Pharm. Fall 2010 Chap 45

Front 1

“Friendly” lipoproteins are the _____.

Back 1

HDL

Front 2

The “bad” lipoproteins include _______, _____, and ______.

Back 2

Chylomicrons, LDL, and VLDL

Front 3

Clients should fast for ________ hours before a lipid profile.

Back 3

12 – 14

Front 4

Nonpharmacologic method for cholesterol reduction is that the total fat intake should be ____% and the cholesterol intake should be _____ mg or less.

Back 4

30;
300

Front 5

The most common discomfort (side effect) of many antilipidemics is ________.

Back 5

Gastrointestinal discomfort

Front 6

An antilipidemic medication may take several (days, weeks) to decrease the blood lipid levels.
Choose the correct answer.

Back 6

weeks

Front 7

The desired cholesterol level is _______.

Back 7

Less than 200 mg/ dl

Front 8

Some clients report a decreased libido with the drug _______.

Back 8

Clofibrate

Front 9

Peripheral vasodilators are more effective in disorders resulting from vasospasms than _______.

Back 9

Vessel occlusion

Front 10

The hemorrheologic group such as pentoxifylline (Trental) increases _______ blood flow

Back 10

Microcirculation

Front 11

Which drug group does the drug belong to?

Colestipol hydrochloride

Back 11

Fibrants

Front 12

Which drug group does the drug belong to?

Gemfibrozil (Lopid)

Back 12

Fibrants

Front 13

Which drug group does the drug belong to?

Atorvastatin (Lipitor)

Back 13

Statins

Front 14

Which drug group does the drug belong to?

Simvastatin (Zocor)

Back 14

Statins

Front 15

Which drug group does the drug belong to?

Cholestyramine resin (Questran)

Back 15

Bile-acid sequestrant

Front 16

Which drug group does the drug belong to?

Ezetimibe (Zetia)

Back 16

Antihyperlipidemic

Front 17

Give the rationale for the nursing interventions related to antilipidemics

Monitor the client’s blood lipid levels

Back 17

Serum lipid levels (cholesterol, LDL, HDL, and triglycerides) need to be closely monitored, every 3 to 6 months, to determine if drug dose is adequate or needs to be increased or decreased

Front 18

Give the rationale for the nursing interventions related to antilipidemics

Monitor laboratory tests for liver function

Back 18

The ALT, ALP, and GGT values should be checked every 6 months. If liver disorder is present, drug dose should be decreased. Antilipidemics are metabolized by the liver.

Front 19

Give the rationale for the nursing interventions related to antilipidemics

Advise the client to take the antilipidemic with sufficient water or with meals

Back 19

Antilipidemics can cause GI discomofort. Taking antilipidemics with sufficient water and at mealtime decreases the possibility of GI distress

Front 20

Give the rationale for the nursing interventions related to antilipidemics

Instruct the client to have an annual eye examination

Back 20

Cataracts have been reported when taking some of the antilipidemics. Annual eye test is advised.

Front 21

Give the rationale for the nursing interventions related to antilipidemics

Instruct the client to maintain a low-fat diet

Back 21

Antilipidemics are not a substitute for diet and decreasing the blood lipid levels. Low-fat diet is suggested

Front 22

Give the rationale for the nursing interventions related to antilipidemics

Inform the client that it may take several weeks for the blood lipid levels to decline.

Back 22

When first taking antilipidemics, it takes several weeks before the blood lipid levels decline.

Front 23

Elevated apolipoproteins can be an indicator of LDL and coronary heart disease (CHD). Which Apo is an indicator of low-density lipoprotein that could lead to CHD?

Back 23

Apo B

Front 24

A severe side effect of a “statin” drug is:

Back 24

Rhabdomyolysis

Front 25

Homocysteine is a protein in the blood that has been linked to cardiovascular disease and stroke. It may also promote:

Back 25

Blood clotting

Front 26

An herb that has been taken for intermittent claudication, though it has not been approved by the FDA, is:

Back 26

Ginkgo biloba

Front 27

What is the desired level for Cholesterol:

Back 27

Less than 200 mg/ dl

Front 28

What is the desired level for Low-density lipoprotein (LDL):

Back 28

Less than 130 mg/ dl

Front 29

What is the desired level for High-density lipoprotein (HDL):

Back 29

Greater than 45 mg/ dl (prefer: greater than 60 mg/ dl)

Front 30

Situation: A.B.’s lipid levels are as follows: cholesterol, 258 mg/ dl; LDL, 160 mg/ dl; HDL, 38 mg/ dl. A.B.’s diet consisted of less than 30% total daily fat intake and less than 300 mg of daily cholesterol intake. After 2 months A.B.’s lipid levels were the following: cholesterol, 246 mg/ dl; LDL, 150 mg/ dl; HDL, 42 mg/ dl.

Why did A.B.’s serum lipids not drop after 2 months of a low-fat and low-cholesterol diet?

Back 30

Diet modification will usually lower cholesterol levels by only 10% to 30%.

Front 31

Situation: A.B.’s lipid levels are as follows: cholesterol, 258 mg/ dl; LDL, 160 mg/ dl; HDL, 38 mg/ dl. A.B.’s diet consisted of less than 30% total daily fat intake and less than 300 mg of daily cholesterol intake. After 2 months A.B.’s lipid levels were the following: cholesterol, 246 mg/ dl; LDL, 150 mg/ dl; HDL, 42 mg/ dl.

A.B. was prescribed simvastatin (Zocor) 10 mg, daily, to take in the evening.

A.B. asked if she could eat whatever she wanted because of the Zocor. Your response could be:

Back 31

“You should maintain a low-fat and low-cholesterol diet and exercise.”

Front 32

Vasodilan is also prescribed for treatment of all of the following conditions EXCEPT:
a. Transient ischemic attach
b. Raynaud’s disease
c. Buerger’s disease
d. Paget’s disease

Back 32

d. Paget’s disease

Front 33

The usual dose of Vasodilan is:

Back 33

10- 20 mg t.i.d.

Front 34

Situation: E.B. is 54 years old and is taking isoxsuprine hydrochloride (Vasodilan) for peripheral vascular disease.

List four points you would include in E.B.’s health teaching plan:

Back 34

Take medications with meals; avoid alcohol, smoking, and aspirin; explain possible side effects of drug, such as flushing, headache, and dizziness

Front 35

Assessment of adequate blood flow to the extremities includes the following: Select all that apply.
a. Pallor
b. Coolness of extremities
c. Pain
d. Heat
e. Movement of all extremities

Back 35

a. Pallor
c. Pain
d. Heat

Front 36

Antilipidemics other than the “statins” are prescribed for reducing cholesterol and LDL levels, which include: Select all that apply
a. Bile-acid sequestrants
b. Alpha-adrenergic antagonists
c. Direct thrombin inhibitors
d. Nicotinic acid
e. Antiphatelets
f. Cholesterol absorption inhibitors

Back 36

a. Bile-acid sequestrants
c. Direct thrombin inhibitors
f. Cholesterol absorption inhibitors

Front 37

Rosuvastatin (Crestor) is a: Select all that apply
a. HMG-CoA reductase inhibitor
b. Cholesterol absorption inhibitor
c. Statin drug
d. Combination of two antilipidemics
e. Bile-acid sequestrant

Back 37

a. HMG-CoA reductase inhibitor
c. Statin drug

Front 38

The client is receiving Crestor 5 mg, PO, daily. Available: Crestor 10 mg and 20 mg tablets

Which bottle would you select?

Back 38

10 mg bottle

Front 39

The client is receiving Crestor 5 mg, PO, daily. Available: Crestor 10 mg and 20 mg tablets

How many tablets would you give?

Back 39

½ tablet

Front 40

R.T.’s cholesterol level is 267 mg/ dl. Her LDL level is 146 mg/ dl and her HDL level is 44 mg/ dl. She is 36 years old and weighs 210 pounds. R.T. was initially prescribed atorvastatin (Lipitor) 10 mg daily, and later it was increased to 20 mg daily.

R.T. wants to know what the desired cholesterol level is.

How would you respond to her question?

Back 40

Desired cholesterol level is less than 200 mg/ dl. Because R.T.’s level is greater than 200 mg/ dl, she has been prescribed atorvastatin (Lipitor).

Front 41

R.T.’s cholesterol level is 267 mg/ dl. Her LDL level is 146 mg/ dl and her HDL level is 44 mg/ dl. She is 36 years old and weighs 210 pounds. R.T. was initially prescribed atorvastatin (Lipitor) 10 mg daily, and later it was increased to 20 mg daily.

What is atorvastatin? For what reason(s) would R.T. receive this drug? Is the drug dose within normal range?

Back 41

Atorvastatin is an antilipidemic drug that inhibits the synthesis of cholesterol. This drug will lower R.T.s LDL and increase her HDL. R.T.’s drug does is within therapeutic range.

Front 42

R.T.’s cholesterol level is 267 mg/ dl. Her LDL level is 146 mg/ dl and her HDL level is 44 mg/ dl. She is 36 years old and weighs 210 pounds. R.T. was initially prescribed atorvastatin (Lipitor) 10 mg daily, and later it was increased to 20 mg daily.

What information do you need to know from R.T. concerning taking atorvastatin and pregnancy?

Back 42

R.T. should know that the pregnancy category for atorvastatin is “X.” Therefore she should not take the drug if she is contemplating pregnancy or is already pregnant.

Front 43

What is the protein-binding power of atorvastatin? What effect is likely to occur when taking a highly protein-binding drug such as warfarin with atorvastatin?

Back 43

Atorvastatin is a highly protein-bound drug at 98%. Two highly protein-bound drugs, such as warfarin and atorvastatin, will compete for protein-binding sites. With insufficient protein sites, one of the highly protein-bound drugs will be a free circulating drug and could cause side effects.

Front 44

R.T.’s cholesterol level is 267 mg/ dl. Her LDL level is 146 mg/ dl and her HDL level is 44 mg/ dl. She is 36 years old and weighs 210 pounds. R.T. was initially prescribed atorvastatin (Lipitor) 10 mg daily, and later it was increased to 20 mg daily.

R.T. wants to know when she should take atorvastatin. How would you respond?

Back 44

Atorvastatin is taken once per day. Many individuals take it in the evening

Front 45

R.T.’s cholesterol level is 267 mg/ dl. Her LDL level is 146 mg/ dl and her HDL level is 44 mg/ dl. She is 36 years old and weighs 210 pounds. R.T. was initially prescribed atorvastatin (Lipitor) 10 mg daily, and later it was increased to 20 mg daily.

What laboratory tests should be monitored while R.T. is taking atorvastatin?

Back 45

The serum liver enzymes should be checked periodically. If liver impairment is present, it can cause an increase in liver enzymes and could cause an increase in liver dysfunction.

Front 46

R.T.’s cholesterol level is 267 mg/ dl. Her LDL level is 146 mg/ dl and her HDL level is 44 mg/ dl. She is 36 years old and weighs 210 pounds. R.T. was initially prescribed atorvastatin (Lipitor) 10 mg daily, and later it was increased to 20 mg daily.

What client teaching is essential for R.T.’s drug therapy?

Back 46

Client teaching for R.T.: lose weight; eat foods low in cholesterol and fat (check food labels); have liver enzymes checked periodically; keep medical appointments; etc.