The nurse is teaching a client with elevated LDL cholesterol and decreased HDL cholesterol about strategies to manage this disorder

Question

The client asks the nurse why there is a difference in the direction of change in the goals for altering HDL versus LDL cholesterol. Which response by the nurse is the most appropriate?
1. "It is most important to increase HDL cholesterol, and if we can reduce LDL cholesterol also, that might be of some help."
2. "We want to reduce HDL cholesterol and increase LDL cholesterol because these changes will protect you against atherosclerosis."
3. "We want to increase HDL cholesterol, which helps rid the body of excess cholesterol, and to decrease LDL cholesterol, which carries excess cholesterol to the body tissue to be stored."
4. "I think you have misunderstood what I have told you, since we want both values to be reduced."

Answer 1

Correct Answer: 3
Rationale 1: Both HDL and LDL cholesterol must be within an optimal range to reduce the risk of coronary artery disease.
Rationale 2: An elevation in LDL cholesterol increases storage of cholesterol in tissues, and a decrease in HDL cholesterol decreases the ability of the liver to metabolize and excrete excess cholesterol.
Rationale 3: An elevation in HDL cholesterol and a decrease in LDL cholesterol maintain an optimal balance between storage of cholesterol in tissues and removal of cholesterol by the liver.
Rationale 4: Reduction in LDL cholesterol below 100 mg/dL and an increase in HDL cholesterol above 40 mg/dL are optimal for preventing atherosclerosis.
Global Rationale: An elevation in HDL cholesterol and a decrease in LDL cholesterol maintain an optimal balance between storage of cholesterol in tissues and removal of cholesterol by the liver. Both HDL and LDL cholesterol must be within an optimal range to reduce the risk of coronary artery disease. An elevation in LDL cholesterol increases storage of cholesterol in tissues, and a decrease in HDL cholesterol decreases the ability of the liver to metabolize and excrete excess cholesterol. Reduction in LDL cholesterol below 100 mg/dL and an increase in HDL cholesterol above 40 mg/dL are optimal for preventing atherosclerosis.