A gardener needs a decongestant because of seasonal allergy problems and asks the nurse whether he should take an oral form or a nasal spray. Which of these is a benefit of orally administered decongestants?

Choice A reason: The client waits 10 min between inhalations is not the correct answer. This is not a recommended practice for using an albuterol inhaler. The client should wait at least 1 min between inhalations to allow the medication to reach the lungs and avoid overdose.

Choice B reason: The client takes a quick inhalation while releasing the medication from the inhaler is the correct answer. This is the correct way to use an albuterol inhaler. The client should breathe in quickly and deeply while pressing down on the inhaler to release the medication. This ensures that the medication is delivered to the airways and not the mouth or throat.

Choice C reason: The client exhales as the medication is released from the inhaler is not the correct answer. This is not a recommended practice for using an albuterol inhaler. The client should exhale before using the inhaler, not during or after. Exhaling while using the inhaler can cause the medication to be wasted or to irritate the mouth or throat.

Choice D reason: The client holds his breath for 10 seconds after inhaling the medication is not the correct answer. This is not a recommended practice for using an albuterol inhaler. The client should hold his breath for only a few seconds after inhaling the medication, not 10 seconds. Holding the breath for too long can cause dizziness, headache, or chest discomfort.

Choice A reason: Venous thromboembolism is a contraindication for taking SERMs. SERMs are drugs that act like estrogen in some tissues and block estrogen in others. They can help prevent bone loss and fractures in postmenopausal women, but they can also increase the risk of blood clots in the veins, such as deep vein thrombosis and pulmonary embolism. Therefore, women who have a history of or are at high risk for venous thromboembolism should not take SERMs.

Choice B reason: Breast cancer is not a contraindication for taking SERMs. In fact, some SERMs, such as tamoxifen and raloxifene, are used to treat or prevent breast cancer in women who have estrogen receptor-positive tumors. These SERMs block the effects of estrogen in the breast tissue and reduce the growth of cancer cells.

Choice C reason: Hypocalcemia is not a contraindication for taking SERMs. Hypocalcemia is a low level of calcium in the blood. SERMs do not affect calcium levels directly, but they can help prevent calcium loss from the bones by mimicking the effects of estrogen in the bone tissue. However, women who take SERMs should also take adequate calcium and vitamin D supplements to maintain bone health.

Choice D reason: Stress fractures are not a contraindication for taking SERMs. Stress fractures are small cracks in the bones that result from repeated stress or overuse. SERMs can help prevent stress fractures by strengthening the bones and reducing the risk of osteoporosis. However, women who take SERMs should also avoid excessive or inappropriate physical activity that can cause stress fractures.