A. Description 说明
Hyperlipidemia is a condition in which there are high levels of lipids circulating in the blood, which can predispose a child to heart disease.
血液循环中的脂类水平高，容易使儿童罹患心脏疾病 B. Laboratory Values 实验室值
Laboratory values for lipids for individuals aged 2 to 19 years are as follows:
2 – 19岁个体脂实验室值如下：
1. Total cholesterol: less than 170 mg/dL (4.25 mmol/L) is acceptable, 170 to 199 mg/dL (4.25 to 4.9 mmol/L) is borderline, 200 mg/dL (5 mmol/L) or greater is high.
总胆固醇：<170 mg/dL (4.25 mmol/L)可接受；170 – 199 mg/dL (4.25 – 4.9 mmol/L)，临界；≥200 mg/dL (5 mmol/L)，高。
2. Low-density lipoprotein cholesterol: less than 110 mg/dL (2.75 mmol/L) is acceptable, 110 to 129 mg/dL (2.75 to 3.22 mmol/L) is borderline, 130 mg/dL (3.25 mmol/L) or greater is high.
低密度脂蛋白胆固醇：＜110 mg/dL (2.75 mmol/L)，可接受；110 -- 129 mg/dL (2.75 -- 3.22 mmol/L)，临界；≥130 mg/dL (3.25 mmol/L)，高。
3. High-density lipoprotein cholesterol: greater than 45 mg/dL (1.12 mmol/L) is acceptable, 40 to 45 mg/dL (1.0 to 1.12 mmol/L) is borderline, less than 40 mg/dL (1.0 mmol/L) is low.
高密度脂蛋白胆固醇：＞45 mg/dL (1.12 mmol/L)，可接受；40 -- 45 mg/dL (1.0 -- 1.12 mmol/L)，临界；＜40 mg/dL (1.0 mmol/L)，低。
4. Triglycerides: less than 100 mg/dL (1.14 mmol/L) for 9 years and younger is acceptable; less than 130 mg/dL (1.48 mmol/L) for 10 years and older is acceptable.
甘油三酯：＜100 mg/dL (1.14 mmol/L) 9岁以下可接受；＜130 mg/dL (1.48 mmol/L)10岁以上可接受。 C. Nursing Considerations 护理考虑
1. Any person with hyperlipidemia as a child is likely to have the condition later in life, and it predisposes them to cardiac events.
小孩时有高酯血症，以后就很可能得此病，而且容易出现心脏事件。
2. Referral to a specialist (cardiology) should be made if there is an elevation in any of the above values.
若上述值升高，就应安排专家（心脏病学）会诊。
3. Treatment focuses on lifestyle modifications and behavior changes. See Box 28-1 for recommended dietary and physical activity changes for preventing diabetes mellitus, which also applies with the treatment focus for hyperlipidemia.
治疗重点是生活方式转变和行为改变。有关饮食和体育锻炼转变、预防糖尿病建议参见表框28-1，这些建议也适用于高酯血症的重点治疗。
★Vocabulary for Today ★
lipid – n. 脂质
predispose – v. 使易害，使易罹患
total cholesterol – 总胆固醇
borderline – a. 临界的，边缘的
low-density lipoprotein – 低密度脂蛋白
high-density lipoprotein – 高密度脂蛋白
triglyceride – n. 甘油三酯
hyperlipidemia – n. 高酯血症
cholestryamine – n. 考来烯胺
Questran – n. 消胆胺
1. A nurse is giving instruction to a client who is receiving cholestyramine (Questran) for the treatment of hyperlipidemia. Which of the following statements made by the client indicates the need for further instructions?
A. “This medication comes in a powder that must be mixed with juice or water before administration”.
B. “I will avoid eating foods rich in saturated fats”.
C. “I will continue taking nicotinic acid as part of the treatment”.
D. “Constipation, belching and heartburn are some of the side effects”.
2. A nurse is providing instructions to a client who is on nicotinic acid for the treatment of hyperlipidemia. Which statement made by the nurse indicates a comprehension of the instructions?
A. “I should take aspirin 30 minutes before nicotinic acid”.
B. “I will drink alcohol in moderation”.
C. “Yellowing of the skin is a common side effect”.
D. “This medication is taken on an empty stomach“.
答案 Key to Questions 1. C. “I will continue taking nicotinic acid as part of the treatment”. Rationale: A combination of cholestyramine (Questran) and nicotinic acid damages the liver. Options A, B, and D are true regarding this medication. 2. A. “I should take aspirin 30 minutes before nicotinic acid”. Rationale: The use of aspirin or a nonsteroidal anti-inflammatory drug 30 minutes before decreases flushing which is a side effect of taking nicotinic acid. Option B, drinking alcohol will cause liver abnormalities. Option C is a sign of liver dysfunction and should be immediately informed the physician. Option D, this medication is taken with meals to decrease gastrointestinal upset.
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