Hyperlipidemia Nursing Care Plans Diagnosis and Interventions
Hyperlipidemia NCLEX Review and Nursing Care Plans
Hyperlipidemia refers to an unusually high level of fats in the blood, such as cholesterol and triglycerides. Hyperlipidemia can be hereditary; however, it is usually the result of a sedentary lifestyle and unbalanced diet.
There are no signs of hyperlipidemia, yet it is very prevalent. The total cholesterol level of 93 million people in the United States aged 20 and over is higher than the recommended limit. Only a blood test can tell if an individual has this condition.
Furthermore, hyperlipidemia can be controlled, but it is generally a lifelong medical condition. A person must be mindful of what he or she consumes and exercise on a regular basis. Medications are commonly prescribed, too. A timely diagnosis and treatment plan to stop the disease from progressing are vital.
Causes of Hyperlipidemia
Cholesterol is a fatty substance found in the blood. Also referred to as lipid, cholesterol is needed by the body to build healthy cells, but it can also increase the risk of heart disease if it is too high.
It is the liver’s function to produce cholesterol, which is used to break down food and make hormones. Cholesterol is also found in foods such as meat and other products. Because the liver can produce as much cholesterol as the body requires, the cholesterol increases more due to the foods we consume.
A person with a high cholesterol level (hyperlipidemia) may develop fatty deposits in their blood vessels, which may build up over time, making it more difficult for blood to flow freely through the arteries. It deprives the brain and heart of the essential elements of nutrition and oxygen.
To diagnose hyperlipidemia, a physician will order a lipid panel that requires 9 to 12 hours of fasting. A blood sample will be taken by a professional and sent to a laboratory for analysis. The levels of the following will be shown in this test:
- HDL (high-density lipoprotein) cholesterol – also known as “good” cholesterol.
- LDL (low density lipoprotein) cholesterol – also known as “bad” cholesterol; the main source of cholesterol accumulation and obstruction in the arteries
- Total cholesterol – Both low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol are included.
- Triglycerides – another type of fat found in the blood that raises the risk for heart disease
Hyperlipidemia is caused by a combination of high triglycerides, high LDL cholesterol, and a lack of HDL cholesterol that removes the bad cholesterols from the arteries.
A triglyceride level of less than 150 mg/dL is considered normal, whereas a total cholesterol level of more than 200 mg/dL is deemed abnormal.
Acceptable cholesterol levels might still vary from person to person, based on the medical history and present health concerns. The results should be discussed with the physician for better interpretation.
Types of Hyperlipidemia
Hyperlipidemia is divided into two main classifications: familial and acquired. The acquired type is the consequence of underlying medical conditions, certain medications, and lifestyle preferences, whereas the familial type is from the genes that an individual inherits from their parents.
Acquired Hyperlipidemia. Acquired hyperlipidemia is most commonly caused by lifestyle preferences that elevate bad cholesterol levels while lowering good cholesterol levels.
An imbalanced diet, inadequate physical activity, smoking or frequent exposure to secondhand smoke, obesity, and extensive alcohol use are the typical lifestyle choices that increase the risk of developing high cholesterol levels. Kidney disease, diabetes, polycystic ovarian syndrome (PCOS), thyroid dysfunction, liver disease, other hereditary disorders, and pregnancy may also have the potential to raise cholesterol levels.
Certain drugs, such as contraceptive pills, diuretics, corticosteroids, antiretroviral therapy (ART) for HIV treatment, and beta-blockers, might influence cholesterol levels in some cases. Even though these medications affect cholesterol levels, this impact is generally insufficient to warrant discontinuing them.
Familial Combined Hyperlipidemia. A type of hyperlipidemia that can be inherited from parents or grandparents is called familial combined hyperlipidemia (or mixed hyperlipidemia).
People with familial mixed hyperlipidemia are more likely to develop high cholesterol or triglyceride levels in their teens and be diagnosed in their 20s or 30s. Early coronary artery disease and heart attack are more likely to occur as a result of this disorder.
An individual with familial mixed hyperlipidemia may develop cardiovascular disease signs at a young age. These manifestations include the following:
- chest pain
- heart attack
- incompletely healed sores on the toes
- cramps in the calves when walking
- difficulty speaking, drooping on one side of the face, and weakness in the limbs – signs of stroke
Treatment and Prevention of Hyperlipidemia
Lifestyle Changes. The primary line of treatment for hyperlipidemia is to improve one’s lifestyle. These adjustments are an important aspect of treatment, even for familial combined hyperlipidemia. These may be enough to lower the risk of heart disease and stroke. If a person’s hyperlipidemia is currently treated with medication, lifestyle modifications can help them decrease their cholesterol levels even further.
- Eat a Healthy Diet. Lifestyle changes include eating a healthy diet. Avoid saturated and trans fats and eat healthier fats. Red meat, bacon, sausage, and full-fat dairy products are the most common sources of saturated fats. On the other hand, fried meals and processed foods like cookies, crackers, and other snacks, contain trans fats. These should all be avoided or lessened as much as possible. Opt for leaner meats such as chicken, turkey, and fish. Cooking with monounsaturated fats such as olive, avocado, and canola oil is also a good idea. Consistently read the product’s label for the ingredients when going to the supermarket. Consumption of omega-3-rich meals should be increased, as they offer several heart-healthy benefits. Salmon and mackerel are among the fish that contain omega-3. Nuts and seeds are also foods rich in Omega-3. Regular fiber intake is also good for the heart. LDL cholesterol levels can be reduced by consuming soluble fiber, which is found in oats, apples, carrots, beans, and other vegetables. Eating more vegetables and fruits is highly recommended, as they are low in saturated fat and high in fiber and vitamins.
- Achieve the Ideal Weight. To help lower total cholesterol levels, people who are overweight or obese should begin to lose weight. The first step in losing weight is to figure out how many calories a person should consume and how many calories they should burn. A typical adult must lose 3,500 calories from their diet to lose a pound, but losing as little as 5% to 10% of the body weight can already help lower cholesterol levels. An individual must consult with a physician or a trained dietitian to develop a healthy meal plan to begin losing weight.
- Increase Physical Activities. Physical activity is beneficial to one’s overall well-being. It aids in weight loss and lowering total cholesterol levels. The HDL cholesterol levels drop when people do not get enough exercise, which means that not enough good cholesterol is present to remove the bad cholesterol from the arteries. Three to four times a week, 40 minutes of moderate to strenuous exercises are required to lower total cholesterol levels. Each week, an individual should aim for 150 minutes of total activity. Biking, brisk walking, swimming, going to the gym, and even using the stairs instead of the elevator are some of the routines that can help.
- Encourage Smoking Cessation. Smoking elevates triglycerides and lowers good cholesterol levels. It can increase the risk of cardiovascular disease even if the smoker has not been diagnosed with hyperlipidemia. Other risk factors for heart disease, such as high blood pressure and diabetes, are aggravated by smoking.. Smokers can reduce their LDL cholesterol levels and improve their HDL cholesterol levels, which protect the arteries, by quitting. On the other hand, nonsmokers should stay away from secondhand smoke as much as possible.
- Manage Stress. Chronic stress has been linked to an increase in LDL cholesterol and a decrease in HDL cholesterol in some studies. Stress management should be practiced to cope with various adversities that an individual may experience. Stress can also be reduced by sleeping for at least seven hours every night.
Medications. If lifestyle modifications are not enough to reduce cholesterol levels, the doctor may prescribe medications to help an individual lessen it:
- Statins or HMG-CoA reductase inhibitors – types of medications that prevent the liver from manufacturing cholesterol. They are a prevailing alternative for lowering cholesterol levels in the blood.
- Cholesterol absorption inhibitors – operate in conjunction with statins; a modern class of medicine that prevents cholesterol from being absorbed into the body by the intestine.
- Antilipidemics – the liver’s ability to produce fats is affected by some antilipemic medications that may be prescribed. These medications raise HDL cholesterol while lowering LDL cholesterol and triglycerides. Another type of medicine that works on the liver is fibrates. They may increase HDL and lower triglycerides, but they are not as effective in lowering LDL.
Nursing Diagnosis for Hyperlipidemia
Hyperlipidemia Nursing Care Plan 1
Nursing Diagnosis: Acute Pain related to decreased myocardial flow resulting from accumulated fats in the arteries secondary to hyperlipidemia as evidenced by verbalization of chest pain, restlessness, excessive sweating, and elevated vital signs.
The patient’s report of chest pain will decrease in occurrence, extent, and severity. Relief of pain will also be demonstrated as evidenced by vital signs within the normal range, absence of excessive sweating and restlessness.
|Hyperlipidemia Nursing Interventions||Rationale|
|Advise the patient to call the nurse right away when the patient experiences chest pain.||Coronary artery spasm can occur as a result of pain and decreased cardiac output, which can lead to, aggravate, and/or prolonged chest pain. Unbearable pain might also trigger a vasovagal response that lowers blood pressure and heart rate.|
|Evaluate and record the patient’s responsiveness to the medications.||It will provide information about the progression of the disease, assess the efficacy of treatments, and may signify the need for a change in pharmacological treatment.|
|Assess claims of discomfort in the left side of the jaw, neck, shoulder, arm, or hand.||It’s possible that the pain will radiate, and a careful evaluation will assist distinguish the chest pain from a more serious condition.|
|Keep the patient well-rested during periods of chest pain.||Complete rest decreases myocardial oxygen demand, reducing the risk of hyperlipidemia-related cardiac complications.|
|Place the patient in a semi or high fowler’s position if the patient has shortness of breath.||Gas exchange is enhanced in this position, which helps to alleviate shortness of breath.|
|Closely observe the heart rate and rhythm of the patient.||The risk of acute life-threatening cardiovascular complications increases in patients with long-standing hyperlipidemia.|
|Stay with the patient if he is in pain or seems restless and anxious.||Anxiety causes the release of chemicals that increase cardiac workload and can cause chest discomfort to worsen and/or last longer. The presence of a nurse can assist to alleviate emotions of helplessness and anxiety.|
|Administer pain medication as prescribed by the physician.||Medications aid in the patient’s perception of pain, thereby lowering, if not eliminating, it.|
Hyperlipidemia Nursing Care Plan 2
Nursing Diagnosis: Deficient Knowledge related to unfamiliarity and misinterpretation of information about hyperlipidemia as evidenced by frequent questions and requests for additional information.
Desired Outcome: The patient will express awareness of the condition/disease process, as well as the potential complications, and will make the appropriate lifestyle modifications.
|Hyperlipidemia Nursing Interventions||Rationale|
|Discuss to the patient the causes of hyperlipidemia and the importance of preventing and controlling it.||Patients with hyperlipidemia have to understand why it occurred and how to manage the condition. Therapeutic management focuses on reducing the risk of serious medical complications and encouraging a healthy lifestyle.|
|Highlight the need for regular diagnostic procedures, as well as the importance of cholesterol levels and the differences between LDL and HDL contributors.||Patients with two or more risk factors, such as smoking, medical conditions, or family history, should keep triglycerides and LDL cholesterol below the maximum range.|
|Emphasize the significance of weight management, smoking cessation, dietary improvements, physical activities, and stress management.||Knowing the importance of risk factors allows patients to make the necessary modifications. Patients with hyperlipidemia who do not improve to a low-fat diet and exercise program for six months will need to take medication.|
|Demonstrate how to self-monitor vital signs, particularly the heart rate and blood pressure.||The patient must learn when to seek immediate medical help and recognize the early signs of any hyperlipidemia-related complications.|
|Discuss the mechanism of action and effects of hyperlipidemia drugs that have been prescribed to the patient.||The patient may be more willing to comply if they have a better understanding of their medications.|
|Discuss the necessity of scheduling follow-up visits with the patient.||Hyperlipidemia is a condition that should be closely monitored and controlled continuously.|
Hyperlipidemia Nursing Care Plan 3
Risk for Decreased Cardiac Output
Nursing Diagnosis: Risk for Decreased Cardiac Output related to buildup of fats deposits in the blood vessels secondary to hyperlipidemia
Desired Outcome: The patient’s report of dyspnea, chest discomfort, and irregular heartbeats will be less frequent, and the patient’s tolerance for physical exertion will also improve.
|Hyperlipidemia Nursing Interventions||Rationale|
|Monitor the patient’s vital signs and heart rate closely.||The most common complications of hyperlipidemia are heart-related disorders. Early detection and management may be aided by monitoring basic heart functions.|
|Watch out for potential heart murmurs and auscultate the lungs for unusual breath sounds.||Abnormal findings of the heart and lungs may reveal signs of serious medical complications of hyperlipidemia.|
|As directed, engage in self-care activities and provide sufficient rest periods.||Reduces heart workload by conserving the patient’s energy.|
|Check for signs and symptoms of cardiovascular disorders.||Early recognition of signs and symptoms is required for effective management.|
|Assess the color of the patient’s skin, as well as the existence and strength of pulses.||When cardiac output drops, peripheral circulation declines, leaving the skin pale or gray in color and weakening the strength of peripheral pulses.|
|Provide supplemental oxygen as necessary.||To improve cardiac function, reduce ischemia, and lower lactic acid production, increase the amount of oxygen available for myocardial absorption.|
|Administer medications as ordered by the physician.||Prescribed medicines are necessary to reduce heart workload and reduce the risk of hyperlipidemia complications.|
Hyperlipidemia Nursing Care Plan 4
Nursing Diagnosis: Anxiety related to underlying pathophysiological reaction and changes in health status secondary to hyperlipidemia as evidenced by restlessness, verbalized concern about lifestyle changes, and fear of potential complications.
Desired Outcome: The patient will verbalize awareness of feelings of anxiety, report tolerable levels of anxiety, and demonstrate effective coping strategies.
|Hyperlipidemia Nursing Interventions||Rationale|
|Assess the level of stress and anxiety when discussing the purpose of tests and other procedures.||Anxiety caused by a fear of an unknown diagnosis and prognosis might be alleviated with proper explanation.|
|Assist the patient in expressing their emotions and worries, reassuring him that these are normal reactions.||Concerns that are expressed verbally relieve stress, verify coping abilities, and make it easier to deal with emotions. Feelings that aren’t verbalized are more expected to cause anxiety and lead to stressful circumstances.|
|Inform the patient that a treatment regimen and lifestyle adjustments have been put in place to help in preventing hyperlipidemia-related complications.||Helps the patient to gain stronger confidence in their medical treatment and to incorporate their abilities in managing the condition.|
|As directed by the physician, administer sedatives or tranquilizers.||Help the patient calm down until physically able to re-establish acceptable coping mechanisms.|
|Encourage the patient’s family members and significant others to treat him like their usual treatment.||When the people around the patient are overly considerate, the patient may feel more anxious about his condition.|
Hyperlipidemia Nursing Care Plan 5
Nursing Diagnosis: Noncompliance related to lack of information and understanding to the condition, complexity of treatment, and difficulty in behavioral changes secondary to the diagnosis of hyperlipidemia
Desired Outcome: The patient will convey an understanding of the treatment plan and demonstrate a willingness to follow through with the lifestyle adjustments and drugs.
|Hyperlipidemia Nursing Interventions||Rationale|
|Compare the findings of previous diagnostic tests to the present levels.||This information provides a baseline for determining compliance.|
|Observe how well the patient comprehends his existing condition as well as the significance of medical services.||Each patient’s perception on maintenance differs. Some people may refuse medical treatments because of their spiritual beliefs, while others may prefer to adopt alternative treatments. This method will serve as a baseline for subsequent treatment plan.|
|Evaluate the circumstances that the patient considers are preventing his ability to comply.||Each patient’s input is unique, allowing the correction plan to be adjusted to each individual.|
|Establish a therapeutic connection between the patient and his family members.||It gives the patient feelings of security in the nurse’s competence and increases trust in the outcome of the treatment.|
|Involve the patient in determining the correct course of treatment for him.||Patients who are involved in the planning process have a stronger commitment in a successful result.|
|Eliminate any known barriers to compliance of the patient.||Long waiting times in clinics, advocating challenging physical activities, and prescribing medications with a long list of adverse effects can reduce compliance. These barriers should all be avoided as much as possible.|
|Avoid unnecessary drugs and provide a simple treatment plan that is efficient.||When the therapy is short and simple to comprehend, it is more likely to be followed by the patient.|
|Modify the treatment plan according to the patient’s needs.||Most of the time, a “one size fits all” strategy isn’t going to work. Treatment should vary from one patient to another.|
|Provides positive reinforcements for desired and compliant behaviors.||It will give the patient the impression that his efforts are valued, and he will most likely continue to comply.|
|Give precise instructions to the patient as much as possible.||The patient has more control over the behavioral modifications he needs if he has specific information.|
|Provide social support to the patient.||It may assist the patient in acquiring a better awareness of the advantages of adhering to the treatment plan.|
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