During a follow-up visit, a patient who has been on estrogen therapy admits that she has continued to smoke cigarettes. The nurse will remind the patient that smoking while on estrogen may lead to increased:

Choice A reason: This is incorrect because nausea is not a common or serious adverse effect of estrogen therapy. However, the patient should take the estrogen with food or milk to prevent stomach upset.

Choice B reason: This is incorrect because triglycerides are not affected by estrogen therapy. However, the patient should monitor their cholesterol and blood pressure levels regularly and follow a healthy diet and exercise regimen.

Choice C reason: This is correct because smoking and estrogen therapy are both risk factors for thrombosis, which is the formation of blood clots in the blood vessels. The patient should stop smoking and report any signs of thrombosis, such as leg pain, swelling, redness, or warmth, to the provider.

Choice D reason: This is incorrect because bleeding during menstruation is not increased by estrogen therapy. However, the patient should report any abnormal vaginal bleeding, such as spotting, heavy bleeding, or prolonged bleeding, to the provider.

Choice A reason: The client waits 10 min between inhalations is not the correct answer. This is not a recommended practice for using an albuterol inhaler. The client should wait at least 1 min between inhalations to allow the medication to reach the lungs and avoid overdose.

Choice B reason: The client takes a quick inhalation while releasing the medication from the inhaler is the correct answer. This is the correct way to use an albuterol inhaler. The client should breathe in quickly and deeply while pressing down on the inhaler to release the medication. This ensures that the medication is delivered to the airways and not the mouth or throat.

Choice C reason: The client exhales as the medication is released from the inhaler is not the correct answer. This is not a recommended practice for using an albuterol inhaler. The client should exhale before using the inhaler, not during or after. Exhaling while using the inhaler can cause the medication to be wasted or to irritate the mouth or throat.

Choice D reason: The client holds his breath for 10 seconds after inhaling the medication is not the correct answer. This is not a recommended practice for using an albuterol inhaler. The client should hold his breath for only a few seconds after inhaling the medication, not 10 seconds. Holding the breath for too long can cause dizziness, headache, or chest discomfort.