A nurse is assessing a client who is receiving androgen therapy to treat endometriosis.
For which of the following adverse effects should the nurse monitor?
Weight loss.
Hypotension.
Muscle hypertrophy.
Edema.
The Correct Answer is D
Choice A rationale
Androgen therapy can lead to fluid retention, which would typically cause weight gain rather than weight loss. Androgens promote anabolism and can increase muscle mass and erythrocyte production, but they also influence fluid balance by affecting renal sodium and water reabsorption.
Choice B rationale
Androgen therapy generally does not cause hypotension. In some cases, it may lead to a slight increase in blood pressure due to fluid retention and effects on the renin-angiotensin-aldosterone system. Hypotension is not a recognized common adverse effect of androgen therapy.
Choice C rationale
Androgen therapy does promote muscle hypertrophy due to its anabolic effects, increasing protein synthesis and muscle mass. However, this is generally a desired therapeutic effect, not an adverse effect requiring monitoring for cessation, especially when used for conditions like muscle wasting.
Choice D rationale
Androgens can cause fluid retention, leading to edema. This occurs due to their influence on mineralocorticoid receptors in the renal tubules, which promotes sodium and water reabsorption. Nurses should monitor for signs of fluid overload, such as peripheral or pulmonary edema, and changes in body weight.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Ethinyl estradiol and norethindrone, a common oral contraceptive combination, can sometimes lead to weight gain rather than weight loss. This is often attributed to fluid retention and changes in appetite or metabolism, rather than a catabolic effect causing weight reduction.
Choice B rationale
Easy bruising is not a typical manifestation of ethinyl estradiol and norethindrone use. While some hormonal contraceptives can affect coagulation factors, leading to an increased risk of thrombosis, they do not generally cause increased capillary fragility or platelet dysfunction manifesting as easy bruising.
Choice C rationale
Oral contraceptives containing estrogen, such as ethinyl estradiol, can actually cause a slight increase in blood pressure in some individuals due to their effects on the renin-angiotensin-aldosterone system, leading to sodium and water retention. Low blood pressure is not a common adverse effect.
Choice D rationale
Breakthrough bleeding, or irregular uterine bleeding that occurs during hormone therapy, is a common adverse effect of combined oral contraceptives like ethinyl estradiol and norethindrone, especially during the initial cycles of use. It results from an imbalance in the hormonal effects on the endometrium.
Correct Answer is A
Explanation
Choice A rationale
Cromolyn is a mast cell stabilizer that works by inhibiting the release of inflammatory mediators like histamine from mast cells. This prophylactic action requires consistent, daily use to build up therapeutic levels and prevent the initiation of the asthmatic response, rather than acting as a rescue medication during an acute attack.
Choice B rationale
Using cromolyn as soon as one feels like wheezing is incorrect because cromolyn is not a bronchodilator and does not provide immediate relief for acute bronchospasm. Its mechanism of action involves stabilizing mast cells, which prevents the degranulation and release of inflammatory mediators, thus preventing symptoms from occurring.
Choice C rationale
Expecting to feel better in a week is an inappropriate timeframe for assessing cromolyn's efficacy. The full prophylactic benefits of cromolyn may take several weeks of consistent use to become apparent. Patients should be educated on the preventative nature and delayed onset of action.
Choice D rationale
While cromolyn can be used prophylactically before exercise, using it 2 hours before playing softball is not the recommended timing. For exercise-induced bronchospasm, cromolyn is typically administered 15 to 30 minutes prior to the activity to allow for adequate absorption and mast cell stabilization before exertion.
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