Week 9: Dyslipidemia (7 questions) Flashcards
High-density lipoprotein (HDL)
> 45
“good cholesterol”
cardioprotective
Low-density lipoprotein (LDL)
less than 130
“bad cholesterol”
hypercholesterolemia
HMG-CoA Reductase Inhibitors: (Statins)
Cant take statins if? 3
- Allergy
- Pregnancy (Category X)
- Liver disease or elevation of liver enzymes
HMG-CoA Reductase Inhibitors: (Statins)
Can elavate?
and?
can cause?
-Elevated liver enzymes
-Elevated creatinine phosphokinase CPK (more than 10x normal value)
-Myopathy (muscle pain)
*rhabdomyolysis (can lead to acute renal failure and even death)
Rhabdomyolysis
Instruct client to report what?
muscle soreness or coca cola urine
HMG-CoA Reductase Inhibitors (Statins)
Interactions? what to avoid when on statins?
Warfarin (increases bleeding)
Grapefruit juice
Gemfibrozil (increased risk for myopathy)
Atorvastatin
Dosed when?
With what?
can raise?
Dosed once daily
usually with the evening meal or at bedtime to correlate with cholesterol production in the body
Can modestly raise HDL
Simvastatin
Dosed when?
With what?
Can raise what?
New clients should not start with what dose?
Dosed once daily
usually with the evening meal or at bedtime to correlate with cholesterol production in the body
Can modestly raise HDL
New clients should NOT start with an 80 mg dose
HMG-CoA Reductase Inhibitors: (Statins)
Nursing Considerations
monitor what enzymes?
monitor for cuse of what injury?
abdominal pain where?
Monitor liver enzymes prior to starting therapy
Monitor clients for cues of liver injury (jaundice, dark urine)
If client develops unexplained muscle tenderness or pain, esp. w/ other cues such as fatigue, anorexia,
**RUQ ABDOMINAL PAIN, “coca cola” urine, or jaundice
notify provider immediately
Bile Acid Sequestrants
What do they do?
what line of treatment?
Contraindications (dont give if?)
Lower LDL by preventing reuse of bile acids
2nd line of treatment after statins
Biliary or bowel obstruction
Phenylketonuria (PKU)
Bile Acid Sequestrants
Adverse Effects
- Belching
- Bloating
- Constipation
- Nausea
Bile Acid Sequestrants:
Considerations (toxicity & interactions)
treatment of overdose?
encourage what?
quick addition can do what?
Tx of overdose includes restoring gut motility
Encourage fiber rich foods (whole grains, leafy vegetables, and fresh fruits)
Quick addition of fiber can result in gas, bloating and cramps; introduce gradually
Cholestyramine
How are other meds administered?
What to do when administering dry powder?
***Administer other medications 1 hour before or 4-6 hours AFTER the administration of this medication
***Caution when administering dry powder- choking hazard; must be diluted in 4-6oz. of water, milk, fruit juice, or other non carbonated beverages.
Colesevelam
How to administer?
how are other meds administered?
***Administer other medications 1 hour before or 4-6 hours after the administration of this medication
Add 8oz of water or fruit juice to avoid esophageal distress
Niacin (B3 supplement)
Effective in?
Increases?
Can cause?**
advise clients to?**
Effective in lowering triglyceride, total serum cholesterol, and LDL levels
Increases HDL levels
***Can cause flushing of the face and neck;
***advise clients to take aspirin or a NSAID 30 minutes before niacin
