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Question 1

if the creatine kinase level becomes elevated during statin​ therapy, what should happen?

Answer 1

the drug should be immediately discontinued.

Question 2

What is the drug that’s mechanism of action interferes with HMG-CoA reductase, the critical enzyme in the biosynthesis of cholesterol.

Answer 2

Statins

Question 3

What is the drug that’s mechanism of action decreases both VLDL and LDL levels

Answer 3

Niacin.

Question 4

What is the drugs that’s mechanism of action blocks the absorption of cholesterol from the small intestine

Answer 4

Ezetimibe

Question 5

What is the drug that’s mechanism of action binds bile acids, thus increasing the excretion of cholesterol in the stool

Answer 5

Bile acid sequestrants

Question 6

Rare but serious adverse effects of statins

Answer 6

Severe myopathy and rhabdomyolisis

Question 7

Patients taking statins could benefit from enhancing their diet with foods rich in CoQ10- like pork- why?

Answer 7

Statins reduce coQ10 synthesis

Question 8

Lipid lowering drugs can deplete or diminish the absorption of what?

Answer 8

Fat soluble vitamins and folic acid

Question 9

Gemfibrozil is contraindicated in patients with what

Answer 9

Chronic kidney disease

Question 10

What drug is the only drug in a class called cholesterol absorption inhibitors and can block absorption of cholesterol which can cause the body to respond by creating more cholesterol?

Answer 10

Ezetimibe (Zetia)

Question 11

Gemfibrozil (fibric acid derivative) is indicated for the treatment of what conditions

Answer 11

Hyper triglycerides and hypercholesterolemia
(It lowers VLDL with an increase in HDL)

NOT effective for lowering LDL

Question 12

A patient has a triglyceride level of 450 mg/dL. Which drug should the nurse anticipate being prescribed for this patient

Answer 12

Fibric acid

Question 13

Cholestyramine (Questran) can bind to other drugs. When should it be taken with a patient who also takes digoxin

Answer 13

2hours before or 4 hours after

Question 14

If statins are having minimal impact and aren’t tolerated well by the patient, what drug would be the next choice

Answer 14

Gemfibrozil (lopid)

Question 15

A patient is prescribed Gemfibrozil (Lopid). For which reason should the nurse expect the medication to be discontinued for this patient

Answer 15

Elevated low density lipoproteins (LDL)

Question 16

Cholestyramine is contraindicated for what

Answer 16

Biliary obstruction

Question 17

Triglycerides should be less than what number to be in normal range

Answer 17

Less than 150

Question 18

What is the drug Atorvastatin (Lipitor)

Answer 18

Statin.
Side effects- myalgia, arthralagia, rhabdomyolisis (leads to renal failure!) elevated hepatic enzymes.

Question 19

What do B-complex Vitam B do for lipid disorders and name the drug given

Answer 19

Decreases the VLDL into LDL, reduced triglycerides.
Niacin is what’s given
Side effects- flushing, nausea, diarrhea, hepatotoxicity, gout

Question 20

What do Fibric Acid Drugs do for lipid disorders

Answer 20

Activate the enzyme lipoprotein lipase, lower LDL, triglycerides and most effective lipid drug to increase HDL

Fenofibrate (Lofibra)
-administered with meals to decrease GI upset

Question 21

What do the kidney excrete that helps regulate bp

Answer 21

Renin enzyme

Question 22

What do kidneys excrete that stimulates red blood cell production

Answer 22

Erythropoietin hormone

Question 23

If a drug is bound to plasma proteins will it pass through the glomerulus and enter the filtrate or continue circulating in the blood.

Answer 23

Continue circulating. It’s too big

Question 24

Diuretic drugs and therapy for kidney failure

Answer 24

Diuretics: Loop/ thiazide/ potassium sparing.
Used for: HTN, AKI & CKD, heart failure, pulmonary edema.

Nurse teaching: monitor weight, HR, BP

Question 25

Bumetanide (bumex) is what kind of drug

Answer 25

Loop diuretic. Most potent of them.
It blocks the reabsorption of Na+ an Cl- in the nephron loop.
Side effect: hypokalemia, hypotension
Ototoxic

Question 26

Ethacrynic acid (edecrin) is what kind of drug

Answer 26

Loop diuretic.
Side effect: ototoxicity.

Question 27

Chlorothiazide (Diuril) and hydrochlorothiazide (microzide) are what kind of drugs

Answer 27

Thiazide diuretics.
Block Na+ reabsorption and increase k+ and water excretion.
Side effect: hypokalemia (palpitations), hypotension, dehydration

Question 28

Spironolactone (Aldactone) is what kind of drug?

Answer 28

Potassium sparing diuretic. Na+ & water excretion is increased & body retains more K.
Side effect: hyperkalemia, no K supplements and limit K in diet.
Reduces mortality in pt with CHF.

Question 29

Furosemide and torsemide are what kind of drugs

Answer 29

Loop diuretic
Furosemide (Lasix)- is the most popular and lasts 6 hrs.

Question 30

Loop diuretics are mainly used for ….

Answer 30

Edema …..

Question 31

Loop diuretic side effects.

Answer 31

Ototoxic. Decreased potassium and magnesium. Metabolic alkalosis (blood pH turning basic). Dehydration. (Fluid loss)

Question 32

Potassium sparing diuretics can treat what and have what side effects

Answer 32

Tx: HTN, heart failure, edema.
Side effects: elevated potassium levels; high levels can lead to gynecomastia

Question 33

Thiazide and thiazide like diuretics work on what part of kidneys. Used for what?

Answer 33

Distal convoluted tubule. To prevent sodium from being reabsorbed.
Used for HTN, Edema.

Question 34

Thiazide diuretics side effects

Answer 34

Gout.
Decreased sodium (hyponatremia)
Decreased potassium (hypokalemia)
Increased Uric acid (hyperuremia)
Increased blood glucose (hyperglycemia)

Question 35

OTC medications like NSAIDs, antacids, acetaminophen, and cough and flu, should be avoided with diuretics why?

Answer 35

All contain high levels of sodium.

Question 36

If a patient is dehydrated and has a low BP. What do you give

Answer 36

Normal saline.

Question 37

If a patient is dehydrated with a normal BP. What do you give.

Answer 37

0.45% NaCl

Question 38

The drug Questran can take how long for effectiveness?

Answer 38

30 days or more.

Question 39

Gemfibrozil is contraindicated in clients with what conditions

Answer 39

hepatic​ impairment, severe chronic kidney disease​ (CKD), pre-existing gallbladder​ disease, or those with prior hypersensitivity to the drug

Question 40

Loop​ diuretics, compared with​ potassium-sparing diuretics, will result in what?

Answer 40

greatly increase urinary​ output, decrease​ edema, and promote the excretion of potassium.

Question 41

A client is prescribed spironolactone​ (Aldactone). For which electrolyte imbalance should the nurse monitor this​ client?

Answer 41

Because spironolactone is a​ potassium-sparing diuretic, the client is at risk for cardiac dysrhythmias and hyperkalemia. The client is also at risk for hyponatremia and hypomagnesemia.

Question 42

A client taking a diuretic develops gynecomastia. Which medication should the nurse suspect as causing this​ finding?

Answer 42

Spironolactone

Question 43

client is taking hydrochlorothiazide​ (Microzide). Which effect should the nurse expect from concurrent use with a​ corticosteroid?

Answer 43

decreased serum potassium levels

Hydrochlorothiazide and corticosteroids can both cause​ hypokalemia, and this likelihood is increased when the two medications are taken together

Question 44

A client is prescribed a carbonic anhydrase inhibitor. Which response should the nurse expect after administering this​ medication?

Answer 44

minimal diuresis.
The carbonic anhydrase inhibitors are rarely used as diuretics because they produce only a weak diuresis and can contribute to metabolic acidosis.

Question 46

Normal levels for….
Na, K, Mg, Ca, creatinine

Answer 46

Na: 135-145
Ca: 8-10
K: 3.5-5.0
Mg: 1.5-2.5
Creatinine: 0.7-1.2