Assignment 5: Chap 7, 8: Womens & Men

Androgens may be prescribed to women to treat conditions related to the effects of the female sex hormones. Danazol is prescribed to prevent or treat fibrocystic breast disease and: alopecia. endometriosis. folic acid deficiencies. toxic shock syndrome.

endometriosis. Danazol may be used in women to prevent or treat endometriosis and fibrocystic breast disease.

A nurse is caring for a 25-year-old clinic client who is starting on birth control pills. What statement by the client indicates that she needs further teaching? "I will monitor my weight and have my blood pressure checked in 3 months." "I know my nausea is common, but it should subside in a few weeks." "I may gain or lose weight while I am taking these pills." "I will exercise more if I experience chest or leg pain."

"I will exercise more if I experience chest or leg pain." Chest or leg pain may be indicative of a thrombus, and medical care should be sought immediately. The other options are correct statements but do not address the question asked.

The nurse counsels a client taking sildenafil to avoid which beverage prior to or while using this medication? Alcohol Electrolyte replacement beverage Carbonated beverages Whole Milk

ALCOHOL Clients who take sildenafil should not take this medication with any beverage that includes alcohol. It increases the risk of orthostatic hypotension, tachycardia, dizziness, and headache.

What would danazol (Danocrine) be administered to women for? Prevent toxic shock syndrome Decrease symptoms of endometriosis Increase hair growth Reverse folic acid deficiencies

Decrease symptoms of endometriosis Danazol may be used in women to prevent or treat endometriosis or fibrocystic breast disease. Danazol is not prescribed for increased hair growth, to reverse folic acid deficiencies, or to prevent toxic shock syndrome.

When fluoxymesterone is administered to a 14-year-old male, what is the expected result? Virilization Lessening of depression Decrease in facial acne Development of sexual organs

Development of sexual organs In prepubertal boys, administration of androgens will stimulate development of masculine characteristics. These include development of sex organs, deepened voice, and development of body musculature. Virilization is an adverse effect associated with the use of anabolic steroids in females. There is no expected impact on acne or depression.

Chapter 8: Mens: A 28-year-old female client with endometriosis is taking danazol (Danocrine) as treatment. The client is upset about increased facial hair, a weight gain of 15 pounds, and a change in her voice, and she discusses her concerns with the nurse. What nursing diagnoses would be most appropriate for this client? Sexual dysfunction related to androgenic effects Acute pain related to need for injections Disturbed body image related to drug therapy Deficient knowledge regarding drug therapy

Disturbed body image related to drug therapy The client is concerned about the way she looks and the sound of her voice. The most appropriate nursing diagnosis would be disturbed body image. Danazol is not administered by injection, therefore, acute pain would not be applicable. Sexual dysfunction and deficient knowledge would be possible nursing diagnoses for this client, but the concerns expressed by the client fail to support these diagnoses.

Androgen deficiency states are a major indicator for administration of anabolic steroids, which include all of the following except: Hypergonadism. Oligospermia. Testicular dysfunction. Cryptorchidism.

Hypergonadism. The most clear-cut indication for use of anabolic steroids is to treat androgen deficiency states such as hypogonadism, cryptorchidism, impotence, and oligospermia. Hypogonadism may result from hypothalamic-pituitary or testicular dysfunction.

A client is prescribed testosterone gel. Which would the nurse include in the teaching plan? Select all that apply. Waiting 5 minutes after opening the gel packet to apply the gel. Washing hands with soap and water after applying. Applying the gel once daily in the morning. Allowing the application site to dry before getting dressed. Rubbing the gel vigorously on the scrotum.

Washing hands with soap and water after applying. Applying the gel once daily in the morning. Allowing the application site to dry before getting dressed. The nurse would instruct the client to apply the gel once daily in the morning to clean, dry, intact skin of the shoulders and upper arms or abdomen. After the packet is opened, the contents are squeezed into the palm of the hand and immediately applied to the sites. The sites are allowed to dry before the client gets dressed. The gel is not applied to the genitals. The client should wash his hands well with soap and water after applying.

A 20-year-old woman will soon begin taking oral contraceptives for the first time. What advice should the nurse provide to this client? "It will take 10 to 12 weeks before the birth control pills will actually prevent pregnancy, so be vigilant with other contraceptives until then." "Some women get some pain in their chest or abdomen when they take oral contraceptives, but this will pass as your body gets used to them." "You need to carefully consider whether you might want to get pregnant later in your life." "Make sure to seek care quickly if you experience bad headaches, calf pain, or changes in vision."

"Make sure to seek care quickly if you experience bad headaches, calf pain, or changes in vision." An important nursing intervention is teaching about signs and symptoms of potential complications of estrogen and progestin contraceptives. These may include headaches, vision changes or pain in the calves, abdomen or chest and should be reported promptly. The use of oral contraceptives does not preclude future pregnancy. There is not a 10- to 12-week time span between the initiation of oral contraceptives use and the prevention of pregnancy.

After teaching a woman using an intravaginal estrogen preparation, the nurse determines that the teaching was successful when the client states that she will remain lying for at least how long after instilling the drug? 45 minutes 10 minutes 30 minutes 20 minutes

30 minutes After an intravaginal application, the client should remain in the recumbent position for at least 30 minutes for optimal absorption. Times of 10 and 20 minutes are not the optimal time. The time of 45 minutes does not enhance medication effects.

A nurse is reviewing the medication history of a client. The nurse understands that a PDE5 inhibitor would be inappropriate for a client taking: Ketoconazole. Indinavir. Erythromycin. Nitroglycerin.

Nitroglycerin. The PDE5 inhibitors cannot be taken in combination with any organic nitrates or alpha-adrenergic blockers because serious cardiovascular effects may occur, including death. Increased PDE5 inhibitor levels and effects may be seen with ketoconazole, indinavir, and erythromycin; the dosage of the inhibitor would need to be reduced.

The nurse is caring for a woman who is receiving estrogen for treatment of amenorrhea. What evidence will the nurse use to indicate that the medication is working properly? Occurrence of menstruation Decrease in hot flashes Appearance of secondary sexual characteristics Lack of menstruation

Occurrence of menstruation Amenorrhea is the lack of menstruation so an indication that the estrogen has been effective is the occurrence of menstruation.

A nurse is obtaining a history from an older adult woman. During the interview, the woman states, "When I feel like I have to urinate, the urge is really strong and I go to the bathroom really frequently, often waking up several times during the night to go." The nurse would most likely identify this as which condition? overactive bladder syndrome urge incontinence stress incontinence neurogenic bladder

overactive bladder syndrome Overactive bladder syndrome involves conditions of urgency, frequency, and nocturia, with or without incontinence. Stress incontinence involves losing urine without meaning to during physical activity. Urge incontinence involves the strong, sudden need to void due to bladder spasms or contractions. Neurogenic bladder refers to impaired bladder function caused by a nervous system abnormality.

After teaching a patient who is prescribed estradiol vaginal cream, the nurse determines that the patient has understood the instructions when she states that she will administer the medication at which frequency? Once a month Once every other day Once a week Once a day

Once a day Intravaginal estradiol is administered every day.

Estradiol (Estraderm) is administered to postmenopausal women to prevent which condition? Endometriosis Osteoporosis Uterine cancer Dysfunctional uterine bleeding

Osteoporosis Estrogen is given to prevent osteoporosis. Observe for improved bone density tests and absence of fractures. Endometriosis and dysfunctional uterine bleeding do not occur in post menopausal women. Estrogen does not prevent uterine cancer.

Women generally do not eat foods high in calcium, which means that women of all ages generally consume less than the recommended amount of calcium. What supplement may be helpful in reducing bone loss? Vitamin C Vitamin D Vitamin B12 Vitamin A

Vitamin D Menopause is associated with loss of many of the effects of estrogen and progesterone on the body, including retention of calcium in the bones, lowered serum lipid levels, and maintenance of secondary sex characteristics. Calcium and vitamin D supplementation may be helpful in reducing bone loss and preventing the morbidity associated with osteoporotic fractures.

A nurse teaching a 57-year-old client about the factors that must be considered around the use of hormone replacement therapy (HRT) should discuss what increased risk associated with the therapy? venous thromboembolism bronchiectasis malignant hyperthermia Crohn's disease

venous thromboembolism Studies have demonstrated no evidence for HRT in secondary prevention of heart disease and showed increased rates of CHD, thromboembolic stroke, venous thromboembolism, dementia, and breast cancer.

What statement by the client prescribed a combination contraceptive several months ago indicates a need for health education? "I've been checking my blood pressure at the drug store from time to time since I started on the pill." "I've learned that the pill is almost 100% effective if you take it on schedule." "It's good to know that the pill protects against some sexually transmitted infections (STIs)." "I didn't know that some people take the pill for problems with their period, not to avoid getting pregnant."

"It's good to know that the pill protects against some sexually transmitted infections (STIs)." Oral contraceptives provide no protection against STIs. Effectiveness approaches 100%, and blood pressure monitoring is appropriate and necessary. Health care providers also use oral contraceptive preparations to treat menstrual disorders.

The nurse is counseling a woman who is concerned about fertility. The woman asks how to chart her ovulation. The nurse should explain that, on average, ovulation occurs on which day of a 28-day cycle? 14 12 1 10

14 Cyclical changes in the ovaries occur in response to FSH and LH. The average cycle is 28 days and ovulation is typically in the middle of the cycle, between the FSH and LH phases of the cycle. Although 14 days is most likely the time of ovulation, the client can still get pregnant.

A client has been prescribed transdermal estradiol. What important information does the nurse share with this client? Avoid prolonged sun exposure The estrogen levels with this route of administration mimic menopause. There is more nausea with this type of administration than the oral route. The client won't feel any effects of this medication for 2 weeks.

Avoid prolonged sun exposure Clients who use transdermal estradiol should avoid prolonged sun exposure because the total amount of drug absorbed and the resulting plasma drug concentrations from transdermal estrogen can increase during exposure to heat.

A client has begun treatment for penile erectile dysfunction. What explanation should the nurse provide regarding the primary effect a prescribed phosphodiesterase type 5 inhibitor will have on this condition? This classification of medications have virtually no adverse reactions The emotional distress associated with this dysfunction is eliminated This classification of medication can be administered orally Blood flow to the penis will be improved

Blood flow to the penis will be improveD Phosphodiesterase type 5 inhibitors are drugs used in the treatment of erectile dysfunction that cause smooth muscle relaxation, allowing the flow of blood into the corpus cavernosum. While it is true the medication is administered orally, that is not the address the effect it has on the function of the penis. Neither of the remaining options provide accurate information about the medication or it's affect on the penis.

A young male patient, age 14, has been prescribed testosterone for delayed onset of puberty. Follow-up care includes a visit to the clinic at least every 6 months for ongoing assessment. It will be most important for the nurse to monitor: Fluid intake and output Sodium and potassium levels Bone growth Hemoglobin levels

Bone growth When testosterone is used in prepubescent boys to treat hypogonadism or delayed onset of puberty, the premature closure of the long bones may lead to stunted growth. To monitor the action of testosterone on the patient, radiographs should be taken every 6 months to assess bone age. Radiographs help document bone maturation and the effect of testosterone on the epiphyseal centers. Although it is important to assess a patient's fluid intake and output, hemoglobin and hematocrit levels, and sodium and potassium levels, in this situation assessing bone growth would be the most important.

A client is receiving androgen therapy. Which would cause the nurse the greatest concern? Increased creatinine level ' Increased creatinine clearance Elevated liver enzyme levels Decreased thyroid function

Elevated liver enzyme levels Elevated liver enzyme levels indicate impaired hepatic function that could be related to the development of hepatocellular cancer—a potential and life-threatening effect associated with androgen therapy. Decreased thyroid function and increased creatinine and creatinine clearance levels are not associated with disease states and can last for up to 2 weeks after discontinuing therapy.

The nurse is instructing the parents of an 11-year-old male who has testosterone deficiency. Which symptom, if found in this child, would cause the discontinuation of this medication? Improved school skills Increased appetite Skeletal growth Enlarged penis

Enlarged penis Testosterone therapy would be discontinued if the child demonstrated signs of precocious sexual puberty such as enlargement of the penis. It would also be discontinued if the epiphyseal plate showed signs of early closure.

A client is menopausal and has been given a prescription for estrogen. She asks the nurse what some of the risks are in taking this medication. The nurse's best response is: Estrogen decreases the risk of dementia, myocardial infarctions, strokes, breast cancer, and blood clot. Estrogen has not been proven to increase any medical conditions. As long as estrogen and progesterone are taken together, there are no increased health risks. Estrogen increases the risk of certain cancers, myocardial infarctions, and blood clots.

Estrogen increases the risk of certain cancers, myocardial infarctions, and blood clots. The FDA has issued a BLACK BOX WARNING that estrogens increase the risk for developing cancer of the uterus. The warning instructs individuals who take estrogens with or without progestins of the increased risk of dementia, myocardial infarctions, strokes, breast cancer, and blood clot.

A patient presenting with an androgen deficiency state is prescribed an oral anabolic steroid. A higher dose of steroid is indicated due to its: Antagonistic effects on male sex hormones. High excretion rate in feces. Being metabolized more slowly by the kidneys. Extensive metabolism in the first pass through liver.

Extensive metabolism in the first pass through liver. Oral testosterone is extensively metabolized on its first pass through the liver so that nearly half a dose is lost before it reaches systemic circulation.

Testosterone is injected directly into the corpus spongiosum. False True

False Alprostadil is injected directly into the corpus cavernosum. Testosterone may be injected intramuscularly.

A 9-year-old boy is taking testosterone injections for treatment of hypogonadism. What should be measured every 6 months on this child? Vision Hand and wrist epiphyseal growth plates LFT Cholesterol level

Hand and wrist epiphyseal growth plates Arrange for radiographs of the long bones of children every 3 to 6 months, so that the drug can be discontinued if bone growth reaches the norm for the child's age. It would not be necessary to measure LFTs, cholesterol levels, or the child's vision.

The nurse is instructing a client who will be taking finasteride for treatment of benign prostatic hypertrophy and gives the client information about which possible sexual side effects? (Select all that apply.) Impotence Shriveled testicles Decreased volume of ejaculate Priapism Reduced libido

Impotence Decreased volume of ejaculate Reduced libido Clients taking finasteride may develop impotence, infertility, gynecomastia, reduced libido, and ejaculatory disorders, such as decreased volume of ejaculate.

The nurse is caring for a woman who went through menopause 5 years earlier. The nursing plan of care for this client includes teaching related to the importance of what dietary change? Increased fluid intake to prevent dehydration from increased urination Reduced caloric intake because of lower activity levels Increased calcium intake to reduce calcium loss in bones Increased intake of fatty foods to maintain lipid levels

Increased calcium intake to reduce calcium loss in bones Estrogen and progesterone levels are reduced in menopause resulting in loss of protective mechanisms provided by these hormones. The client requires extra calcium intake to prevent osteoporosis caused by loss of calcium in the bones. Serum lipid levels rise after menopause, thus putting the woman at increased risk of heart disease so the client should be taught to limit fat intake. Post-menopausal women's activity levels do not need to decline and they may be as active as they wish to be. No need exists for increased fluid intake secondary to menopause.

In older adult men, anabolic steroids may be prescribed for a deficiency condition. If hypertensive, what might be the cause for an increase in blood pressure? Potassium retention Increased bioavailability of androgens Increased RBD production Increased fluid and sodium retention

Increased fluid and sodium retentioN Sodium and water retention are associated with androgen and anabolic steroid use, which aggravates hypertension.

The nurse is discussing the use of vaginal estrogen for a woman with vaginal atrophy. The nurse knows that vaginal estrogen has what advantage over other forms of estrogen? It can be used in women of all ages. It treats the vaginal tissue with little systemic effects. It causes no adverse effects. It takes away all symptoms of menopause.

It treats the vaginal tissue with little systemic effects. Vaginal estrogen is prescribed because it treats vaginal tissue with little systemic effects.

People taking anabolic steroids may experience which adverse effect? Elevated blood glucose level Bradycardia Elevated BUN Jaundice

Jaundice Like the androgens, the anabolic steroids are well absorbed and widely distributed throughout the body. They are metabolized in the liver and excreted in the urine.

The nurse is assessing a 22-year-old male. What symptoms would indicate that this client may be experiencing androgen deficiency? (Select all that apply.) Large amount of pubic hair Low sperm count Very small testicles Enlarged penis Inability to have an erection

Low sperm count Very small testicles Inability to have an erection Signs of androgen deficiency include hypogonadism, cryptorchidism, impotence, and oligospermia.

A teenage client who is using testosterone to treat a hormone deficiency calls the clinic to report acne-like skin eruptions on the face. How should the nurse counsel this client? Gradually decrease the dose of testosterone. Make an immediate appointment with a dermatologist. Stop taking this drug immediately. Practice frequent and thorough skin cleansing.

Practice frequent and thorough skin cleansing. Teenage clients who use testosterone often report acne. The best practice is for clients to practice frequent and thorough skin cleansing. It is not necessary to see the dermatologist again but the client should not stop or decrease the dosage of the medication without first having a discussion with the dermatologist.

The nurse instructs the client taking medication for erectile dysfunction to call the health care provider if which adverse effect occurs after taking the medication? Nasal congestion Lack of erection Priapism Flushing of the face

Priapism The client should contact the health care provider if priapism occurs or if the client has an erection for longer than 4 hours. Lack of erection indicates the medication has not been effective, and flushing of the face and nasal congestion are adverse effects of the medication but would not require contacting the provider.

A patient is receiving estrogen therapy. What would the nurse instruct the patient to report immediately? Abdominal bloating Shortness of breath Dizziness Weight gain

Shortness of breath Estrogens are associated with the development of thrombi and emboli. Reports of shortness of breath may indicate a possible pulmonary embolism necessitating emergency treatment. Abdominal bloating, weight gain, and dizziness are common adverse effects of estrogen therapy that should be reported, but it is not necessary to report them immediately.

A group of students are reviewing the drugs available for treating penile erectile dysfunction. The students demonstrate understanding when they identify which drug as a PDE5 inhibitor? Sildenafil Danazol Alprostadil Oxandrolone

Sildenafil Sildenafil is a PDE5 inhibitor used to treat penile erectile dysfunction. Alprostadil is a prostaglandin. Oxandrolone is an anabolic steroid. Danazol is an androgen

The anatomy and physiology instructor is discussing the action of endogenous estrogen on the body. What effect would the instructor tell the students estrogen has on breast tissue in the body? Depresses formation of connective tissue during the 3rd decade of life Stimulates construction of lacrimal ducts Restricts deposition of fat to abdomen and thighs Stimulates growth of breasts in early adulthood

Stimulates construction of lacrimal ducts Estrogens are important for the development of the female reproductive system and secondary sex characteristics.

Anabolic steroids are analogs of testosterone with increased protein-building effects. True False

TRUE The anabolic steroids are testosterone analogues with more anabolic or protein-building effects than androgenic effects.

A client diagnosed with benign prostatic hypertrophy (BPH) is prescribe tamsulosin. The client communicates with the nurse about a friend that was prescribed sildenafil for his BPH. Which is the nurse's best response regarding the difference in the use of the two drugs for BPH? Sildenafil is recommended for initial therapy of BPH. Tamsulosin relaxes muscles in the prostate and bladder and increases ability to urinate. Tamsulosin is recommended for long-term therapy of BPH. Sildenafil activates nerves in the head and neck and decreases blood pressure.

Tamsulosin relaxes muscles in the prostate and bladder and increases ability to urinate. The alpha-1 adrenergic blockers (tamsulosin) are recommended over PDE5 inhibitors (sildenafil) for initial monotherapy for the treatment of BPH. Alpha-1 adrenergic blockers (tamsulosin) provide immediate therapeutic benefits, while PDE5 inhibitors (sildenafil) require long-term treatment (6-12 months) before symptom improvement. Tamsulosin relaxes muscles in the prostate and bladder and increases the client's ability to urinate. Sildenafil improves ED by a vasodilatory effect in the smooth muscle of the corpus cavernosum.

After speaking with college students about birth control, the nurse realizes more education is needed when one student says: "I may have some nausea and vomiting when I first start taking these pills." "Birth control pills will help prevent sexually transmitted diseases." "I should try to always take my pill at the same time each day." "If my legs start to swell and hurt, I should seek medical help immediately."

"Birth control pills will help prevent sexually transmitted diseases." Oral contraceptives are effective at preventing pregnancy but will not prevent STDs. Abstinence and physical barriers, such as condoms, are the most effective at preventing the spread of STDs.

Which statement indicates that the client understands the follow-up needed after an injection of Depo-Provera? "I know that I will need to return in 6 months for another injection." "I know that I do not need to worry about STDs after getting this injection." "I know that this injection lasts for 3 months." "I know that this injection is good for 1 year."

"I know that this injection lasts for 3 months." Long-acting progestin contraceptive preparations such as the intramuscular depot medroxyprogesterone (Depo-Provera) last 3 months per injection; intrauterine progesterone lasts 1 year; and levonorgestrel subcutaneous implants (Norplant) last 5 years.

The health care provider has ordered a variety of laboratory assessments on a client who will need estrogen replacement. The follow labs are ordered: blood urea nitrogen (BUN), creatinine, and liver function tests (LFTs). What is the nurse's best statement explaining to a client the need to draw the labs? "Medication adjustments are based on baseline laboratory values." "The labs will identify your body's ability to filter and excrete medications." "I will get the prescriber to talk to you about the laboratory assessments ordered." "Additional labs will be ordered if these values indicate problems with your body."

"The labs will identify your body's ability to filter and excrete medications." Estrogens are used cautiously in a variety of disease processes, including liver impairment. The liver filter or metabolizes medications. The kidneys are the main organ that excretes medications. The nurse is providing a rationale to the client about drawing laboratory assessments. Medication adjustments are based on baseline laboratory values, but this does not explain why labs are needed currently. The health care provider or the nurse can discuss the laboratory assessments when they are completed. Additional labs may be ordered on a future date but teaching is focused on the need for labs currently.

A new client telephones the clinic requesting a renewal prescription for contraceptives she has been taking for 4 years. It has been more than a year since her last health care visit, but she is unable to come into the clinic until next month. She insists she is "doing fine" on this medication and must have her prescription now. Considering the circumstances and related safety issues, how should the clinic nurse respond? "Since you are doing well on this regimen, I'll arrange to get the prescription filled for a month to last until your clinic appointment." "Before estrogen based drugs are prescribed, you must see the health care provider to get an order for a mammogram." "If you have a physical within 2 years, I can get your medication refilled." *"Before the drugs are prescribed, a complete medical history, physical examination, Pap test, urinalysis, and weight and blood pressure measurements are recommended."

*"Before the drugs are prescribed, a complete medical history, physical examination, Pap test, urinalysis, and weight and blood pressure measurements are recommended." Because estrogens, progestins, and hormonal contraceptives are often taken for years and may cause adverse reactions, clients taking these drugs need continued supervision by a health care provider. Before the drugs are prescribed, a complete medical history; a physical examination including breast and pelvic examinations and a Pap test; urinalysis; and weight and blood pressure measurements are recommended. These examinations should be repeated at least annually if the client is taking the drugs.

A client is receiving a medroxyprogesterone contraceptive injection. The nurse would instruct the client to return for the next dose at which time? 1 year 6 months 3 years 3 months

3 months Medroxyprogesterone, a synthetic progestin used in the treatment of abnormal uterine bleeding and secondary amenorrhea, is also used as a contraceptive. This drug is given IM every 3 months. Longer than this time frame the medication is not effective for contraception.

What would a nurse attribute to estrogen? Breast growth Thickened cervical mucus Increased body temperature Increased appetite

Breast growth Although progesterone plays a role in breast growth to prepare for lactation, estrogen plays a major role in breast growth overall. Progesterone is responsible for thickened cervical mucus, increased body temperature, and increased appetite.

A female patient receiving fluoxymesterone, an androgenic drug, for metastatic breast cancer is disturbed by the physical changes seen in her body. Which feature of virilization may be seen in the patient receiving this therapy? Hypopigmentation of the skin Increase in body weight Deepening of the voice Decrease in clitoris size

Deepening of the voice Deepening of the voice may be seen as a feature of virilization following male hormone therapy in a female patient. Virilization is the acquisition of male characteristics in the female. Other features of virilization include pigmentation, and not hypopigmentation, of the skin, and increase, not decrease, in the size of the clitoris. Increase in body weight is not a sign of virilization. It may occur due to impaired nutrition of the body.

A client who is taking an estrogen reports swelling and weight gain. The nurse notes some peripheral edema. Which nursing diagnosis would the nurse identify as the priority? Fluid volume excess Ineffective peripheral tissue perfusion Imbalanced nutrition, less than body requirements Acute pain

Fluid volume excess The client is experiencing fluid retention, which makes this nursing diagnosis appropriate. This nursing diagnosis would be appropriate if the client was experiencing a decreased intake due to nausea and vomiting. Acute pain would be appropriate if the patient was experiencing headache or abdominal cramping. This nursing diagnosis would be appropriate if the patient was experiencing signs and symptoms of a thromboembolic disorder.

A client with a history of benign prostatic hypertrophy (BPH) is seeking androgenic medication treatment for penile erectile dysfunction. What information should the nurse provide the client regarding this therapy? It will likely require an extensive period of therapy It has been associated with type 2 diabestes It increases the risk for prostate cancer It could trigger adult onset asthma

It increases the risk for prostate cancer Benign prostatic hypertrophy, a common problem in older men, may be aggravated by androgenic effects that may enlarge the prostate further, leading to urinary difficulties and increased risk of prostate cancer. None of the other options present accurate information regarding this therapy.

A male clent who uses a transdermal testosterone gel for treatment of his oligospermia applies the medication first thing in the morning and washes it off before bed. What client education is necessary? Only use the gel at times of procreation. Use additional doses of the gel. Use the same amount of doses, just increase the amount of gel used. Leave the gel on until the next application is due.

Leave the gel on until the next application is due. Topical gel produces normal serum testosterone levels within 4 hours of application, and the absorption continues for 24 hours. Steady-state serum concentrations occur by the second or third day of use. When gel use is discontinued, serum testosterone levels remain steady for 24 to 48 hours but decrease to pretreatment levels within about 5 days.

When educating a client prescribed testosterone transdermal patch therapy, the nurse will provide what information regarding patch placement? Clean skin sites with alcohol prior to application of the patches Place the patches on the back, abdomen, upper arms, or thighs. The new patch should be applied upon arising each morning Rotate the application sites to allow for a 15-day rotation cycle

Place the patches on the back, abdomen, upper arms, or thighs. Instructions should stress applying two Androderm systems nightly to clean, dry skin on back, abdomen, upper arm, or thigh. Do not apply to scrotum. Rotate sites, with 7 days between applications to a site.

During pregnancy, what becomes a massive endocrine gland? Embryo Umbilical cord Placenta Uterus

Placenta The placenta serves as a massive endocrine gland during pregnancy, maintaining high levels of estrogen and progesterone to support the uterus and developing fetus. The umbilical cord is important for nutrient and oxygen exchange between the fetus and the mother. The embryo implants in the wall of the uterus and becomes the developing fetus. The uterus provides the area for implantation of the embryo and growth of the fetus.

A client is in the clinic for a follow-up visit after having been on hormone replacement therapy for 3 months. Which report by the client would immediately concern the nurse? A craving for sugar A decrease in weight-bearing exercise Smoking a pack of cigarettes a day Gaining ten pounds in the last 3 months

Smoking a pack of cigarettes a day All of the options are poor health habits and will affect the client's health. However, the immediate concern is smoking. The nurse should stress that women who take estrogen should not smoke because of the increased risk for thrombotic events. A weight gain of 10 pounds, a craving for sugar, and a decrease in weight-bearing exercise would not immediately concern the nurse.

A 27-year-old woman is concerned that she is pregnant even though she has been using oral contraceptives. During the assessment, the nurse discovers the client has been using various herbs. Which of the following herbs is contraindicated for use with oral contraceptives? St. John's wort Valerian Chamomile Pennyroyal

St. John's wort St. John's wort is commonly used for depression. It is known to increase the breakdown of estrogen, which decreases its effectiveness. It also appears to increase metabolism allowing breakthrough bleeding, follicle growth, and ovulation with unplanned pregnancies.

A female client expresses the desire to suppress her female sex characteristics to facilitate a transition to being male. Which androgen does the nurse anticipate the provider will prescribe? Testosterone Progesterone Estrogen Dihydrotestosterone (DHT)

Testosterone Prescribers may order male sex hormones for women to antagonize or reduce the effect of female sex hormones. Administration of androgen (DHT) or anabolic steroids to women causes suppression of menstruation and atrophy of the endometrial lining of the uterus. Progesterone and estrogen are common androgens of the female client and so would not facilitate transition to male sex characteristics.

What aspect of a client's current health status may contraindicate the use of a PDE5 inhibitor? The client has a history of unstable angina pectoris. The client has type 2 diabetes and takes glyburide daily. The client is morbidly obese. The client takes phenytoin for the prevention of seizures.

The client has a history of unstable angina pectoris. Clients who are not sufficiently healthy to engage in sex should not be prescribed PDE5 inhibitors. Unstable angina may preclude the exertion necessary for sexual activity, and it is often treated with nitrates, contraindicating the use of PDE5 inhibitors. Obesity, diabetes, seizures, and the use of antiseizure medications do not contraindicate PDE5 inhibitors.

A 20-year-old woman has been prescribed estrogen. As with all women taking estrogen, the nurse will carefully monitor the client for: decreased libido. a decrease in secondary sexual characteristics. early epiphyseal closure. cardiovascular complications.

cardiovascular complications. Women taking estrogen are at an increased risk of cardiovascular complications, along with ovarian and breast cancer. Early epiphyseal closure is a condition the nurse would watch for in a prepubescent girl who takes estrogen. Diminished libido and lack of secondary sexual characteristics are not identified adverse effects of estrogen.

A 21-year-old woman is prescribed an oral contraceptive pill to prevent pregnancy. The nurse should inform the client of which adverse effects of this medication? Nausea Cessation of bleeding and/or spotting Weight loss Reduction of breast tissue

nausea Taking combination oral contraceptives is commonly accompanied by nausea. The nurse should tell the client to anticipate this adverse effect. Breakthrough bleeding or spotting is likely with the medication. The nurse would be incorrect to inform the client that bleeding with cease completely. More commonly, clients taking oral contraceptives experience mild to moderate weight gain, not loss. Breast swelling and tenderness is common with this medication, not a reduction in breast tissue.