REPRODUCTIVE AND GENITOURINARY
A health care professional is caring for a patient who is taking bethanechol (urecholine) for urinary retention. When advising the patient abut taking the drug, which of the following instructions should the health care provider include (Select all that apply)
Avoid driving that require alertness: can cause dizziness and fainting increase fluid intake: can cause diarrhea and increased salivary and gastric secretions. increase fluids to maintain hydration stay close to a bathroom after taking the drug: can cause rapid relief of urinary retention or diarrhea, with fecal incontinence.
A health care professional is caring for a male patient who has hyperthyroidism that has not responded to treatment. the health care professional should recognize that this thyroid disorder is a contraindication for which of the following genitourinary system drugs
BETHANECHOL (URECHOLINE) -bethanechol is a cholinergic drug that can cause cardiac dysrhythmias in patients who have hyperthyroidism because it can trigger the release of norepi which can induce dysrhythmias.
A health care professional should question the use of conjugated equine estrogen (vagifem) by a patient who has a history of which of the following?
BLOOD CLOTS - patients who have a history of thromboembolitic disease may not use estrogen replacement therapy because of the risk of thrombopheblitis, MI, pulmonary embolism, or suspected/confirmed cancer
A health care professional is caring for a patient who is receiving hCG (pregnyl) to stimulate ovulation. Which herbal preparation can cause interaction?
Black cohosh -decreases effectiveness of hCG and also Clomiphene (clomid).
when talking with a patient about taking sildenafil (viagra) to treat erectile dysfunction, the health care professional should include which of the following instructions
Do not take the drug with high fat foods -high fat foods delay absorption and reduce peak effects of sildenafil.
A health care professional administers oxybutin (ditropan) to a patient to treat neurogenic bladder. which of the following assessment findings should the health care professional recognize as an adverse effect (select all that apply)
Fever, dilated pupils, distended bladder, dizziness -Oxybutin is an anticholinergic that causes: Dry mouth Constipation Mydriasis (pupil dilation), dry eyes, blurred vision Headache Dizziness, drowsiness Fever, heat exhaustion Urinary retention
Prior to administering HcG (pregnyl) to a patient to stimulate ovulation, the health care professional should give her menotropins, or hMG (repronex) to promote?
Follicular maturation -
A health care professional should question the use of EE and drospirenone (yasmin) by women who have renal disease for risk of which of the following
HYPERKALEMIA - can cause potassium retention . contraindicated in women that have renal, adrenal, or liver disease. should monitor serum potassium and use it with caution with other drugs that can cause potassium retention like potassium sparing diuretics.
when talking with a patient about taking conjugated estrogen and medroxyprogesterone (prempro), the health care professional should include which of the following instructions?
Have blood pressure checked regularly -can cause hypertension.
A health care professional is caring for a patient who is about to begin clomiphene (clomid), therapy to treat infertility. the health care professional should monitor the patient for which of the following adverse effect.
OVARIAN HYPERSTIMULATION SYNDROME -pelvic pain can indicate ovarian hyperstimulation and can lead to ovarian cyst rupture. health care professionals should monitor patients who are taking clomiphene for ovarian enlargement and advise them to seek medical attention immediately for sudden pelvic pain.
which of the following drugs should the provider prescribe to induce labor in a woman who is at 42 weeks
OXYTOCIN (PITOCIN) -methylergonovine (methergine): ergot alkaloid, only administered after the delivery of placenta
A health care professional is caring for a patient who is about to begin taking cabergoline to teat infertility. The health care professional should explain to the patient the need to monitor of which of the following laboratory tests?
PROLACTIN - cabergoline is a hyperprolactinemia inhibitor. It inhibits the secretion of prolactin. the primary care provider should monitor prolactin levels to determine appropriate dosage.
A hralth care professional is caring for a patient who is about to begin taking finasteride (proscar) to treat benign prostatic hypertrophy. The health care professional should explain to the patient the need to monitor which of the following laboratory tests?
Prostate-specific antigen (PSA) -should monitor PSA levels at baseline and periodically thereafter. increases in PSA can indicate prostate cancer. PSA levels should decrease with finasteride (5-alpha reductase inhibitor) therapy.
A health care professional should question the use of combination oral contraceptive ethinyl estradiol and drospirenone (yasmin) by a patient who
SMOKES HALF A PACK OF CIGARETTES A DAY - smoking increase risks of thromboembolitic events
A patient taking oral contraceptives calls her health care professional because sho forgot to take one of her pills. which of the following instructions should the health care professional provide
TAKE THE MISSED DOSE ALONG WITH THE NEXT DOSE - should the patient miss two doses, take an additional dose each day for the next 2 days
A health care professional is caring for a patient who is taking combination oral contraceptive ethinyl estradiol and drospirenone (yasmin) and is about to begin taking rifampin to treat tuberculosis, because of a likely drug interaction, the health care professional should tell the patient to
USE ADDITIONAL BIRTH CONTROL -rifampin can increase metabolism of oral contraceptives reducing the effectiveness.
A health care professional is caring for a patient who is about to begin taking conjugated equine estrogen (premarin). The health care professional should tell the patient to report which of the following indications of a serious adverse reaction
VAGINAL BLEEDING -Estrogen HRT increases the risk of endometrial cancer. Health care professionals should tell patients using the drugs to report recurrent or persistent vaginal bleeding and pelvic pain.
when talking with a patient who is receiving leuprolide (lupron) to treat endometriosis, the health care professional should advise the patient to expect which of the following side effects.
VAGINAL DRYNESS -can cause vaginal dryness, vasomotor instability, headache, and bone loss. should advise patient to use water soluble lubricants.
A health care professional is caring for a patient who is about to begin using transdermal testosterone gel (Androgel) to treat delayed puberty. when talking with the patient, which of the following instructions should the health care professional include? (select all that apply)
cover the are of application with clothing, wash hand after applying, do not shower for several hours. -Transdermal (Androderm) Patch: Apply once a day; upper arm, back, abdomen, or thigh. Rotate sites; use each site only once a week. Gel: Wash hands after application; cover site. Buccal tablets (Striant) Apply to gums above an upper incisor; alternate sides of mouth. Apply external pressure.
A health care professional is caring for a patient who has benign prostatic hypertrophy and is taking tamsulosin (flomax) the health care professional should question the use of the drug if the patient also has which of the following?
erectile dysfunction for which he takes sildenafil (viagra) - drugs that lower blood pressure such as sildenafil, can worsen hypotension in combination with tamsulosin.
when talking with patient about using leuprolide (lupron) to treat endometriosis, the health care professional should include which of the following instructions?
perform weight bearing exercise -can cause bone loss. should recommend weight bearing exercise and increase intake of calcium and vit D
A health care professional is caring for a patient who is about to begin taking transdermal conjugated estrogen and medroxyprogesterone (CombiPatch) to treat postmenopausal symptoms. the health care professional should explain to the patient that the drug combination includes which of the following therapeutic effects? (select all that apply)
reduce risk of ovarian cancer: combination cntraceptives reduces risks of ovarian cancer. However, estrogen when used alone increase risks of endometrium and ovarian cancer relives hot flushes: prevents osteoporosis: combination or estrogen alone increases bone density.
a health care professional is caring for a patient who is receiving IV methylergonovine (methergine) to stop postpartum hemorrhage. which adverse effect should the provider monitor
seizure activity hypertension bradycardia
after administering terbutaline (brethine) to a patient to inhibit preterm labor, the health care professional should assess which of the following?
terbutaline can cause tachycardia, chest pain, and palpitations. health care professionals should monitor pt's ECG and FHR and rhythm.
A primary care provider has prescribe a dinoprostone (cervidil) vaginal insert to promote cervical ripening in a patient who is at 40 weeks of gestation. when administering dinoprostone, which of the following actions should the health care professional take? (select all that apply)
Gel (Prepidil) Have patients void prior to insertion. Administer intracervically using a syringe and an endocervical catheter. Have patients lie supine during instillation and remain supine for 30 min. Repeat dosing every 6 hr twice if the desired therapeutic effect has not occurred. Monitor uterine hyperstimulation. Report hyperstimulation immediately. Begin oxytocin 6 to 12 hr after the last dose Vaginal insert (Cervidil) Insert the pouch into the posterior fornix of the vagina. Have patients lie supine for 2 hr. Remove the pouch when active labor begins or 12 hr later. Follow the monitoring precautions.
