Week 6: Drugs for Lipid Disorders

The client states to the​ nurse, "My healthcare provider says I have heart disease and I need to decrease the cholesterol in my diet. I​ don't understand how this​ happened." Which response should the nurse provide the​ client? "The arteries around your heart are narrowed by low density lipoprotein​ (LDL) cholesterol buildup in​ them." ​"Low density lipoprotein​ (LDL) cholesterol is converted to saturated​ fat, which is stored in your coronary​ arteries." ​"Too much low density lipoprotein​ (LDL) cholesterol narrows all the arteries in your body so your heart does not receive enough blood to be​ healthy." ​"It is a good idea to decrease low density lipoprotein​ (LDL) cholesterol in your​ diet, although current research has not proven a correlation​ yet."

"The arteries around your heart are narrowed by low density lipoprotein (LDL) cholesterol buildup in them."

A client tells the nurse they will need a prescription for high cholesterol but does not know which would be best. Which information should the nurse provide the​ client? SAT "The best drugs to raise the high density lipoprotein​ (HDL) levels are the fibric acid​ drugs." ​"The statin drugs are good but will cause a lot of flushing if you swallow them with warm​ fluids." ​"The bile resins keep cholesterol from being absorbed but have some side​ effects." ​"The statin drugs inhibit the making of cholesterol and are considered the best​ choice." ​"Fibric acid drugs will decrease​ triglycerides, but your low density lipoprotein​ (LDL) will still be​ high."

- the bile resins keep cholesterol from being absorbed but have some side effects -The statin drugs inhibit the making of cholesterol and are considered the best choice -Fibric acid drugs will decrease triglycerides, but your LDL will still be high

Which information about the dietary intake of lipids should the nurse provide a​ client? SAT ​"Phospholipids will help prevent​ Alzheimer's disease." ​"Phospholipids are essential to building plasma​ membranes." ​"Cholesterol is a building block for estrogen and​ testosterone." ​"Triglycerides are the major form of fat in the​ body." ​"Cholesterol in the diet is unnecessary as the liver synthesizes​ it."

-phospholipids are essential to building plasma membranes -cholesterol is a building block for estrogen and testosterone -triglycerides are the major form of fat in the body -cholesterol in the diet is unnecessary as the liver synthesizes it

Which assessment is a nursing priority for a client receiving cholestyramine​ (Questran)? Auscultation of heart sounds Assessment of​ 24-hour urine output Auscultation of bowel sounds in all four abdominal quadrants Palpation for peripheral edema in the lower extremities

Auscultation of bowel sounds in all four abdominal quadrants Assessent of bowel sounds is a priority because this medication could cause obstruction of the intestines.

A patient has been prescribed gemfibrozil​ (Lopid). Which laboratory tests should the nurse schedule for the client on the next clinic​ appointment? Blood glucose Liver enzymes Potassium Hemoglobin and hematocrit Urinalysis

Blood glucose Liver enzymes Hemoglobin and hematocrit

The educator is reviewing the classifications of prescriptions used to decrease blood cholesterol levels with a nurse. Which prescriptions should the educator include in the discussion of fibric acid​ agents? SAT Tricor Zetia. Lopid Colestid Zocor

Tricor Lopid

Which type of lipid serves as fuel for the body when energy is​ needed? Steroids Triglycerides Lecithins Phospholipids

Triglycerides Triglycerides are the major storage form of fat in the body and the only type of lipid that serves as an important energy source.

The patient is receiving cholestyramine​ (Questran) and complains of constipation. The physician orders bisacodyl​ (Dulcolax) tablets. When is the best time for the nurse to administer the bisacodyl​ (Dulcolax) tablets? One hour after administration of cholestyramine​ (Questran). The drugs can be administered together. Bisacodyl​ (Dulcolax) can be given any time but must be taken with food. Four hours after administration of cholestyramine​ (Questran).

Four hours after administration of cholestyramine (Questran)

The nurse has completed nutritional teaching for a client with a high low density lipoprotein​ (LDL) level. Which menu choice made by the client indicates an understanding of the​ teaching? Beef tenderloin with gravy and​ noodles, fruit salad with apples and​ grapefruit, slice of rye​ bread, and apple pie Grilled chicken with rice and​ broccoli, tossed salad with walnuts and sliced​ apples, slice of​ whole-wheat bread, and​ low-fat chocolate pudding Grilled chicken salad with strawberries and​ pecans, baked macaroni and​ cheese, and​ low-fat brownie ​Low-fat hamburger with​ whole-wheat bun, tossed salad with walnuts and olive​ oil, and​ raisin-oatmeal cookie

Grilled chicken with rice and brocolli, tossed salad with walnuts and sliced apples, slice of whole wet bread and low fat chocolate pudding

Which type of lipoprotein is often referred to as​ "the good​ type?" HDL LDL VLDL Triglycerides

HDL

The nurse is providing education about lipids for a client with hyperlipidemia. Which information should the nurse include in the education? High density lipoprotein​ (HDL) is called good cholesterol because it increases the oxygen content in the arteries and reduces the amount of plaque buildup. High density lipoprotein​ (HDL) is called good cholesterol because it removes cholesterol from the body and gets rid of it in the liver. High density lipoprotein​ (HDL) decreases low density lipoprotein​ (LDL) and prevents it from converting to very low density lipoprotein​ (VDRL), which is the worst kind of cholesterol in the body. High density lipoprotein​ (HDL) decreases the bad cholesterol​ (low density lipoprotein​ [LDL]), and promotes excretion of it through the kidneys.

High density lipoprotein is called good cholesterol because it removes cholesterol from the body and gets rid of it in the liver High density lipoprotein​ (HDL) assists in the transport of cholesterol away from body tissues and back to the liver in a process called reverse cholesterol transport.

Which is the priority action of the nurse when caring for a client receiving a statin with elevated creatine kinase​ (CK) levels? Administer the prescription and continue to assess for muscle pain. Hold the prescription and obtain another creatine kinase​ (CK) level in 6 hours. Administer the prescription and obtain another creatine kinase​ (CK) level in 6 hours. Hold the prescription and notify the healthcare provider.

Hold the prescription and notify the healthcare provider Elevated creatine kinase levels could indicate myopathy if this is suspected the prescription is held and the healthcare provider is notified

The nurse has completed the education for a client prescribed gemfibrozil​ (Lopid). Which statement made by the client indicates an understanding of the​ information? "My physician said it really​ doesn't matter how I take this​ medication." ​"I must take this medication with food or I can have​ heartburn.". ​"Taking this medication with yogurt will help it to absorb​ better." ​"I should take this medication on an empty stomach to help it absorb​ better."

I must take this medication with food or I can have heartburn Gemfibrozil should be administered with food to decrease gastrointestinal distress.

The nurse has provided education for a client prescribed fenofibrate​ (Lofibra). Which statement made by the client indicates an understanding of the​ information? "I will take my prescription with​ food." ​"I will report nausea and vomiting to my healthcare​ provider." ​"I will monitor myself for​ bruising." ​"I will expect to see a change in color of my​ stool."

I will expect to see a change in color of my stool Fenofibrate increases the risk of bleeding. A change in color of the stool should be reported. Fenofibrate should be taken with meals to avoid adverse gastrointestinal symptoms. Fenofibrate is a fibric acid drug with a risk of bruising and bleeding. Nausea and vomiting are adverse effects of fenofibrate and should be reported to the healthcare provider to avoid dehydration.

The nurse has provided client education regarding therapeutic lifestyle changes to help control cholesterol levels. Which statement made by the client indicates an understanding of the​ information?SAT I will maintain an optimal​ weight." ​"I will implement a medically supervised exercise​ plan." ​"I will increase saturated fat in my​ diet." ​"I will increase insoluble fiber in my​ diet." ​"I will eliminate tobacco​ use."

I will maintain an optimal​ weight." ​"I will implement a medically supervised exercise​ plan." I will eliminate tobacco​ use."

Which describes the mechanism of​ atorvastatin's (Lipitor) ability to lower blood cholesterol​ levels? Prevents dietary absorption within the GI tract. Increases excretion by activating enzymes within the hepatic system. Binds exogenous cholesterol and excreting it in the feces. Inhibits an enzyme that is essential for cholesterol synthesis.

Inhibits an enzyme that is essential for cholesterol synthesis This medication is a statin, statins inhibit an enzyme in the liver and we make less LDL because it's not metabolized/produced

Which anatomical location is Ezetimibe​ (Zetia) effective in blocking the absorption of​ cholesterol? Gallbladder Liver Stomach Jejunum

Jejunum

The nurse reviewing a​ client's serum cholesterol levels notes the​ following: Low density lipoprotein​ (LDL) = 105​ mg/dl High density lipoprotein​ (HDL) = 37​ mg/dl Low density lipoprotein​ (LDL)/high density lipoprotein​ (HDL) ratio​ = 4.1 Which should the nurse identify as the priority outcome in the​ client's plan of​ care? Validate that the client understands the importance of lifestyle changes. Maintenance of normal lipid levels without the use of pharmacotherapy. Education about diet and exercise. The​ client's achievement of normal lipid levels through compliance with medications.

Maintenance of normal lipid levels without the use of pharmacotherapy The client has borderline lab values. Clients with borderline lab values can control their dyslipidemia through nonpharmacological interventions.

Which assessment data obtained from a client receiving a statin is a priority for the nurse to report to the healthcare​ provider? ​"My calves​ hurt, and I had a hard time walking to the​ bathroom." ​"My heart rate really went up this​ morning." ​"I know I just started this medicine​ yesterday, but my stomach really is​ upset." ​"Will you call my healthcare​ provider? I have a really bad​ headache."

My calves hurt and I had a hard time walking to the bathroom The nurse must asses for complaints of muscle pain, tenderness, and weakness as this could indicate a type of myopathy known as rhabdomyolysis.

The nurse is preparing to provide education for a client prescribed a statin. Which adverse effects should the nurse include in the​ teaching?SAT Headache Abdominal pain Myopathy Muscle or joint pain Rhabdomyolysis

Myopathy Rhabdomyolysis Severe myopathy is a rare but serious adverse effect associated with statins. Rhabdomyolysis is an example of a rare but serious adverse effect associated with statins.​ Headache, abdominal​ pain, and muscle or joint pain are examples of minor adverse effects associated with statins.

Which statement is accurate regarding the use of nicotinic acid​ (Niacin) for lowering blood cholesterol​ levels? Due to adverse​ effects, niacin should not be used with statins. High doses of 25-30 mg per day are often necessary. Works primarily by lowering LDL and HDL levels. Niacin may also reduce triglyceride levels.

Niacin may also reduce triglyceride levels

The nurse is discussing with a​ client, the dietary intake of​ omega-3 and​ CoQ10-rich foods to control lipid levels. Which foods should the nurse include in the​ discussion?SAT Sardines Shrimp Almonds Olive oil Carrots

Sardines Almonds Olive oil

Which lipid type is associated with the highest risk for the development of​ atherosclerosis? Steroids Phospholipids Triglycerides Lecithins

Steroids

Which information should the nurse include in the education for a client prescribed niacin to lower lipid​ levels? "Take one aspirin 30 minutes before you take your​ niacin." ​"Be sure to take your niacin on an empty stomach as soon as you​ arise." ​"Take your niacin tablet with food and at least one full glass of​ water." ​"It may be time to ask your healthcare provider about switching to another​ drug."

Take one aspirin 30 minutes before you take your niacin

Which statement correctly identifies why restricting dietary intake of cholesterol generally will not result in a significant reduction of blood​ cholesterol? Cholesterol is found in nearly all​ foods, and it is not possible to eliminate it from the diet. Cholesterol is made within the body and cannot be absorbed via external sources. Most clients are not compliant with the dietary restriction. The liver reacts to a​ low-cholesterol diet by making more cholesterol.

The liver reacts to a low-cholesterol diet by making more cholesterol

The nurse reviewing records should determine that which​ client's lab values are associated with the highest risk of developing heart​ disease? Total​ 200, LDL​ 104, HDL 30 Total​ 186, LDL​ 125, HDL 54 Total​ 220, LDL​ 162, HDL 20 Total​ 210, LDL​ 135, HDL 58

Total 220, LDL 162, HDL 20

Which statement provides the best rationale for monitoring HDL and LDL as opposed to total​ cholesterol? Total cholesterol does not differentiate the amounts of​ "good" cholesterol and​ "bad" cholesterol. HDL and LDL measurements are more general and frequently used to assessed clients that are not at risk for heart disease. HDL and LDL monitoring is less expensive than measuring total cholesterol. Total cholesterol measurements are often inaccurate and not as reliable as HDL and LDL.

Total cholesterol does not differentiate the mounts of good and bad cholesterol

The educator is preparing education about the different types of lipids for a nurse. Which should the educator include in the​ presentation? SAT Triglycerides Phospholipids Steroids Lecithins. Bile acids

Triglycerides Phospholipids Steroids

Which assessment finding for a client receiving a statin is a priority for the nurse to report to the healthcare​ provider? Urine output of 20​ mL/hour. Bowel sounds markedly increased in all four quadrants of the abdomen. Urine output of 200​ mL/hour. Moderate elevation in liver function tests​ (LFTs).

Urine output of 20 mL/hour Urine output of less than 30mL/hr is considered renal failure. Renal failures occurs with rhabdomyolysis