Term
| High-density lipoprotein (HDL) |
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Definition
(“good”)
Removes cholesterol from blood
Transports cholesterol to liver for elimination |
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Term
| Low-density lipoprotein (LDL) |
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Definition
(“bad”)
Contains higher percent of cholesterol |
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Term
| Very low-density lipoprotein (VLDL) |
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Definition
| Contains mostly triglycerides, less cholesterol |
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Term
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Definition
Contain mostly triglycerides
Transport fatty acids and cholesterol to liver |
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Term
| Antihyperlipidemics in lamens terms |
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Definition
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Term
| Nonpharmacologic methods for cholesterol reduction |
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Definition
Reduce saturated fats in diet.
Reduce total fat intake to 30% or less of caloric intake.
Reduce cholesterol intake to 300 mg/day or less.
Exercise as possible.
Stop smoking. |
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Term
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Definition
Resin antilipidemics (bile-acid sequestrants)
Folic acid derivatives (fibrates)
Nicotinic acid
Cholesterol absorption inhibitor
Statins/vastatins
Combination anticholesterol drugs |
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Term
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Definition
inhibit cholesterol synthesis in the liver
decreases the concentration of cholesterol, decreases LDL, and slightly increases HDL cholesterol. |
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Term
| Statins/Vastatins Side effects and adverse effects |
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Definition
Side Effects: GI disturbances, headaches, muscle cramps, and tiredness
Adverse Effects: Liver impairment and Rhabdomyolysis (skeletal muscle disorder) |
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Term
| Statins/Vastatins Nursing interventions |
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Definition
Monitor liver enzymes.
Report unexplained muscle tenderness or weakness, fever, and malaise. |
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Term
| Peripheral Arterial Disease Etiology |
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Definition
Arteriosclerosis
Hyperlipidemia
Atherosclerosis |
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Term
| Peripheral Arterial Disease (PAD) Rx treatment |
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Definition
Treatment
Peripheral vasodilators to improve blood flow |
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Term
| Alpha-adrenergic antagonists |
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Definition
| Peripheral Vasodilator, Acts directly on vascular smooth muscle |
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Term
|
Definition
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Term
| Direct-acting peripheral vasodilators |
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Definition
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Term
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Definition
| Peripheral Vasodilators, inhibits aggregation of platelets and red blood cells and helps increase flow through peripheral vessels |
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Term
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Definition
| Peripheral Vasodilators, prevent thrombosis in the arteries by suppressing platelet aggregation |
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Term
| Selected antihypertensives |
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Definition
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Term
| The normal range for cholesterol is ___ to ___. |
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Definition
| The normal range for cholesterol is 150 to 200. |
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Term
| The normal range for LDLs is less than ___. |
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Definition
| The normal range for LDLs is less than 100. |
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Term
| The normal range for HDLs is ___ to ___. |
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Definition
| The normal range for HDLs is 45 to 60. |
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Term
A nurse who is giving a statin(Lipitor) realizes the importance of monitoring for which serious adverse reaction?
A. Pharyngitis
B. Rash/pruritus
C. Rhabdomyolysis
D. Agranulocytosis |
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Definition
| C Rationale: Serious adverse reactions of statins (Lipitor) include rhabdomyolysis, myalgia, photosensitivity, and cataracts. Less serious side effects include headache, rash, pruritus, constipation, diarrhea, sinusitis, and pharyngitis. |
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Term
A client’s serum lipids are cholesterol 197
mg/dl, low-density lipoprotein (LDL) 110 mg/dl, and
high-density lipoprotein (HDL) 35 mg/dl. The nurse
knows what about these values?
A. Serum lipids are within desirable values.
B. Cholesterol is within desirable value, but LDL and HDL are not.
C. Cholesterol is not within desirable value, though LDL and HDL are.
D. Cholesterol, LDL, and HDL are not within desirable values. |
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Definition
Answer: B
Rationale: The normal range for cholesterol is 150 to 200. The normal range for LDLs is less than 100. The normal range for HDLs is 45 to 60. |
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Term
| Drugs that lower blood lipids are called ____, ____, ____, and ____. |
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Definition
| Drugs that lower blood lipids are called antihyperlipidemics, antilipidemics, antilipemics, and hypolipidemics. |
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Term
| hyperlipidemia is defined as |
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Definition
| an excess of one or more lipids in the blood, also referred to as hyperlipoproteinemia |
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Term
True or False
Dietary changes need to be made and an exercise program followed even after drug therapy has been initiated. |
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Definition
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Term
True or False
Antihyperlipidemic drug therapy is a lifetime commitment for maintaining a decrease in serum lipid levels. |
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Definition
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Term
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Definition
peripheral arterial (vascular) disease
numbness and coolness of the extremities, intermittent claudication (pain and weakness of limb when walking but no symptoms at rest), and possible leg ulcers |
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Term
| Abruptly stopping statin drug therapy can lead to what? |
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Definition
| rebound effect might occur which could lead to an AMI and possible death. |
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Term
Which statement indicates the client understands discharge instructions regarding cholestyramine (Questran)?
A) a. “I will take Questran 1 hour before my other medications.”
B) b. “I will increase fiber in my diet.”
C) c. “I will weigh myself weekly.”
D) d. “I will have my blood pressure checked weekly.” |
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Definition
| B. Cholestyramine can cause constipation; thus, increasing fiber in the diet is appropriate. All other drugs should be taken 1 hour before or 4 hours after cholestyramine to facilitate proper absorption. |
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Term
The nurse plans which intervention to decrease the flushing reaction of niacin?
A) a. Administer niacin with an antacid.
B) b. Administer aspirin 30 minutes before nicotinic acid.
C) c. Administer diphenhydramine hydrochloride (Benadryl) with niacin.
D) d. Apply cold compresses to the head and neck. |
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Definition
| B. Administration of an antiinflammatory agent such as aspirin has been shown to decrease the flushing reaction associated with niacin. In addition, avoiding hot beverages, such as coffee, when taking niacin may also prevent flushing. |
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Term
The nurse is reviewing instructions for a client taking an HMG-CoA reductase inhibitor (statin). What information is essential for the nurse to include?
A) a. “Take this medication on an empty stomach.”
B) b. “Take this medication at the same time each day.”
C) c. “Take this medication with breakfast.”
D) d. “Take this medication with an antacid.” |
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Definition
| B. Because the liver produces the most cholesterol during the night, it was previously believed that statin drugs, which work to decrease this synthesis, should be given during the evening so that blood levels were highest coinciding with this production. However, with the prolonged duration of action of some statin drugs, administration does not have to be specifically in the evening, but it is important to take them at approximately the same time every day. |
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Term
A client is prescribed gemfibrozil (Lopid) for treatment of hyperlipidemia type IV. What is important for the nurse to teach the client?
A) a. “Take aspirin before the medication if you experience facial flushing.”
B) b. “You may experience headaches with this medication.”
C) c. “You will need to have weekly blood drawn to assess for hyperkalemia.”
D) d. “Cholesterol levels will need to be assessed daily for one week.” |
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Definition
| B. Side effects of gemfibrozil (Lopid) include headache, fatigue, dizziness, blurred vision, and insomnia. Flushing is a side effect of niacin. |
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Term
Which statement made by the client indicates understanding about discharge instructions on antihyperlipidemic medications?
A) a. “Antihyperlipidemic medications will replace the other interventions I have been doing to try to decrease my cholesterol.”
B) b. “It is important to double my dose if I miss one in order to maintain therapeutic blood levels.”
C) c. “I will stop taking the medication if it causes nausea and vomiting.”
D) d. “I will continue my exercise program to help increase my high-density lipoprotein serum levels.” |
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Definition
| D. Antihyperlipidemic medications are an addition to, not a replacement for, the therapeutic regimen used to decrease serum cholesterol levels. |
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Term
A client is prescribed ezetimibe (Zetia). Which assessment finding will require immediate action by the nurse?
A) a. Headache.
B) b. Slight nausea.
C) c. Muscle pain.
D) d. Fatigue. |
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Definition
| C. Clients who experience severe muscle pain while taking Ezetimibe (Zetia) need to report the findings right away, as this may be indicative of a serious problem. |
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Term
A nurse is caring for a client taking cholestyramine (Questran). The client is complaining of constipation. What will the nurse do?
A) a. Call the health care provider to change the medication.
B) b. Tell the client to skip a dose of the medication.
C) c. Have the client increase fluids and fiber in his diet.
D) d. Administer an enema to the client. |
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Definition
| C. Cholestyramine is an anion exchange resin that binds to bile to form an insoluble complex that is excreted. Constipation can occur and can be treated with conventional therapy, which includes increasing fluid and fiber in the diet. |
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Term
Which statement indicates to the nurse that the client needs further medication instruction about colestipol (Colestid)?
A) a. "The medication may cause constipation, so I will increase fluid and fiber in my diet."
B) b. "I should take this medication 1 hour after or 4 hours before my other medications."
C) c. "I might need to take fat-soluble vitamins to supplement my diet."
D) d. "I should stir the powder in as small an amount of fluid as possible to maintain potency of the medication." |
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Definition
| D. Colestipol (Colestid) is a powder that must be well diluted in fluids before administration to avoid esophageal irritation or obstruction and intestinal obstruction. The powder should not be stirred because it may clump; it should be left to dissolve slowly for a least 1 minute. |
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Term
Which assessment finding in a client taking an HMG-CoA reductase inhibitor (statin) will the nurse act on immediately?
A) a. Decreased hemoglobin
B) b. Elevated liver function tests
C) c. Elevated HDL
D) d. Elevated LDL |
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Definition
| B. HMG-CoA reductase inhibitors can cause hepatic toxicity; thus it is necessary to monitor liver function tests every 3 months for the first year of treatment. The nurse should act on this finding immediately. Decreased hemoglobin should be addressed, but not immediately. It is most likely not related to the administration of the HMG-CoA reductase inhibitor. |
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Term
A 70-year-old client who is taking several cardiac antidysrhythmic medications has been prescribed simvastatin (Zocor){a Antihyperlipidemics statin} 80 mg/day. What is essential information for the nurse to teach the client?
A) a. “This dose may lower your cholesterol too much.”
B) b. “These factors may put you at higher risk for myopathy.”
C) c. “You should not take this drug with cardiac medications.”
D) d. “This combination will cause you to have nausea and vomiting.” |
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Definition
| B. Reported risks for myopathy include an older age and a higher dose. The recommended dose is 40 mg. This client's dose is almost double that value, although still within the approved dosing range for the drug. |
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Term
A client diagnosed with hypercholesterolemia is prescribed lovastatin (Mevacor){a Antihyperlipidemics statin}. The nurse is reviewing the client's history and would contact the health care provider about which of these conditions in the client's history?
A) a. Chronic pulmonary disease
B) b. Hepatic disease
C) c. Leukemia
D) d. Renal disease |
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Definition
| B. Lovastatin (Mevacor) can cause an increase in liver enzymes and thus should not be used in clients with preexisting liver disease. |
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Term
A nurse is caring for a client with elevated triglyceride levels who is unresponsive to HMG-CoA reductase inhibitors (statin). What medication will the nurse administer?
A) a. cholestyramine (Questran)
B) b. colestipol (Colestid)
C) c. gemfibrozil (Lopid)
D) d. simvastatin (Zocor) |
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Definition
| C. Gemfibrozil (Lopid), a fibric acid derivative, promotes catabolism of triglyceride-rich lipoproteins. |
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Term
The nurse would question an order for cholestyramine (Questran) if the client has which condition?
A) a. Impaction
B) b. Glaucoma
C) c. Hepatic disease
D) d. Renal disease |
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Definition
| A. Cholestyramine (Questran) binds with bile in the intestinal tract to form an insoluble complex. It can also bind to other substances and lead to intestinal obstruction. |
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Term
The nurse reviews the history for a client taking atorvastatin (Lipitor) {a Antihyperlipidemics statin}. What will the nurse act on immediately?
A) a. Client takes medications with grape juice.
B) b. Client takes herbal therapy including kava kava.
C) c. Client is on oral contraceptives.
D) d. Client was started on penicillin for a respiratory infection. |
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Definition
| C. Atorvastatin (Lipitor) increases the estrogen levels of oral contraceptives. The client's oral contraceptive may need to be altered. |
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Term
| Peripheral vasodilators are drugs that dilate ____ that have been narrowed by ____. |
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Definition
| Peripheral vasodilators are drugs that dilate vessels that have been narrowed by vasospasm. |
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