Reference no: EM133696359

Introduction recap:

Lipids are essential energy-yielding nutrients or macronutrients that are organic and composed of carbon, hydrogen, and oxygen - but lack nitrogen. Characteristics of lipids include:

• Lipids are characterized by their insolubility in water meaning that lipids do not dissolve in water.
• All lipids are hydrophobic.
• Most of the fat we eat is in the form of triglycerides.

Discussion on Lipids

Chylomicrons transport fats from the intestinal mucosa to the liver. Chylomicrons release triglycerides and a portion of cholesterol into the liver, where they are converted into low-density lipoproteins (LDL). LDL then transports cholesterol and fat to the body's cells. High-density lipoproteins (HDL) help lipids and cholesterol return to the liver for elimination. When oxidized LDL cholesterol levels rise significantly, atheroma develops in the arterial walls, causing atherosclerosis. Because of its high cholesterol content, LDL is considered the most atherogenic lipoprotein. HDL cholesterol can traverse the atheroma and remove cholesterol.

Scenario/Summary

The following case study demonstrates the importance of understanding the biochemical pathway of cholesterol synthesis in treating clients diagnosed with hypercholesterolemia.

A 43-year-old client visits the primary care practitioner for a cardiac stress test. As the nurse inquires about the client's past medical history, she learns that the client has a strong family history of premature cardiac disease, and his two older brothers are currently being treated for hypercholesterolemia. Other than mild exertional dyspnea (shortness of breath), a review of systems is otherwise negative. A physical examination reveals a body mass index of 31 kg/m² and an abdominal waist circumference of 40 inches (102 cm), which, based on your nursing education, is considered moderate abdominal obesity. The nurse educates the client about simvastatin, a drug that inhibits Hydroxymethylglutaryl-CoA (HMG-CoA) reductase, an enzyme needed for cholesterol synthesis in the liver.

Deliverables

Please address the following questions in complete sentences.

Question 1) What clues in this clinical vignette make the prescription of atorvastatin necessary for the treatment of this client's hypercholesterolemia?

Question 2) Explain the chemical structure and synthesis of high-density lipoprotein (HDL), low-density lipoprotein(LDL), and Very-low-density lipoprotein (VLDL) cholesterol. Be sure to specify if HDL/LDL/VLDL is healthy or unhealthy.

Question 3) Describe the chemical structure of cholesterol and lipids (fats).

Question 4) fibrates are a type of cholesterol-lowering medication prescribed to lower triglyceride levels by increasing cells' uptake and subsequent usage of fatty acids to make what?

Question 5) Describe the difference between saturated vs unsaturated fatty acids.