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 ["31"]
Explanation
To find out how many gtt/min the nurse should regulate the infusion;
We can use the following formula:
Flowrate(gtt/min) = Totalvolume(mL) / Time(min) × Dropfactor(gtt/mL)
Given:
Total volume = 500 mL
Time = 4 hours = 240 minutes (since 1 hour = 60 minutes)
Drop factor = 15 gtt/mL
Substituting the given values into the formula:
Flowrate(gtt/min) =500mL/240min ×15gtt/mL
After performing the calculation, we find that the flow rate equals 31.25 gtt/min.
So, the nurse should regulate the infusion to 31 gtt/min (rounded to the nearest whole number).
Correct Answer is B
Explanation
A) Expresses that they cannot get enough air to breathe: While this statement suggests respiratory distress, it is not as objective an assessment finding as a respiratory rate of 7 breaths/minute. Objective measurements are typically more reliable indicators for initiating interventions.
B) Respiratory rate of 7 breaths/minute: A respiratory rate of 7 breaths/minute is indicative of respiratory depression, which is a potential side effect of opioid analgesics like morphine sulfate. Naloxone is an opioid antagonist used to reverse opioid-induced respiratory depression. Administering a prescribed PRN dose of naloxone is appropriate to counteract the respiratory depression and prevent further complications.
C) Bilateral wheezing on auscultation: Wheezing is more commonly associated with bronchoconstriction or airway obstruction rather than opioid-induced respiratory depression. Naloxone is not indicated for wheezing unless there is concurrent opioid-induced respiratory depression.
D) Pulse oximeter reading of 89% on room air: While a pulse oximeter reading of 89% indicates hypoxemia, it may not be solely due to opioid-induced respiratory depression. Other factors, such as hypoventilation, ventilation-perfusion (V/Q) mismatch, or lung disease, could contribute to decreased oxygen saturation. Administering naloxone solely based on pulse oximetry readings may not address the underlying cause adequately. It is essential to assess the client comprehensively, considering clinical signs and symptoms along with objective data.
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