Podcast
Questions and Answers
A patient's lab results show a cholesterol level of 210 mg/dL, LDL of 110 mg/dL, and HDL of 40 mg/dL. Based on this information, which of the following statements is most accurate?
A patient's lab results show a cholesterol level of 210 mg/dL, LDL of 110 mg/dL, and HDL of 40 mg/dL. Based on this information, which of the following statements is most accurate?
- The patient's LDL level is optimal, but cholesterol and HDL are abnormal.
- The patient's cholesterol level is elevated, LDL is borderline high, and HDL is low. (correct)
- The patient's cholesterol and LDL levels are within normal range, but HDL is low.
- All three values (cholesterol, LDL, and HDL) are within the normal range.
A patient taking atorvastatin (Lipitor) reports muscle pain and weakness. Which of the following actions is the most important for the nurse to take?
A patient taking atorvastatin (Lipitor) reports muscle pain and weakness. Which of the following actions is the most important for the nurse to take?
- Instruct the patient to stop taking atorvastatin immediately and schedule an appointment with the provider.
- Reassure the patient that muscle pain is a common, benign side effect of statins.
- Assess the patient's urine for changes in color and notify the provider, as this could indicate rhabdomyolysis. (correct)
- Advise the patient to take an over-the-counter pain reliever, such as acetaminophen, and monitor if the pain is alleviated.
A patient with peripheral vascular disease is prescribed cilostazol. The nurse understands that this medication works by which mechanism?
A patient with peripheral vascular disease is prescribed cilostazol. The nurse understands that this medication works by which mechanism?
- Blocking calcium channels in vascular smooth muscle, causing vasodilation.
- Inhibiting platelet aggregation and promoting vasodilation. (correct)
- Directly relaxing the smooth muscle of peripheral blood vessels.
- Blocking alpha-adrenergic receptors, leading to vasodilation.
A patient with intermittent claudication is interested in using herbal remedies. Which of the following statements should the nurse include when educating the patient about Ginkgo biloba?
A patient with intermittent claudication is interested in using herbal remedies. Which of the following statements should the nurse include when educating the patient about Ginkgo biloba?
A patient is prescribed both nifedipine and atorvastatin. What is the primary reason a nurse should monitor this patient's blood pressure more frequently?
A patient is prescribed both nifedipine and atorvastatin. What is the primary reason a nurse should monitor this patient's blood pressure more frequently?
A client taking antihyperlipidemic medication reports unexplained muscle tenderness and weakness. Which action should the nurse take first?
A client taking antihyperlipidemic medication reports unexplained muscle tenderness and weakness. Which action should the nurse take first?
A client is prescribed cilostazol for intermittent claudication. The nurse understands that this medication improves blood flow through which mechanism?
A client is prescribed cilostazol for intermittent claudication. The nurse understands that this medication improves blood flow through which mechanism?
The nurse is teaching a client about managing peripheral vascular disease. Which lifestyle modification is most important for the client to implement?
The nurse is teaching a client about managing peripheral vascular disease. Which lifestyle modification is most important for the client to implement?
A client with peripheral vascular disease is prescribed cilostazol. Which pre-existing condition should the nurse report to the provider before administering the first dose?
A client with peripheral vascular disease is prescribed cilostazol. Which pre-existing condition should the nurse report to the provider before administering the first dose?
The nurse is providing discharge instructions to a client prescribed an antihyperlipidemic medication. What should the nurse emphasize regarding the expected time frame for therapeutic effects?
The nurse is providing discharge instructions to a client prescribed an antihyperlipidemic medication. What should the nurse emphasize regarding the expected time frame for therapeutic effects?
A client taking cilostazol reports frequent headaches. What is the most appropriate nursing intervention?
A client taking cilostazol reports frequent headaches. What is the most appropriate nursing intervention?
A client with peripheral vascular disease is started on cilostazol. Which assessment finding would indicate a therapeutic effect of the medication?
A client with peripheral vascular disease is started on cilostazol. Which assessment finding would indicate a therapeutic effect of the medication?
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. What should the nurse conclude about these values?
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. What should the nurse conclude about these values?
A patient's lipid panel shows an elevated LDL level. Which dietary modification is most important for the patient to implement based on this result?
A patient's lipid panel shows an elevated LDL level. Which dietary modification is most important for the patient to implement based on this result?
A patient taking a statin medication reports muscle pain and weakness. Which action should the nurse take first?
A patient taking a statin medication reports muscle pain and weakness. Which action should the nurse take first?
A patient with a history of heavy alcohol use is prescribed a statin. What is the primary concern the nurse should have regarding this patient's medication regimen?
A patient with a history of heavy alcohol use is prescribed a statin. What is the primary concern the nurse should have regarding this patient's medication regimen?
A patient is prescribed a bile-acid sequestrant along with other medications. What is the most important instruction the nurse should provide to the patient?
A patient is prescribed a bile-acid sequestrant along with other medications. What is the most important instruction the nurse should provide to the patient?
A patient taking a statin reports experiencing persistent heartburn. Which medication taken concurrently would be of most concern with the statin?
A patient taking a statin reports experiencing persistent heartburn. Which medication taken concurrently would be of most concern with the statin?
A patient is started on nicotinic acid (niacin) for hyperlipidemia. The patient complains of facial flushing after taking the medication. Which intervention is most appropriate?
A patient is started on nicotinic acid (niacin) for hyperlipidemia. The patient complains of facial flushing after taking the medication. Which intervention is most appropriate?
Which of the following statements best describes the function of High-Density Lipoproteins (HDLs) in the body?
Which of the following statements best describes the function of High-Density Lipoproteins (HDLs) in the body?
A patient with hyperlipidemia is prescribed a new medication. Which of the following assessment findings would be most concerning and warrant immediate notification of the healthcare provider?
A patient with hyperlipidemia is prescribed a new medication. Which of the following assessment findings would be most concerning and warrant immediate notification of the healthcare provider?
Flashcards
HDL (High-Density Lipoprotein)
HDL (High-Density Lipoprotein)
Removes cholesterol from blood, transporting it to the liver for elimination.
LDL (Low-Density Lipoprotein)
LDL (Low-Density Lipoprotein)
Contains a higher percentage of cholesterol; too much leads to plaque formation
Nonpharmacologic Cholesterol Reduction
Nonpharmacologic Cholesterol Reduction
Lifestyle changes like diet and exercise to lower cholesterol without medication.
Antihyperlipidemics
Antihyperlipidemics
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Statins (HMG-CoA Reductase Inhibitors)
Statins (HMG-CoA Reductase Inhibitors)
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Statins and Liver Function
Statins and Liver Function
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Rhabdomyolysis
Rhabdomyolysis
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Nursing Interventions: Statins
Nursing Interventions: Statins
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Cilostazol
Cilostazol
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Intermittent Claudication
Intermittent Claudication
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Ginkgo Biloba
Ginkgo Biloba
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Less than 100
Less than 100
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Arteriosclerosis
Arteriosclerosis
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Hyperlipidemia
Hyperlipidemia
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PVD Signs/Symptoms
PVD Signs/Symptoms
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Claudication
Claudication
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Peripheral Vasodilators
Peripheral Vasodilators
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Cilostazol Actions
Cilostazol Actions
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Cilostazol Contraindications
Cilostazol Contraindications
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Study Notes
Lipoproteins
- Lipoproteins are reviewed in the text.
- The major categories of lipoproteins include:
- High-density lipoprotein (HDL), which is considered "healthy" and removes cholesterol from the blood, transporting it to the liver for elimination
- Low-density lipoprotein (LDL), considered "lethal," contains a higher percentage of cholesterol
- Very low-density lipoprotein (VLDL) which contains mostly triglycerides, less cholesterol
- Chylomicrons, which contain mostly triglycerides and transport fatty acids and cholesterol to the liver
Nonpharmacologic Methods for Cholesterol Reduction
- Nonpharmacologic methods for cholesterol reduction include:
- Reducing saturated fats and cholesterol in the diet
- Reducing total fat intake to 30% or less of caloric intake
- Reducing cholesterol intake to 300 mg/day or less
- Exercising
- Stopping smoking
Types of Antilipidemics
- Types of antilipidemics include:
- Hepatic 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins)
- Bile-acid sequestrants
- Fibrates (fibric acid)
- Nicotinic acid
- Cholesterol absorption inhibitor
HMG CoA Reductase Inhibitors (Statins)
- Statins are used for hyperlipidemia (high cholesterol).
- Statins inhibit the enzyme HMG CoA reductase in cholesterol biosynthesis.
- Statins decrease LDLs and increase HDLs.
- Abrupt discontinuation of statins may lead to a rebound effect.
- Side effects and adverse effects of statins are rare, but can include GI issues, headache, photosensitivity, cataracts, liver impairment, hyperglycemia, and rhabdomyolysis (skeletal muscle disorder).
- Contraindications for statins include active liver disease and pregnancy
- Caution should be used in patients with a history of liver disease or alcohol use
- Statins can interact with antacids.
Nursing Process: Statins
- Assess vital signs and baseline serum cholesterol levels
- Check liver function and obtain a medical/medication history
- Perform a pregnancy test.
- Monitor blood lipid levels and liver function
- Observe for signs and symptoms of GI upset.
- Report unexplained muscle tenderness, weakness, fever, and malaise
- Inform the client that it may take several weeks or months before blood lipid levels decline
- Emphasize compliance.
- Take at bedtime.
- Maintain a low-fat/low-cholesterol diet.
- Instruct the client to have annual eye examinations and report changes in visual acuity
- Do not stop abruptly.
Peripheral Vascular Disease
- Peripheral vascular disease can be caused by arteriosclerosis or hyperlipidemia.
- Signs and symptoms include numbness, coolness, pain in extremities, claudication, and leg ulcers
- Treatment involves peripheral vasodilators like cilostazol, which increase blood flow
Cilostazol
- Cilostazol improves peripheral blood flow.
- Cilostazol causes peripheral vasodilation and weakly inhibits platelet aggregation.
- Cilostazol is used for intermittent claudication and other peripheral vascular diseases
- Side effects/adverse reactions include dizziness, headache, GI distress, peripheral edema, tachycardia, palpitations, possible bleeding, and orthostatic hypotension
- Contraindications include severe heart failure and bleeding disorders.
- Use caution in patients with liver and renal disease.
- Cilostazol can interact with other drugs that cause vasodilation or bleeding, as well as grapefruit juice
Nursing Process: Cilostazol
- Obtain baseline vital signs for future comparison.
- Assess for signs of inadequate blood flow to extremities
- Evaluate medication/medical history
- Monitor vital signs, especially blood pressure and heart rate
- Inform client that a desired therapeutic response may take 1.5 to 3 months
- Advise client not to smoke or ingest alcohol
- Encourage client to change position slowly but frequently to avoid orthostatic hypotension
- Take with food, avoid grapefruit juice
Practice Question 1
- A client’s serum lipids are cholesterol 197 mg/dL, LDL 110 mg/dL, and HDL 35 mg/dL.
- Cholesterol is within desirable value, but LDL and HDL are not.
- The normal range for cholesterol is 150 to 200.
- The normal range for LDL is less than 100.
- The normal range for HDL is 45 to 60.
Practice Question 2
- A nurse is administering atorvastatin calcium
- Monitoring for rhabdomyolysis is important as a serious adverse reaction
- Serious adverse reactions of atorvastatin include rhabdomyolysis, myalgia, photosensitivity, and cataracts.
- Less serious side effects include headache, rash, pruritus, constipation, diarrhea, sinusitis, and pharyngitis.
Practice Question 3
- A client is receiving medication therapy for peripheral vascular disease
- Cilostazol is an antiplatelet drug.
- Papaverine is a direct-acting peripheral vasodilator.
- Prazosin is an alpha blocker
- Nifedipine is a calcium channel blocker.
Practice Question 4
- Ginkgo biloba is associated with the treatment of intermittent claudication
- It is used with an antiplatelet drug to treat intermittent claudication due to its vasodilating and antioxidant effects.
- It is not been approved by the FDA.
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Description
A review of lipoproteins (HDL, LDL, VLDL, and chylomicrons) and nonpharmacologic methods for cholesterol reduction, including dietary changes, exercise, and smoking cessation. Overview of antilipidemic medications.
