A client who is experiencing vasomotor symptoms related to menopause receives a new prescription for estrogen replacement. Which client condition should the nurse report the healthcare provider prior to administering the first dose of the medication?
Colorectal cancer.
Pulmonary embolism.
Dyspareunia.
Osteoporosis.
The Correct Answer is B
A) Colorectal cancer:
While a history of colorectal cancer is important to note in a client’s medical history, it is not typically a contraindication for estrogen replacement therapy. Estrogen replacement therapy may even have benefits in terms of reducing the risk of colorectal cancer in some cases. However, the primary concern in this scenario is the client’s history of pulmonary embolism, which presents a significant risk factor for adverse outcomes with estrogen therapy.
B) Pulmonary embolism:
A history of pulmonary embolism is a significant contraindication for estrogen replacement therapy. Estrogen therapy increases the risk of thromboembolic events, and individuals with a history of pulmonary embolism are already predisposed to such events. Administering estrogen replacement therapy to a client with a history of pulmonary embolism could further increase the risk of recurrent embolism or deep vein thrombosis, leading to potentially life-threatening complications.
C) Dyspareunia:
Dyspareunia, or painful sexual intercourse, is a symptom commonly associated with menopause and may be an indication for estrogen replacement therapy. However, it is not a contraindication for treatment unless there are other complicating factors that need to be considered.
D) Osteoporosis:
Osteoporosis, characterized by decreased bone density and increased susceptibility to fractures, is often treated with estrogen replacement therapy to help maintain bone health and reduce the risk of fractures. While it is important to consider the client’s osteoporosis diagnosis when initiating estrogen therapy, it is not typically a contraindication for treatment unless there are other specific concerns or complications present.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) Apply the lotion to plaques on the face: Betamethasone valerate lotion is a potent corticosteroid that is generally not recommended for use on the face due to the risk of adverse effects, such as skin thinning and irritation. Therefore, applying the lotion to plaques on the face is not advisable.
B) Rub the lotion into the area twice daily for 5 weeks: While it is essential to follow the prescribed frequency and duration of medication use, specific instructions for betamethasone valerate lotion may vary depending on the severity of the condition and the healthcare provider's recommendations. This instruction lacks specificity and may not be accurate for all clients.
C) Use gloves to rub the lotion into the area: While wearing gloves may be necessary when applying certain topical medications to prevent contact dermatitis or to protect the hands, it is not typically required when using betamethasone valerate lotion. This instruction may be unnecessary and could lead to unnecessary waste of gloves.
D) Massage the lotion into the psoriasis plaques: This instruction is appropriate because it ensures proper absorption of the medication into the affected skin. Massaging the lotion gently into the psoriasis plaques helps enhance its penetration and effectiveness in treating the condition.
Correct Answer is B
Explanation
A) Diminished renal output:
Diminished renal output could be a potential concern with cefoxitin administration, as it is primarily excreted by the kidneys. However, it is not specifically related to the client’s allergy to penicillin. While it warrants monitoring, it is not the most critical finding to report in this context.
B) Pruritis and macular rash:
The development of pruritis (itchiness) and a macular rash (flat, discolored skin lesions) following the administration of cefoxitin in a client with a documented allergy to penicillin is a significant finding. It suggests a possible allergic reaction to cefoxitin, which belongs to the cephalosporin class of antibiotics. Cross-reactivity between penicillin and cephalosporins is well-documented, with some cephalosporins having a higher risk of allergic reactions in individuals with penicillin allergy. Therefore, pruritis and rash in this context may indicate an allergic response, and it is crucial to report this finding promptly to the healthcare provider for further evaluation and management.
C) Vomiting and diarrhea:
While gastrointestinal symptoms such as vomiting and diarrhea can occur as adverse effects of cefoxitin, they are not specific to an allergic reaction and may occur with various medications. While it is essential to monitor for these symptoms, they are not the most important findings to report in the context of a known penicillin allergy.
D) Vaginal discharge:
Vaginal discharge is not typically associated with an allergic reaction to cefoxitin. While changes in vaginal discharge may be clinically relevant in certain contexts, such as indicating a possible yeast infection or bacterial vaginosis, it is not directly related to the client’s allergy to penicillin or the administration of cefoxitin.
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