Week 3 Cardio Pharm
You are discharging a patient home on HMG-CoA inhibitor therapy. What statement by the patient demonstrates that they have a clear understanding of the teaching you have done?
"I should take this drug at bedtime, since my body makes lipids mostly at night."
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 he states which of the following?
"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 patient?
"It's a good idea to keep your intake of saturated fat to a bare minimum."
A patient calls the clinic and talks to the nurse. They tell they have been taking colesevelem (Welchol) for six months. The patient tells the nurse that they are having small amounts of bright, red rectal bleeding and they are concerned. What would an appropriate response from the nurse be?
"The bleeding may be coming from hemorrhoids. We should check this out."
A female patient is taking a large dose of nicotinic acid to treat hyperlipidemia. She calls the clinic and reports that her face, neck, and chest are red. Which of the following would be an appropriate response by the nurse?
"This is an expected adverse effect of the drug. It should subside in time."
The client wants to know the difference between triglycerides and cholesterol.Which of the following responses by the nurse would be correct?
"Triglycerides and cholesterol are fatlike substances found in your blood."
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 the patient during the entire therapy?
3 capsules
An appropriate goal for a client taking niacin would be to reduce total serum cholesterol to which level?
<200 mg/dL
It has been found that some populations/ethnicities have a higher incidence of hyperlipidemia than others. The nurse knows that which of the following client's would have the greatest chance of developing hyperlipidemia as determined by total cholesterol?
A white American 62 years of age with total cholesterol of 260 mg/dL
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 client is taking cholestyramine (Questran) 4 grams by mouth once daily in the morning and is to begin taking glipizide (Glucotrol XL) 5mg once daily for diabetes. How should the nurse administer these medications? (Select all that apply)
Administer the glipizide in the evening Administer the glipizide 1 hour before the cholestyramine Administer the glipizide 4 hours after the cholestyramine
The nurse is taking a health history on a 38-year-old male bar owner whois taking atorvastatin (Lipitor) for high cholesterol. The nurse will be sure to ask a specific group of questions regarding the patient's use of what?
Alcohol
Which of the following activities increases high-density lipoproteins?
All of these
You are teaching a client at your clinic about non-pharmacologic methods of controlling serum cholesterol levels. What lifestyle change may help increase high-density lipoprotein (HDL) levels?
All the above changes may help increase HDL levels.
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 of the following patients?
An obese male client who is a heavy alcohol user and who has cirrhosis of the liver
The clinic nurse has been assigned to a 43-year-old man who is obese and loves to eat. He has been diagnosed with hyperlipidemia and has been prescribed lovastatin. Which of the following dietary instructions would be a priority for the nurse to discuss with the patient?
Avoid drinking grapefruit juice and decrease intake of fatty acids
When describing the action of atorvastatin, which of the following would the nurse include?
Blocking the enzyme that is involved in cholesterol synthesis
A patient is taking atorvastatin calcium (Lipitor) to reduce serum cholesterol. Which of the following aspects of patient teaching is most important?
Call his physician if he develops muscle pain
A nurse is caring for a female patient who breastfeeds her 3 month old infant. The patient tells the nurse that she has been taking garlic to reduce serum cholesterol levels. Which of the following is an adverse effect of garlic that the nurse should inform the patient of?
Can cause colic in infants
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)
You are engaged in patient teaching with a patient who has just been prescribed a bile acid sequestrant. You teach the patient that he may mix his lipid-lowering agent with a carbonated beverage.What bile acid sequestrant is the patient taking?
Colestipol (Colestid)
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
A patient is taking cholestyramine. The nurse will assess for which of the following common adverse effects of the drug?
Constipation
Your patient asks you what will the atorvastatin (Lipitor) they are prescribed do for them. What is an expected outcome for this patient?
Decrease in serum cholesterol and LDL levels
Bile acid resins can decrease serum levels of several medications, primarily via this mechanism? (Choose one)
Decreased gastrointestinal absorption
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
What intervention may help the client increase HDL levels?
Exercise
Which agent would a nurse identify as a cholesterol absorption inhibitor?
Ezetimibe
Niacin is prescribed to a patient to increase HDL levels. What are the most common adverse effects of this therapy? (Select all that apply.)
Flushing of the face Nausea and stomach upset
A nurse is caring for a patient prescribed nicotinic acid for hyperlipidemia. Which of the following are experienced by patients taking nicotinic acid?
Flushing of the skin
You are teaching your client about nicotinic acid, which the physician has prescribed for treatment of hyperlipidemia. What common adverse effect should you mention to the client?
Flushing of the skin
Which of the following herbal products have shown in studies to lower serum cholesterol and triglycerides? (Choose one)
Garlic
The three major classes of drugs used to control blood lipids are statins, bile acid resins (or sequestrants), and fibrates. Which of the following is a fibrate?
Gemfibrozil
Which of the following medications is classified as a fibric acid derivative (fibrate)? (Choose one)
Gemfibrozil (Lopid)
Which of the following classes of medications are used to treat hyperlipidemia? (Select all that apply)
HMG-CoA reductase inhibitors Fibric acid derivatives Bile acid resins
The most common adverse effects of lovastatin include which of the following?
Headache and flatulence
The nursing instructor is discussing common adverse effects of dyslipidemia drugs. Which of the following would the instructor identify as adverse effects of statins?
Headache and nausea
Increased levels of low-density lipoprotein (LDL) combined with certain risk factors can lead to the development of which medical condition? (Choose one)
Heart Disease
A 54-year-old patient, has a cholesterol level of 240 mg/dL. What serum concentration of cholesterol would this patient have?
High
The client has been prescribed pravastatin (Pravachol). The nurse also notes that the client takes warfarin daily. The nurse evaluates the client for which of the following?
Increased anticoagulant effect
The nurse is teaching a 45-year-old patient about ways to lower cholesterol levels, as they are elevated. One method to lower cholesterol levels is to exercise, which does what?
Increases HDL and decreases triglycerides
A client's serum cholesterol is 286 mg/dL. Lovastatin (Mevacor) is prescribed. The nurse plans care based on the fact that the action of lovastatin does which of the following?
Inhibits the production of cholesterol
A client asks how ezetimibe will help to treat high lipid levels. The nurse explains that it does which of the following?
It decreases the absorption of cholesterol in the small intestine.
Your client appears to be a candidate for statin therapy. What laboratory value should be assessed prior to initiating therapy?
LFT
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 of the following conditions were noted in the client's history?
Liver disease
A client experiencing rhabdomyolysis may present with which of the following symptoms? (Select all that apply)
Malaise Fever Unexplained muscle pain
A nurse is caring for a patient who has been prescribed cholestyramine powder for pruritus treatment. What instructions should the nurse include in the teaching plan for the patient? Select all that apply.
Mix the drug in 2 to 6 fluid ounces of water Mix the drug with fluid soups or pulpy fruits Do not ingest the drug in the dry form
A patient is taking lovastatin (Mevacor). Which of the following is noted as the most common adverse effects?
Nausea, flatulence, and constipation
The most common adverse effects of lovastatin (Mevacor) include which of the following?
Nausea, flatulence, and constipation
The client presents to the physician's office complaining of ringing in her ears. Upon review of the client's medication list, the nurse identifies that it may be caused by which of the following medications?
Niacin
The nurse is providing teaching to a client who is at risk for hyperlipidemia. The nurse tells the client that hyperlipidemia has many risk factors. The nurse knows that which of the following risk factors can be controlled or modified?
Obesity, inactivity, diet, and smoking
When administering a lipid-lowering agent, the nurse would anticipate administering the drug by which route?
Oral
HMG-CoA reductase inhibitors (statins) are in which pregnancy category? (Choose one)
Pregnancy Category X
A 9-year-old child has received an order for pravastatin (Pravachol) 40 mg/d PO for genetically linked hyperlipidemia. In preparation for patient teaching concerning this drug, the nurse's initial action will be what?
Question the doctor concerning the order
The nurse knows that part of the education plan for a patient 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
The client has been taking rosuvastatin for hyperlipidemia. She now presents with complaints of severe weakness. She states she can barely move her extremities because she is so weak. The nurse suspects the client has which of the following?
Rhabdomyolysis
What is the most serious side effect of lovastatin?
Rhabdomyolysis
A patient has an elevated total serum cholesterol of 260. Which of the following aspects of patient teaching of lifestyle changes is most important for the patient?
Stop smoking
Your patient, a 37-year-old woman with moderately elevated lipid levels, requests immediate pharmacotherapy for her dyslipidemia. You explain that a period of intensive diet therapy and lifestyle modification will be utilized before drug therapy is considered. You explain the rationale for this regimen as:
Therapeutic lifestyle changes are the preferred method for lowering blood lipids.
Which of the following are examples of modifiable risk factors for hyperlipidemia? (Select all that apply)
Weight Diet
A 45-year-old man who is a construction worker has been diagnosed with hyperlipidemia and has been prescribed lovastatin. The nurse will advise the patient to
avoid prolonged exposure to sunlight.
You are caring for a patient who has been prescribed lovastatin to control her blood lipid levels. While teaching her about the medication, you should caution her against consuming large amounts of
grapefruit juice.
The nurse is caring for a patient who has high levels of total cholesterol and triglycerides. When discussing management of dyslipidemia with the patient, the nurse will describe the desired blood lipid profile as
high HDL cholesterol, low LDL cholesterol, low total cholesterol, and low triglyceride.
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 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 nurse is taking care of a patient with high cholesterol and triglyceride values.In teaching the patient about therapeutic lifestyle changes such as diet and exercise, the nurse realizes that the desired goal for cholesterol levels is what?
Low LDL values and high HDL values
The nurse is developing a plan of care for a 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
