Nokea
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.
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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.
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.
A nurse educating a client receiving tolterodine (Detrol) should warn the client about which of the following common adverse reactions? Select all that apply.
- A. Anorexia
- B. Xerostomia
- C. Decreased lacrimation
- D. Blurred vision
- E. Diarrhea
Correct Answer: B,C,E
Rationale: Common adverse reactions seen with the use of tolterodine (Detrol) include xerostomia, drowsiness, constipation, headache, decreased lacrimation, decreased sweating, GI disturbances, blurred vision, and urinary hesitancy.
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.
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.