1. The client/caregiver can define cholesterol.
   1. Cholesterol is a soft, fat-like substance in the bloodstream of the body. It is produced by the liver, and we ingest large amounts by eating meat and dairy products.
   2. Too much cholesterol directly increases the risk of heart disease.
   3. A lipid profile is the test often used to evaluate risks for coronary heart disease (the 2001 guidelines from the National Cholesterol Education Panel recommended that all lipid tests be performed after fasting and should measure all four cholesterol components: total cholesterol, high-density lipoproteins, low-density lipoproteins, and triglycerides).
   4. A lipid profile includes high-density lipoproteins, low-density lipoproteins, very- low-density lipoproteins, and triglycerides.
   5. High-density lipoproteins help to carry away or remove excess cholesterol from the bloodstream. Normal values are 45 to 55 mg/dl or higher.
   6. Low-density lipoproteins are most responsible for plaque formation that clogs arteries and creates atherosclerotic plaques. Normal values are between 60 to 180 mg/dl. This can vary with the client’s risk for heart disease.
   7. Triglycerides are fats in the body. They are frequently elevated in clients with obesity, cardiac disease, and diabetes. Triglyceride levels should be less than 150 mg/dl.
   8. A goal for total cholesterol should be below 200 mg/dl.
2. The client/caregiver can list nutritional information to decrease serum cholesterol levels.
   1. Limit milk to skim milk, 1% milk, or cultured buttermilk, and use nonfat or low-fat yogurt or cottage cheese.
   2. Limit breads made without whole milk, eggs, or butter.
   3. Do not prepare vegetables with butter, cream, or cheese sauce.
   4. Use lean meats with fat trimmed and poultry without skin.
   5. Cut down on saturated fats.
   6. Use only two egg yolks per week. Use egg whites or egg substitutes.
   7. Use monounsaturated oils and low-fat dressings. Preferred oils are peanut, olive, and canola oils.
   8. Use low-fat frozen desserts or frozen fruit ices, angel-food cake, and low-fat cookies and snacks.
   9. Use nonfat beverages, carbonated drinks, juices, tea, and coffee.
   10. A diet rich in fiber (20 to 30 grams per day) may also help to reduce cholesterol levels.
   11. Limit cholesterol dietary intake to 300 mg or less daily.
3. The client/caregiver can list additional ways to lower cholesterol and triglyceride levels.
   1. Avoid alcohol.
   2. Cook by boiling, baking, or roasting instead of frying.
   3. Increase activity level.
   4. Achieve and maintain a healthy weight.
   5. Avoid trans-fatty acids and hydrogenated oils used in margarine, commercially prepared cookies, cakes, and so forth.
   6. Limit sugar intake.
   7. Read labels to determine sources of saturated fats and cholesterol.
   8. Consult with a registered dietitian.
   9. Medication therapy as prescribed by a physician.

Resources

American Diabetes Association
www.diabetes.org

American Heart Association
www.americanheart.org

My Pyramid—United States Department of Agriculture
www.mypyramid.gov

National Cholesterol Education Program
www.nhlbi.nih.gov/about/ncep/

National Heart, Lung, and Blood Institute
www.nhlbi.nih.gov

National Institutes of Health
www.nih.gov

The Office of the Surgeon General
www.surgeongeneral.gov/sgoffice

References

Lutz, C., & Przytulski, K. (2001). Nutrition and diet therapy. Philadelphia: F. A. Davis Company.
Lutz, C., & Przytulski, K. (2004). Nutri notes: Nutrition &diet therapy pocket guide. Philadelphia: F. A. Davis Company.
Nutrition made incredibly easy. (2003). Philadelphia: Lippincott Williams & Wilkins.
Perry, A., & Potter, P. (2006). Clinical nursing skills & technique. St. Louis: Mosby Inc.
Taylor, C., Lillis, C., & LeMone, P. (2005). Fundamentals of nursing . Philadelphia: Lippincott, Williams & Wilkins.
Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. Lippincott Williams & Wilkins.