Pharmacology Cholesterol Lowering Agents #5


Which follow-up lab is priority due to potential adverse effects for the client taking atorvastatin?


  1. Creatinine level
    • Rationale:

      This answer is not correct because liver danage, not kidney failure is the main risk factor surrounding use of atorvastatin and other statin medications. Nevertheless, a time when creatinine would be affected with a statin drug is if the serious side effect of rhabdomyolysis occurs. The major symptoms to monitor for is muscle pain. In rhabdomyolysis, muscle fibers break down due to damage and cause kidney damage and failure.

  2. High density lipid level
    • Rationale:

      This answer is not correct because the high density lipid level (HDL) is not a priority because alanine transaminase (ALT) checks for liver dysfunction, a serious side effect of atorvastatin. The HDL should be checked to evaluate the effectiveness of treatment, but is not the priority laboratory result the nurse should monitor.

  3. C-reactive protein level
    • Rationale:

      This answer is not correct because the C-reactive protein (CRP) level is not a priority follow-up lab over an alanine transaminase level in clients taking atorvastatin . The CRP level is checked in clients with elevated cholesterol levels because atherosclerosis (cholesterol depositing within the blood vessels) is associated with inflammation inside of blood vessel walls. The CRP level is elevated in clients with atherosclerosis.

  4. Alanine transaminase level
    • Rationale:

      This answer is correct because alanine transaminase, also known as ALT, is among the liver function tests important to check when a client is on any statin medication. This is due to the risk of liver dysfunction associated with this medication.


Liver damage is associated with taking statin medications. Follow-up liver enzymes labs are essential to monitor for this potential side effect.


Learning Outcomes

Liver damage and dysfunction is a serious side effect of statin medication therapy. Liver function is evaluated through periodic blood tests examining liver enzymes, including alanine transaminase (ALT) and aspartate aminotransferase (AST). Sometimes, clients are unable to take statin drugs due to the effects on the liver. Clinical manifestations of liver damage includes dark urine, jaundice, ascites, and fatigue. The nurse should monitor labs and assess for potential clinical manifestations to reduce damage to the liver.

Test Taking Tip

Remember that when a question asks for what is priority, all answers are correct but it is asking, what do you do first because it is most important above all other answers.

Video Rationale