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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Begin therapy 1 week before the next normal menstrual cycle:
Misoprostol is often prescribed to prevent gastric ulcers induced by nonsteroidal anti-inflammatory drugs (NSAIDs) and is typically taken regularly with meals and at bedtime. The timing of therapy initiation is not necessarily linked to the menstrual cycle. Therefore, instructing the client to begin therapy specifically 1 week before the next normal menstrual cycle is incorrect and indicates a need for further teaching.
B) Use condoms and a backup method of birth control to prevent pregnancy:
Misoprostol is contraindicated during pregnancy due to its potential to induce uterine contractions and cause miscarriage or fetal abnormalities. Therefore, advising the client to use condoms and a backup method of birth control to prevent pregnancy while taking misoprostol is appropriate and aligns with safety precautions.
C) Ensure a negative pregnancy test result 2 weeks before therapy:
Confirming a negative pregnancy test result before initiating misoprostol therapy is essential because the medication can cause harm to a developing fetus. This instruction is correct and reinforces the importance of avoiding pregnancy while taking misoprostol.
D) Call the healthcare provider immediately if there is a chance of conception:
Given the teratogenic effects of misoprostol, advising the client to contact the healthcare provider immediately if there is a chance of conception is crucial. This instruction emphasizes the importance of avoiding pregnancy while taking the medication and seeking medical guidance promptly if pregnancy is suspected.
Correct Answer is D
Explanation
A) Keep medication refrigerated:
Metronidazole tablets do not typically require refrigeration. Storing the medication at room temperature is usually sufficient. Refrigeration may not be necessary and could potentially lead to confusion or unnecessary inconvenience for the client.
B) Drink a liter of water daily:
While maintaining hydration is generally important for overall health, there's no specific requirement to drink a liter of water daily solely because of metronidazole therapy. However, encouraging adequate fluid intake is beneficial to prevent dehydration, especially if diarrhea is present due to Clostridium difficile infection.
C) Take one hour after eating:
Metronidazole can be taken with or without food. It's generally well tolerated with food to reduce gastrointestinal side effects such as nausea. However, taking it with food or on an empty stomach does not significantly affect its effectiveness.
D) Avoid the use of alcohol:
This is the correct answer. Consuming alcohol while taking metronidazole can lead to a disulfiram-like reaction, characterized by symptoms such as flushing, headache, nausea, vomiting, and abdominal cramps. This reaction occurs because metronidazole inhibits the breakdown of acetaldehyde, leading to its accumulation in the body when alcohol is consumed. Therefore, it's crucial to advise clients to abstain from alcohol during metronidazole therapy and for at least 48 hours after completing the course of treatment.
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