Author Question: The nurse is caring for an obese patient with hyperlipidemia who has tried to modify his diet to ... (Read 51 times)

Cooldude101 · **on:** Jul 23, 2018

The nurse is caring for an obese patient with hyperlipidemia who has tried to modify his diet to lose weight and control serum lipid levels without success.

He is currently taking a combination of medications but his total cholesterol remains above 200 . What future therapy might help this patient? A) Endocannabinoid blocker
B) Bile acid sequestrant with niacin
C) Beta-hydroxy-beta-methylglutaryl coenzyme A (HMG-CoA) reductase and gemfibrozil
D) Peroxisome proliferator receptor alpha activator

Question 2

A patient comes to the clinic to talk with the nurse about planned overseas travel. The patient tells the nurse that he or she is planning a trip to an area of the world where malaria is common.

He wants to know how to prevent contracting the disease. What should the nurse respond? A) We can ask the physician to give you some anti-infectives in case you get malaria.
B) We can ask the physician for some anti-infectives for you to take prophylactically.
C) Don't worry, if you get malaria they have some good doctors where you are going.
D) If you get malaria, you can always be treated on the way home.

phuda · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

A
Feedback:
Blocking the endocannabinoid system results in feelings of satiety and decreased appetite, leading to weight loss; decreased release of growth hormone, increased oxygen and glucose use in the muscle, decreased fat synthesis in the liver, decreased levels of triglycerides and low density lipoproteins, and increased levels of high density lipoproteins, improving the lipid profile; increased sensitivity of insulin receptor sites, leading to decreased blood glucose levels; decreased fat production and storage; increased levels of adiponectin; and decreased activity of tumor necrosis factor, a proinflammatory agent, and decreased activity of C-reactive protein, which is associated with proinflammatory and prothrombotic states. Combining bile acid sequestrant with niacin or HMG-CoA with gemfibrozil is contraindicated. Peroxisome proliferator receptor alpha activators help to control lipid levels but do not contribute to dietary changes and appetite suppression.

Answer to Question 2

B
Feedback:
Some anti-infectives are used as a means of prophylaxis when patients expect to be in situations that will expose them to a known pathogen, such as travel to an area where malaria is endemic, or undergoing oral or invasive gastrointestinal surgery in a person who is susceptible to subacute bacterial endocarditis. After the patient contracts malaria, it is much harder to treat so he would not start the medication or obtain treatment after being infected.