ATI Pharmacology Made Easy 4.0: The Reproductive & Genitourinary Systems

For rapid relief of urinary obstruction due to prosthetic enlargement, the health care provider should choose which of the following drugs? -Tamsulosin

An alpha1 adrenergic antagonist provides smooth muscle relaxation and rapid relief of urinary obstruction. It is often used in combination with finasteride. Finasteride may take 6 to 12 months for effects.

The provider talks with the client about clomiphene therapy. Which of the following instructions should the provider include? -C. Begin 5 days after menstruation begins and take it every day for next 5 days.

C, The client should start taking clomiphene 5 days after her ministration begins and continue taking it every day for the next 5 days. She may repeat this dosing schedule at 30 day intervals for three cycles. The primary care provider might recommend taking human chorionic gonadotrophin 7 to 9 days after clomiphene use or 17 to 19 days after menstruation begins.

One month later, the client tells the provider that she has developed some adverse effects. Which of the following effects does clomiphene cause? (Select all that apply) -Blurred vision -Hot flashes -Breast engorgement -Nausea

Clomiphene can cause visual disturbances. The client should avoid driving and engaging in activities that may be dangerous and if the symptoms persist she should have an ophthalmology examination. For severe vision changes she should stop taking the drug. It may also cause hot flashes and breast engorgement. It might help if she wears loose fitting clothing, applies cold compresses to her breast, and wears a supportive bra. Nausea and vomiting may develop with clomiphene therapy. If they do she could try taking the drug with food to minimize these effects. Clomiphene is more likely to cause abdominal pain than muscle pain.

The provider should instruct the client to do which of the following? -Take a pregnancy test

Clomiphene is a pregnancy risk with teratogenic effects. If there is any suspicion of pregnancy, the client should stop taking the drug immediately and take a pregnancy test.

A client is given conjugated estrogen and medroxyprogesterone acetate to treat postmenopausal vasomotor symptoms. The health care provider instructs the client to monitor for which of the following, which may indicate a serious adverse effect of the conjugated estrogen and medroxyprogesterone acetate? -Swelling or pain in calf

Conjugated estrogen and medroxyprogesterone acetate a combination estrogen plus progestin hormone replacement may cause thromboembolism. The client should be instructed to report any redness or swelling of the calf or SOB. It is unlikely to cause tinnitus. It may cause N&V & constipation. It's is unlikely to cause insomnia. Alendronate may cause difficulty swallowing.

Match the pharmacologic term in the left column with a therapeutic use in the right column

Dinoprostone - Induces uterine contractions Terbutaline- Stops uterine contractions Human chorionic gonadotropin - Stimulates ovulation Medroxyprogesterone- Treats endometriosis

Match the pharmacologic term in the left, column with a therapeutic use in the right column

Finasteride - Benign prostatic hypertrophy Oxybutynin chloride - urinary incontinence Slidenafil - erectile dysfunction Testosterone - male puberty induction

A client is prescribed finasteride to treat benign prosthetic hypertrophy. When providing instructions about the finasteride, the nurse should include which of the following information? -Allow 6 to 12 months to see improvement

Finasteride may take 6 to 12 months to reduce symptoms. It may be taken with or without food. It is not necessary to avoid fatty foods. It is unlikely to cause photosensitivity and unlikely to cause drowsiness or sedation. Advise client drug therapy is lifelong.

A client is prescribed testosterone to treat testicular failure. The nurse instructs the client to monitor and report which of the following? -Weight gain

Instruct the client to monitor weight. testosterone may cause sodium & water retention and Edema. Monitor I&O and weight and sodium level. instruct client to report swelling in legs or feet. testosterone is unlikely to cause paresthesia or dizziness. Clomiphene May cause dizziness. Testosterone is unlikely to cause SOB. SOB may be caused by a thromboembolism an adverse effect of medroxyprogesterone acetate.

Combination oral contraceptives such as ethinyl estradiol and drospirenone should be used with caution in clients with which if the following disorders? -Diabetes

It may cause glucose intolerance. Clients with diabetes may need to increase the dosage of insulin or diabetic agent. Monitor serum glucose carefully. Combination oral contraceptives are unlikely to adversely affect clients with hypothyroidism. Clients with an increased risk for clotting such as a history of thrombophlebitis should not use oral contraceptives. Combination oral contraceptives are unlikely to adversely affect clients with thrombocytopenia. Clients with osteoporosis may take combination oral contraceptives.

A client is prescribed clomiphene for infertility. The health care provider instructs the client on clomiphene to monitor for which of the following? -Pelvic pain

Lower abdominal or pelvic pain may indicate ovarian hyperstimulation and may lead to ruptured ovarian cyst. Clients should be monitored carefully for ovarian enlargement and seek medical attention immediately for sudden or severe pelvic pain.

The health care provider administers oxytocin for induction of labor. The health care provider should monitor which of the following in order to assess for an adverse reaction of oxytocin? (Select all that apply) -Urine output -Blood pressure -Duration of contraction -Fetal HR

Oxytocin a uterine stimulant may cause water retention. Monitor I&O and indications of water intoxication such as drowsiness or headache. Oxytocin may cause hypertensive crisis. Monitor blood pressure and fetal and maternal heart rate. Oxytocin may cause uterine hyperstimulation and fetal distress. Monitor length, strength and duration of contractions. Stop infusion, turn client to side and report contractions lasting longer than 60 seconds. Oxytocin is unlikely to affect level of consciousness but it can cause anxiety.

Which of the following drugs should the nurse have available to reverse the adverse effects of terbutaline? -Propanolol (Inderal)

Propranolol is a beta adrenergic antagonist. It slows the HR & reduces the cardiac irritability terbutaline causes. Naloxone is an opioid antagonist that reverses the affects of opioids. Neostigmine, a cholinergic inhibitor, reverses the effects of pancuronium, a nondepolarizing neuromuscular blocking agent. Atropine is an anticholinergic drug that reverses the effects of acetylcholine or muscarinic drugs.

For which of the following clients should a health care provider question the use of sildenafil to treat erectile dysfunction. A client who is taking: -Nitroglycerin as needed for chest pain

Severe hypotension May result if nitroglycerin and sildenafil are used together. Avoid concurrent use. Monitor for hypotension. Sildenafil may be used in clients taking oxybutynin chloride, phenytoin or thyroid.

Recognizing the adverse effects of terbutaline, the nurse should monitor the client for which of the following? -Tachycardia

Terbutaline, a beta2-adrenergic agonist may cause tachycardia in both the client and in the fetus. Monitor V/S carefully including the fetal monitor for tachycardia. Hyperglycemia rather than hypoglycemia is an adverse effect of terbutaline. Hypokalemia rather than hyperkalemia may occur when taking terbutaline. Terbutaline relaxes bronchial constriction & is used to treat asthma therefore wheezing is not an adverse effect of this drug.