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A client is receiving estrogen therapy but also takes phenytoin for seizure control. The nurse would alert the client to the possibility of which of the following?
- A. Potential for blood clots
- B. Increased risk for infection
- C. Possibility of breakthrough bleeding
- D. Increased risk for seizures
Correct Answer: C
Rationale: When estrogen is given with phenytoin, a hydantoin, the client is at increased risk for breakthrough bleeding. Blood clots can be an adverse reaction with estrogen therapy alone. There is no increased risk for infection. When given together, these drugs do not increase the risk for seizures.
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A client is prescribed flavoxate. When reviewing the client's history, the nurse would expect to find which of the following complaints? Select all that apply.
- A. Dysuria
- B. Nocturia
- C. Leakage
- D. Suprapubic pain
- E. Inability to void
Correct Answer: A,B,D
Rationale: Flavoxate, an antispasmodic, is used to relieve symptoms of dysuria, urinary urgency, nocturia, suprapubic pain, and frequency and urge incontinence. Other antispasmodics are used to treat bladder instability, such as leakage caused by a neurogenic bladder. The drug is not used to treat an inability to void.
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.
A client with benign hypertrophy of the prostate has heard claims that the herb sawM palmetto can help relieve his symptoms. The client is eager to know more about this herb. Which of the following pieces of information should the nurse provide the client regarding the use of the herb?
- A. Take the herb as tea, prepared in hot water.
- B. Improvement can be seen within 2 to 3 weeks.
- C. It may delay the need for prostatic surgery.
- D. Stop the herb after 3 months of intake.
Correct Answer: C
Rationale: The nurse should inform the client that saw palmetto might help delay the need for prostatic surgery. The active components are not water soluble and should not be taken as a tea. Improvement can be seen after 1 to 3 months of taking the herb, and not within 2 to 3 weeks. The herb intake should not be stopped after 3 months but should be continued for 6 months, followed by evaluation by the health care provider.
A client is receiving estrogen therapy. When teaching the client about this therapy, the nurse would inform the client about which of the following as a possible adverse reaction? Select all that apply.
- A. Migraines
- B. Breakthrough bleeding
- C. Changes in libido
- D. Weight gain
- E. Breast tenderness
Correct Answer: A,B,C,D,E
Rationale: Adverse reactions associated with estrogens include headache, including migraines, breakthrough bleeding, spotting, or changes in menstrual flow; changes in libido; weight gain or loss; and breast pain, enlargement, and tenderness.
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.