and has not 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"

The nurse is taking a health history on a 58-year-old client who is taking atorvastatin for high cholesterol. What assessment question should the nurse *prioritize* related to the safe use of this drug?

"How many alcoholic drinks do you have in a typical day or week?"

A client who is receiving cholestyramine also take 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 58-year-old man has recently been prescribed atorvastatin (Lipitor) in an effort to reduce his cholesterol levels. The man has acknowledged the potentially harmful effects of hyperlipidemia and is motivated to make changes to resolve this health problem. What advice should the nurse give to this client?

"It's a good idea to keep your intake of saturated fat to a bare minimum"

The nurse knows that part of the education plan for a client with the diagnosis of hyperlipidemia needs to include which lifestyle changes? (Select all that apply)

- Reduction of the intake of saturated fats - Weight loss - Increased physical activity

A client diagnosed with metabolic syndrome is encouraged to implement nonpharmacologic measures to improve existing risk factors. What actions demonstrate an understanding of appropriate measures? Select all that apply.

- adhering to a low-fat diet - walking for 30 minutes several times a week - eating a high-fiber diet - avoiding tobacco products - maintaining a healthy weight

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

Decrease dosage of his medication

Which of the following best reflects the action of ezetimibe?

Decreases the absorption of dietary cholesterol from the small intestine

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

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

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

Pregnancy Category X

After teaching a group of student about metabolic syndrome, the instructor determines that the teaching was successful when the student identify which characteristic?

Triglyceride level above 150 mg/dL

The nurse explains to a client the action of a hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor. What enzyme does the nurse state this drug inhibits?

an enzyme that controls the production of cellular cholesterol

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

at bedtime

Which would be classified as a bile acid sequestrant?

cholestyramine

A client has had cholestyramine added to his or her treatment plan for dyslipidemia. What effect will cholestyramine have on the pharmacokinetics of the thiazide diuretic that the client is currently prescribed?

decreased absorption

The client is diagnosed with hyperlipidemia and prescribed lovastatin. Which is the most common adverse effects of lovastatin?

headache and flatulence

A client asks how ezetimibe will help to treat high lipid levels. The nurse explains that:

it decreases the absorption of cholesterol in the small intestine

The nurse is caring for a client who is takeing ezetimibe and monitors the client for what common adverse effects?

mild abdominal pain and diarrhea

The client receives a prescription for niacin. The nurse is providing education about the medication and possible adverse effects. Which adverse affect would the nurse include?

"Some people get very flushed skin when they take this medication"

A nurse is caring for a client who has been prescribed cholestyramine powder for pruritus treatment. What instructions should the nurse include in the teaching plan for the client? Select all that apply.

- Mix the drug in 2 to 6 fluid ounces (56 to 168 grams) of water - Mix the drug with fluid soups or pulpy fruits - Do not ingest the drug in the dry form

A nurse is analysing the chemistry profile of a client diagnosed with hyperlipidemia. Which measurement(s) will the nurse *prioritize* on the lipid profile? Select all that apply

- Total cholesterol - Triglycerides - LDL

The nurse is conducting an ongoing assessment on a client who was administered an antihyperlipidemic medication. Which assessment(s) should the nurse *prioritize*? Select all that apply.

- Vital signs - Assessment of bowel function

Statin drugs help lower cholesterol, LDL, and triglycerides by which mechanisms? (Select all that apply.)

- promoting breakdown of cholesterol - inhibiting the manufacturing of cholesterol

A client taking atorvastatin presents to the clinic reporting acute muscle pain not associated with exercise or injury. The nurse asks questions to determine if this client has been taking what contraindicated substance?

Grapefruit juice

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

A patient with very high serum triglyceride levels is prescribed the fibric acid derivative clofibrate. In which of the following categories of patients is the use of clofibrate contraindicated?

Patients with primary biliary cirrhosis

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

The health care provider has prescribed fenofibrate for a client discovered to have very high serum triglyceride levels. The nurse should question this order if the client has a history of which additional disorder?

Primary biliary cirrhosis

The nurse is teaching a 45-year-old client about ways to lower cholesterol level. What effects of exercise does the nurse describe on high-density lipoproteins (HDLs) and low-density lipoproteins (LDLs)?

increases HDL and decreases LDL

The nurse is providing education to a client who has been prescribed atorvastatin. In what way will the nurse describe how the drug achieves its desired therapeutic effect?

reduces the amount of cholesterol synthesized by the liver

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

smoking cessation

A nurse is caring for a client prescribed nicotinic acid for hyperlipidemia. The nurse would asses 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

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

In addition to being synthesized in the liver and intestine, from where are blood lipids derived?

diet

The nurse is preparing to teach a client about diet therapy when beginning bile sequestrant medication to lower lipid levels. What important point will the nurse including in the teaching plan?

increasing fiber intake

A client has been prescribed lovastatin for high cholesterol. 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 in which manner?

inhibits cholesterol synthesis

A client recently began taking lovastatin. The nurse should asses the client for what potential adverse effects?

nausea, flatulence, and constipation

A female client presents to the health care provider's office with recurrence of her "hot flashes". The nurse understands that the client is taking what drug to treat her dyslipidemia?

niacin

A nurse in a health care facility is caring for patients receiving the bile acid sequestrant colesevelam. In which category of patients is colesevelam administered with caution?

patients with liver disease