A client who is experiencing vasomotor symptoms related to menopause receives a new prescription for estrogen replacement. Which client condition should the nurse report the healthcare provider prior to administering the first dose of the medication?

Colorectal cancer.

Pulmonary embolism.

Dyspareunia.

Osteoporosis.

Answer and Explanation

The Correct Answer is B

A) Colorectal cancer:
While a history of colorectal cancer is important to note in a client’s medical history, it is not typically a contraindication for estrogen replacement therapy. Estrogen replacement therapy may even have benefits in terms of reducing the risk of colorectal cancer in some cases. However, the primary concern in this scenario is the client’s history of pulmonary embolism, which presents a significant risk factor for adverse outcomes with estrogen therapy.

B) Pulmonary embolism:

A history of pulmonary embolism is a significant contraindication for estrogen replacement therapy. Estrogen therapy increases the risk of thromboembolic events, and individuals with a history of pulmonary embolism are already predisposed to such events. Administering estrogen replacement therapy to a client with a history of pulmonary embolism could further increase the risk of recurrent embolism or deep vein thrombosis, leading to potentially life-threatening complications.

C) Dyspareunia:

Dyspareunia, or painful sexual intercourse, is a symptom commonly associated with menopause and may be an indication for estrogen replacement therapy. However, it is not a contraindication for treatment unless there are other complicating factors that need to be considered.

D) Osteoporosis:

Osteoporosis, characterized by decreased bone density and increased susceptibility to fractures, is often treated with estrogen replacement therapy to help maintain bone health and reduce the risk of fractures. While it is important to consider the client’s osteoporosis diagnosis when initiating estrogen therapy, it is not typically a contraindication for treatment unless there are other specific concerns or complications present.

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Correct Answer is C

Explanation

A) Irrigation and topical antibiotic application to wound area: While wound care is important in managing infections, obtaining cultures before initiating antibiotic therapy takes precedence to ensure appropriate treatment. Topical antibiotics may not adequately address systemic infections caused by gram-negative bacteria.
B) Monitor for signs of sodium and fluid retention: This intervention is important when administering certain antibiotics, such as those in the aminoglycoside class, but it is not the most immediate priority. Monitoring for signs of sodium and fluid retention is typically indicated after antibiotic therapy has commenced and involves assessing the client's clinical status and laboratory values for signs of electrolyte imbalance or fluid overload.
C) Wound and blood specimens for culture and sensitivity: This action is essential before initiating antibiotic therapy because it allows for the identification of the specific organism causing the infection and its susceptibility to antibiotics. This information guides the selection of the most appropriate antibiotic for targeted therapy, improving treatment efficacy and reducing the risk of antibiotic resistance.
D) Complete blood count and serum electrolytes: While monitoring laboratory values is important in the overall management of the client, obtaining cultures for culture and sensitivity testing is the priority before initiating antibiotic therapy. This step helps ensure that the chosen antibiotic is effective against the specific pathogen causing the infection.

A. Platelets. B. Osmolality. C. Glucose D. Calcium

Correct Answer is B

Explanation

A) Platelets:
Platelet levels are not directly affected by antidiuretic hormone (ADH) administration or diabetes insipidus. Platelet monitoring is important in assessing clotting function but is not specifically related to the management of diabetes insipidus or ADH therapy.

B) Osmolality:
This is the correct answer. Osmolality refers to the concentration of solutes in the blood and is a critical parameter to monitor in clients receiving ADH therapy for diabetes insipidus. ADH regulates water reabsorption in the kidneys, thereby affecting blood osmolality. Monitoring serum osmolality helps assess the effectiveness of ADH therapy in maintaining fluid balance and preventing excessive urine output.

C) Glucose:
While glucose monitoring is important in clients with diabetes mellitus, it is not directly related to diabetes insipidus or ADH therapy. Diabetes insipidus is characterized by excessive thirst and urination due to inadequate ADH production or response, which does not involve glucose metabolism.

D) Calcium:
Calcium levels are not typically affected by ADH therapy or diabetes insipidus. Monitoring calcium levels is important in conditions such as hyperparathyroidism or hypoparathyroidism but is not directly relevant to the management of diabetes insipidus.

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A client who is experiencing vasomotor symptoms related to menopause receives a new prescription for estrogen replacement. Which client condition should the nurse report the healthcare provider prior to administering the first dose of the medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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