Nokea
Antilipemic drug therapy is prescribed for a patient, and the nurse is providing instructions to the patient about the medication. Which instructions will the nurse include? (Select all that apply.)
- A. Limit fluid intake to prevent fluid overload.
- B. Eat extra servings of raw vegetables and fruit.
- C. Report abnormal or unusual bleeding or yellow discoloration of the skin.
- D. Report the occurrence of muscle pain immediately.
- E. Drug interactions are rare with antilipemics.
- F. Take the drug 1 hour before or 2 hours after meals to maximize absorption.
Correct Answer: B,C,D
Rationale: Instructions include eating raw vegetables and fruit to prevent constipation, reporting bleeding or jaundice (indicating liver issues), and reporting muscle pain (potential myopathy). Antilipemics have frequent drug interactions, and fluid intake should be encouraged, not limited. Taking with food may reduce GI distress, not before/after meals.
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The nurse will monitor for myopathy (muscle pain) when a patient is taking which class of antilipemic drugs?
- A. Niacin
- B. HMG-CoA reductase inhibitors
- C. Fibric acid derivatives
- D. Bile acid sequestrants
Correct Answer: B
Rationale: HMG-CoA reductase inhibitors (statins) can cause myopathy, including muscle pain, which may progress to rhabdomyolysis. Patients should report unexplained muscle pain immediately. Other classes do not commonly cause myopathy.
The nurse is conducting a class about antilipemic drugs. The antilipemic drug ezetimibe works by which mechanism?
- A. Inhibiting HMG-CoA reductase
- B. Preventing resorption of bile acids from the small intestines
- C. Activating lipins, which breaks down cholesterol
- D. Inhibiting cholesterol absorption in the small intestine
Correct Answer: D
Rationale: Ezetimibe selectively inhibits cholesterol absorption in the small intestine, reducing circulating cholesterol levels. It does not inhibit HMG-CoA reductase, prevent bile acid resorption, or activate lipins.
A patient who has recently started therapy on a statin drug asks the nurse how long it will take until he sees an effect on his serum cholesterol. Which statement would be the nurse's best response?
- A. Blood levels return to normal within a week of beginning therapy.
- B. It takes 6 to 8 weeks to see a change in cholesterol levels.
- C. It takes at least 6 months to see a change in cholesterol levels.
- D. You will need to take this medication for almost a year to see significant results.
Correct Answer: B
Rationale: Statins typically require 6 to 8 weeks to achieve maximum lipid-lowering effects. One week is too short, and 6 months or a year is unnecessarily long for initial effects.
The medication order reads, 'Give simvastatin 30 mg daily at bedtime, PO.' The medication is available in 20-mg tablets. Identify how many tablets the nurse will administer to the patient.
Correct Answer: 1.5
Rationale: To calculate: 20 mg/1 tablet = 30 mg/x tablets. Cross-multiply: (20 * x) = (1 * 30); 20x = 30; x = 30/20 = 1.5 tablets.
A patient is concerned about the adverse effects of the fibric acid derivative she is taking to lower her cholesterol level. Which is an adverse effect of this class of medication?
- A. Constipation
- B. Diarrhea
- C. Joint pain
- D. Dry mouth
Correct Answer: B
Rationale: Fibric acid derivatives, such as gemfibrozil, commonly cause gastrointestinal side effects like diarrhea. Constipation, joint pain, and dry mouth are not typical adverse effects of this class.