Nokea
A client with hyperlipidemia is prescribed ezetimibe. Which of the following assessments should the nurse perform during treatment?
- A. Taking a dietary history of the client
- B. Inspecting skin and eyelids for evidence of xanthomas
- C. Obtaining reports of fasting blood sugar levels
- D. Frequently monitoring blood cholesterol
Correct Answer: D
Rationale: The nurse should frequently monitor blood cholesterol as part of the ongoing assessment for a client receiving ezetimibe. Taking a dietary history of the client and inspecting the skin and eyelids for evidence of xanthomas are the preadministration assessments that a nurse should perform for a client receiving ezetimibe. The nurse obtains the reports of fasting blood sugar for a client with diabetes.
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A client is prescribed a bile acid resin and has been taking this therapy long term. The primary health care provider has prescribed vitamins A and D in waterHIV/AIDS water-soluble form. Which nursing diagnosis would be most likely?
- A. Risk for Impaired Skin Integrity
- B. Constipation
- C. Risk for Injury
- D. Risk for Imbalanced Nutrition: Less Than Body Requirements
Correct Answer: D
Rationale: Bile acid resins may interfere with the digestion of fats and prevent the absorption of the fat-soluble vitamins (vitamins A, D, E, and K) and folic acid. Therefore, the nursing diagnosis of Risk for Imbalanced Nutrition: Less Than Body Requirements would be most appropriate. Adverse reactions associated with nicotinic acid such as flushing would suggest a risk for impaired skin integrity. Constipation would be associated with statin therapy. Risk for injury may be appropriate for clients taking fibrates or statins.
A nurse is caring for a client taking a cholestyramine drug. What instructions should the nurse give to this client to prevent constipation?
- A. Eat foods high in dietary fiber
- B. Follow a complete liquid diet
- C. Be sure to stay on complete bed rest
- D. Take the water-soluble form of vitamin A
Correct Answer: A
Rationale: The nurse should instruct the client taking a cholestyramine drug to eat foods high in dietary fiber to prevent constipation. The nurse need not instruct the client to have a complete liquid diet or complete bed rest, instead, the nurse should instruct the client to exercise to prevent constipation. Clients are asked to take a water-soluble form of vitamin A if they are experiencing impaired digestion of fats and absorption of the fat-soluble vitamins due to long-term therapy of bile acid sequestrants.
The nurse is preparing a client for discharge. The client is prescribed antihyperlipidemic drug therapy. The nurse would include which of the following in the discharge teaching?
- A. Reason for taking the prescribed drug
- B. Drug name
- C. Correct dose
- D. Frequency of administration
- E. Dosage form
Correct Answer: A,B,C,D,E
Rationale: The nurse should review the reasons for the drug and prescribed therapy, including drug name, form and method of preparation, correct dose, and frequency of administration, as part of a client's discharge counseling.
A client is starting cholestyramine therapy for the treatment of hyperlipidemia. When teaching the client about possible adverse reactions, which of the following would the nurse include?
- A. Diarrhea
- B. Malabsorption of vitamin K
- C. Aggravation of hemorrhoids
- D. Flatulence
- E. Myopathy
Correct Answer: B,C,D
Rationale: Adverse reactions reported with the use of bile acid resins, such as cholestyramine, include constipation (that can become severe), aggravation of hemorrhoids, abdominal cramps, flatulence, nausea, increased bleeding related to vitamin K malabsorption, and vitamin A and D deficiencies.
A client with hyperlipidemia has been prescribed niacin by a physician. Which of the following adverse reactions should the nurse monitor for in the client?
- A. Tingling
- B. Constipation
- C. Diarrhea
- D. Cholelithiasis
Correct Answer: A
Rationale: The nurse should monitor for tingling in the client as an adverse reaction to the drug niacin. Constipation, diarrhea, and cholelithiasis are adverse reactions to the drug fenofibrate.