A nurse is collecting data from a client who has been taking medroxyprogesterone for 6 months. Which of the following statements by the client should the nurse identify as the priority to report?

I have occasional vaginal spotting."

I have developed brown patches on my face."

I have breast tenderness."

I have intermittent calf pain."

Answer and Explanation

The Correct Answer is D

A) I have occasional vaginal spotting: Vaginal spotting can occur as a side effect of medroxyprogesterone, especially in the first few months of use. While this should be monitored, it is not an immediate concern that requires urgent reporting unless the spotting becomes heavy or persistent, which could indicate other issues.

B) I have developed brown patches on my face: The development of brown patches on the face (known as melasma) is a known side effect of hormonal contraceptives, including medroxyprogesterone. Although this is an undesirable cosmetic effect, it is not an urgent medical concern that requires immediate attention.

C) I have breast tenderness: Breast tenderness is a common side effect of medroxyprogesterone and other hormonal medications. It is usually mild and resolves over time. While the client should continue to monitor the tenderness, it does not present an immediate risk or require urgent intervention.

D) I have intermittent calf pain: Intermittent calf pain could be a sign of a more serious complication, such as a deep vein thrombosis (DVT), especially since medroxyprogesterone can increase the risk of blood clots. This symptom should be reported immediately to the healthcare provider, as a DVT could potentially lead to a pulmonary embolism if left untreated, which is a life-threatening condition. Therefore, this is the priority finding to report.

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Correct Answer is D

Explanation

A) Cimetidine: Cimetidine is an H2 receptor antagonist used to treat gastrointestinal issues like heartburn or ulcers. It does not have a known significant interaction with enoxaparin. Therefore, it is generally considered safe to use with enoxaparin, but it may require monitoring for other potential drug interactions, such as those with warfarin, not enoxaparin specifically.

B) Docusate: Docusate is a stool softener commonly used to prevent constipation. It does not interact with enoxaparin and is safe for use with the medication. It helps relieve constipation without increasing bleeding risks, which is a concern with certain other medications.

C) Calcium supplement: Calcium supplements are generally safe to use with enoxaparin. There is no significant interaction between calcium and enoxaparin, and calcium is often recommended for clients to maintain bone health, especially in those who are at risk of osteoporosis. Therefore, calcium supplements do not pose a risk when taken with enoxaparin.

D) Naproxen: Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that increases the risk of bleeding. NSAIDs, including naproxen, inhibit platelet aggregation, which can potentiate the anticoagulant effects of enoxaparin and increase the risk of bleeding. Therefore, naproxen should be avoided in clients taking enoxaparin.

Correct Answer is []

Explanation

The client reports joint pain in the knee and wrist with a history of gout in the family. The elevated uric acid level (7.2 mg/dL) supports a diagnosis of gout, a condition caused by uric acid crystal deposition in the joints. The negative ANA and normal ESR make inflammatory autoimmune conditions like rheumatoid arthritis and systemic lupus erythematosus unlikely.

Actions to Take:

Instruct the client to avoid foods high in purines.

Purine-rich foods (e.g., red meat, shellfish, organ meats) contribute to increased uric acid production, exacerbating gout symptoms. Dietary modifications can help reduce flare-ups and long-term complications.

Instruct the client to apply topical analgesics.

Topical analgesics can provide localized pain relief and reduce discomfort in affected joints. They serve as an adjunct to systemic medications in managing acute symptoms.

Parameters to Monitor:

Uric acid levels.

Monitoring uric acid levels helps assess the effectiveness of dietary changes and medications in preventing flare-ups and reducing joint damage.

Joint deformities.

Chronic gout can lead to joint destruction and tophi formation, so assessing for deformities helps track disease progression and the need for further interventions.

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A nurse is collecting data from a client who has been taking medroxyprogesterone for 6 months. Which of the following statements by the client should the nurse identify as the priority to report?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client’s progress.

Correct Answer is []

Explanation

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