Nokea
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.
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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 nurse is providing care to a client diagnosed with benign prostatic hypertrophy. The nurse understands that which of the following drugs inhibit the conversion of testosterone into 5-alpha-dihydrotestosterone (DHT), resulting in a decrease in prostate gland size? Select all that apply.
- A. Terazosin (Hytrin)
- B. Finasteride (Proscar)
- C. Methyltestosterone (Testred)
- D. Dutasteride (Avodart)
- E. Doxazosin (Cardura)
Correct Answer: B,D
Rationale: Finasteride (Proscar) and dutasteride (Avodart) inhibit the conversion of testosterone into 5-alpha-dihydrotestosterone (DHT), which results in a decrease in prostate gland size, making them useful in the treatment of benign prostatic hypertrophy.
Hormones may be used in cancer therapy, especially for advanced disease. Which of the following are hormones used as antineoplastic drugs? Select all that apply.
- A. Testolactone (Teslac)
- B. Leuprolide (Lupron)
- C. Megestrol (Megace)
- D. Bicalutamide (Casodex)
- E. Goserelin (Zoladex)
Correct Answer: A,B,C,E
Rationale: Testolactone (Teslac), leuprolide (Lupron), megestrol (Megace), and goserelin (Zoladex) are hormones used as antineoplastic drugs. Bicalutamide (Casodex) is an antiandrogen, not a hormone.
After reviewing information about estrogens and their use, the instructor determines that the teaching was successful when the students identify which of the following as true? Select all that apply.
- A. Changes in lipids levels occur with the use of estrogens.
- B. Progestin use is recommended when estrogen is used after a hysterectomy.
- C. Estrogen replacement therapy (ERT) helps to lessen the changes to the aging tissues.
- D. Estrogens increase a woman's risk for gallbladder disease.
- E. The use of estrogens is associated with relatively few adverse reactions.
Correct Answer: A,C,D
Rationale: Estrogens can relieve symptoms of menopause but can lead to blood pressure and lipid changes. ERT can help lessen the changes to aging tissues, but the estrogen does increase a woman's risk for gallbladder disease. The addition of progestin is recommended when estrogen is used to treat menopausal symptoms in a woman with an intact uterus. Estrogen alone may be used for estrogen replacement therapy after a hysterectomy. The administration of estrogen by any route may result in many adverse reactions, although these reactions vary in incidence and intensity.
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.