Author Question: A 55-year-old woman has a history of myocardial infarction (MI). A lipid profile reveals LDL of 130 ... (Read 116 times)

Bernana · **on:** Jul 24, 2018

A 55-year-old woman has a history of myocardial infarction (MI). A lipid profile reveals LDL of 130 mg/dL, HDL of 35 mg/dL, and triglycerides 150 mg/dL. The woman is sedentary with a body mass index of 26 .

The woman asks the primary care NP about using a statin medication. The NP should: a. recommend dietary and lifestyle changes first.
b. begin therapy with atorvastatin 10 mg per day.
c. discuss quality-of-life issues as part of the decision to begin medication.
d. tell her there is no clinical evidence of efficacy of statin medication in her case.

Question 2

An 80-year-old patient has a diagnosis of glaucoma, and the ophthalmologist has prescribed timolol (Timoptic) and pilocarpine eye drops. The primary care NP should counsel this patient:

a. that systemic side effects of these medications may be severe.
b. that the combination of these two drugs may cause drowsiness.
c. to begin an exercise program to improve cardiovascular health.
d. that a higher dose of one or both of these medications may be needed.

Silverbeard98 · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

B
This woman would be using a statin medication for secondary prevention because she already has a history of MI, so a statin should be prescribed. Dietary and lifestyle changes should be a part of therapy, but not the only therapy. She is relatively young, and quality-of-life issues are not a concern. There is no clinical evidence to support use of statins as primary prevention in women.

Answer to Question 2

A
Older patients are susceptible to systemic effects of topical eye drops. Timolol can cause cerebrovascular, central nervous system, and respiratory side effects, and pilocarpine can cause systemic -blocker effects. The combination does not cause drowsiness. Although there is some correlation between cardiovascular health and glaucoma, beginning a new exercise program is not indicated. A higher dose of the medications would increase systemic side effects.