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: This is incorrect because orally administered decongestants do not have an immediate onset. They take longer to act than nasal sprays because they have to be absorbed through the gastrointestinal tract. Nasal sprays act directly on the nasal mucosa and have a faster onset.

Choice B reason: This is correct because orally administered decongestants do not cause rebound congestion. Rebound congestion is a condition in which the nasal passages become more swollen and congested after the effect of the nasal spray wears off. This can lead to overuse and dependence on the nasal spray. Orally administered decongestants do not have this effect because they act systemically and not locally.

Choice C reason: This is incorrect because orally administered decongestants do not have a shorter duration. They have a longer duration than nasal sprays because they are metabolized more slowly by the liver. Nasal sprays have a shorter duration because they are eliminated more quickly by the nasal mucosa.

Choice D reason: This is incorrect because orally administered decongestants are not more potent than nasal sprays. They have a similar potency, but they have a different mechanism of action. Orally administered decongestants act on the alpha-adrenergic receptors in the blood vessels, causing vasoconstriction and reducing congestion. Nasal sprays act on the beta-adrenergic receptors in the bronchial smooth muscle, causing bronchodilation and improving airflow.