Nokea
A client is beginning therapy with prescribed terazosin for treatment of BPH. Based on the nurse's understanding of the action of this drug, the nurse would identify which nursing diagnosis as most likely?
- A. Acute Pain
- B. Risk for Injury
- C. Impaired Mucous Membranes
- D. Deficient Knowledge
Correct Answer: B
Rationale: Terazosin, an antiadrenergic drug, can cause a hypotensive reaction. Thus, the client may experience an immediate lowering of blood pressure when first starting this drug and be at risk for injury. Acute Pain would be more appropriate for a client experiencing priapism from erectile dysfunction drugs. Impaired Mucous Membranes would be appropriate for the client receiving antispasmodics. Deficient Knowledge could apply to any client receiving medication.
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After teaching a client how to use an estradiol transdermal system, the nurse determines that the teaching was successful when the client states which of the following? Select all that apply.
- A. I can put the patch on my breasts.
- B. I should rotate the sites, staying away from the same site for about a week.
- C. When I apply it, I should rub the patch vigorously for about 10 seconds.
- D. I apply the patch immediately after I open the pouch.
- E. If the area is oily or irritated, I need to avoid that area.
Correct Answer: B,D
Rationale: When using a transdermal system, the client should apply the system immediately after opening the pouch with the adhesive side down, applying it to the clean dry skin of the buttocks, trunk, abdomen, upper inner thigh, or upper arm. The system should not be applied to the breasts, waistline, or a site exposed to sunlight. The area should not be oily or irritated. Once the patch is applied, the client should press on it firmly with the palm of the hand for about 10 seconds. The application site is rotated with at least 1-week intervals between applications to a particular site.
A nurse is conducting a presentation for a group of middle-aged women about menopause and the changes that occur to the female genitourinary system. Which of the following would the nurse include in the discussion? Select all that apply.
- A. Lengthening of the vaginal wall
- B. Slowed rate of lubrication during sexual arousal
- C. Decreased risk of yeast infection from pH changes
- D. Weakening of the pelvic floor muscles
- E. Thinning of the vaginal walls
Correct Answer: B,D,E
Rationale: Genitourinary changes associated with aging include thinning of the vaginal walls with shortening and loss of elasticity; decreased lubrication with a slowing of the rate during sexual arousal; increased risk of yeast infections due to changes in the pH of the environment; and weakening of the pelvic floor muscles, which can lead to stress incontinence.
A nurse is caring for a client receiving goserelin acetate for prostate cancer. The nurse would monitor the client for which of the following adverse reactions?
- A. Breast atrophy, sexual dysfunction
- B. Pharyngitis, asthenia
- C. Breast tenderness, edema
- D. Hyperglycemia, leukocytosis
Correct Answer: A
Rationale: Breast atrophy and sexual dysfunction may be seen as adverse reactions of goserelin acetate therapy. Pharyngitis and asthenia are seen with the use of anastrozole, Breast tenderness and edema are seen with drugs such as estramustine. Hyperglycemia and leukocytosis are seen as adverse reactions of mitotane.
A client is receiving oxybutynin for treatment of overactive bladder. The client also takes haloperidol (Haldol) as an antipsychotic agent. What effect of the interaction of these two drugs should the nurse observe for in the client?
- A. Decreased effect of the antipsychotic drug
- B. Increased risk for bleeding
- C. Lowered plasma concentrations
- D. Increased effect of the antispasmodic drug
Correct Answer: A
Rationale: The nurse should observe for decreased effectiveness of the antipsychotic drug in the client as the effect of the interaction of the antispasmodic drug and haloperidol. Increased risk for bleeding results from the interaction of oral anticoagulants with anti-infective drugs. Increased effect of the antispasmodic drug occurs with the interaction of an antispasmodic drug with a tricyclic antidepressant. Plasma concentrations are lowered due to the interaction of fosfomycin, which is an anti-infective, with metoclopramide, which is used to relieve gastric upset.
A client is prescribed finasteride to treat his symptoms of BPH. When teaching the client about this drug, the nurse would most likely include a discussion about the possibility of which of the following?
- A. Erectile dysfunction
- B. Dry mouth
- C. Constipation
- D. Decreased libido
- E. Weight gain
Correct Answer: A,D
Rationale: Androgen hormone inhibitors such as finasteride have been associated with the adverse reaction of erectile dysfunction and decreased libido. Dry mouth and constipation are associated with antispasmodics. Weight gain is associated with alpha-adrenergic blockers.