reproductive and genitourinary

A nurse is caring for a male client who has hyperthyroidism and is not responding to treatment. The nurse should identify that hyperthyroidism is a contraindication for which of the following drugs? a. Sildenafil b. Bethanechol c. Tamsulosin d. Finasteride

Bethanechol - can cause dysrhythmias in clients who have hyperthyroidism by triggering the release of norepinephrine

A nurse should question the use of conjugated equine estrogen by a client who has history of which of the following? a. osteoporosis b. peptic ulcer disease c. rheumatoid arthritis d. blood clots

Blood clots - risk of thrombophlebitis, MI, PE, and CVA

A nurse is providing safety education to a client who is scheduled to begin treatment with tamsulosin for BPH. Which of the following instructions should the nurse include in the teaching? a. Change positions slowly b. Crush the medication c. Take the medication on an empty stomach d. Report increased urinary output immediately

Change positions slowly - can cause orthostatic hypotension do not crush or chew take drug same time 30 min after same meal edema or weight gain can occur

A nurse is assessing a client who has new prescription of oxybutynin to treat neurogenic bladder. Which of the following assessment findings should the nurse identify as an adverse effect of the drug? a. diaphoresis b. dilated pupils c. dizziness d. distended bladder e. fever

Dilated pupils - can also cause dry eyes, blurred vision dizziness distended bladder - urinary retention fever - exhaustion and fever

A nurse is caring for a client who received human menopausal gonadotropin. Which of the following findings should the nurse expect? a. Prolactin secretion b. Estrogen release c. Follicular maturation d. Oxytocin secretion

Follicular maturation - before a client receives hCH to stimulate ovulation, they must receive a drug that induces follicular maturation. Client receives hCG 1 day after last dose of hMG or follitropin or 7 to 9 days after last clomiphene dose.

Estrogen hormone replacement therapy adverse reactions

HTN, dizziness, and fluid retention

A nurse is teaching a client about conjugated estrogen and medroxyprogesterone. Which of the following instructions should the nurse include? a. monitor for rectal bleeding b. avoid drinking alcoholic beverages c. have BP checked regularly d. sit up for 30 min after taking drug

Have BP checked regularly - can cause HTN can reduce the risk for colorectal cancer, avoid taking St. John's wort bc it reduces effectiveness

A nurse is teaching a client who has a new prescription for a testosterone transdermal patch. Which of the following statements made by the client indicates an understanding of the teaching? a. I should have pancreatic function tests obtained while taking this drug b. I should have my WBC count checked annually c. I should take off the patch to shower d. I should apply the medication to a different site each time

I should apply the medication to a different site each time Client should have hemoglobin and hematocrit levels checked Liver function testing should be performed

A nurse is caring for a client who is about to begin clomiphene therapy to treat infertility. The nurse should monitor the client for which of the following adverse effects? a. breast cancer b. DVT c. ovarian hyperstimulation syndrome d. restless leg syndrome

Ovarian hyperstimulation syndrome - nurse should monitor a client who is taking clomiphene for ovarian enlargement and advise them to seek medical attention

a nurse is caring for a client who is about to begin taking infasteride to treat BPH. The nurse should explain to the client the need to monitor which of the following lab values? a. PSA b. BUN c. CPK d. ALT

PSA

A nurse is caring for a client who is about to begin taking cabergoline to treat infertility. The nurse should explain to the client the need to monitor which of the following lab values? a. Potassium b. Glucose c. BUN and creatinine d. Prolactin level

Prolactin level - can inhibit secretion of prolactin

A nurse is caring for a client who is taking combination oral contraceptive ethinyl estradiol and drospirenone and is about to begin taking rifampin to treat tuberculosis. Which of the following instructions should the nurse give the client due to a possible drug interaction? a. increases the rifampin dose b. increase oral contractceptive dose c. wait 2 hours between taking each drug d. use additional birth control methods

Use additional birth control methods - rifampin can increase metabolism of oral contraceptives reducing effectiveness, clients who are taking both should use additional methods to prevent unwanted pregnancy other drugs that reduce effect of oral contraceptive: antifungal and anticonvulsants

A nurse is preparing to administer finasteride to a client who has BPH. Which of the following precautions should the nurse plan to take when administering this drug? a. administer medication while client is sitting or reclining. b. withhold the medication if the client doesn't eat c. wear gloves when handling the tablet d. monitor heart rate prior to administration

Wear gloves when handling the tablet - can be absorbed through skin

A nurse is providing teaching to a client who is taking bethanechol for urinary retention. Which of the following instructions should the nurse include? a. avoid driving and activities that require alertness b. increase fluid intake c. take drug with food d. stay close to a bathroom after taking the drug e. increase weight bearing activiites

avoid driving and activities that require alertness increase fluid intake stay close to a bathroom after taking the drug Take 1 hr before or 2 hr after meals

Clomiphene

blocks estrogen receptors causing pituitary gland to secrete LH and FSH

clomiphene adverse effect

blurred vision

leuprolide adverse effect

bone loss

Methylergonovine

can cause HTN

Bethanechol adverse effects

can cause diarrhea and increased salivary and gastric secretions dizziness and fainting

Celecoxib adverse effects

can cause elevations in BUN and creatinine

Oral contraceptive drug interactions

can reduce effects of warfarin and hypoglycemic drugs

A nurse is providing teaching to a client about sildenafil to treat erectile dysfunction. Which of the following instructions should the nurse include? a. Take the drug with a glass of grapefruit juice b. do not take the drug with high-fat foods c. increase intake of foods rich in VK d. avoid aged cheeses and red wine

do not take the drug with high-fat foods avoid grape juice

A provider has prescribed a dinoprostone vaginal insert to promote cervical ripening in a client who is at 40 weeks of gestation. When administering dinoprostone, which of the following actions should the nurse take? a. encourage the client to urinate prior to insertion b. remove the pouch when active labor begins c.monitor for uterine hyperstimulation d. encourage the client to walk after insertion e. monitor the client's temperature

encourage the client to urinate prior to insertion, remove the pouch when active labor beings, monitor for uterine hyper stimulation, monitor the client's temperature Lie supine for at least 2 hr while pouch slowly release the drug

Clomiphene adverse reactions

hot flashes, nausea, and headache

Sildenafil contraindications

nitrates

A nurse is caring for a client who has a new prescription for conjugated equine estrogen. The nurse should instruct the client to report which of the following indications of a serious adverse reaction? a. hot flashes b. UTI c. vaginal bleeding d. bone pain

vaginal bleeding relieves hot flashes and diaphoresis

A nurse is teaching a client about receiving leuoprolide to treat endometriosis. The nurse should instruct the client to expect which of the following side effects? a. vaginal dryness b. HTN c. blurred vision d. orthostatic hypotension

vaginal dryness - use water based lubricants

Finasteride contraindications

women and children cannot take this

Estrogen replacement therapy contraindications

liver disease, uncontrolled vaginal bleeding, or suspected or confirmed breast, vaginal, cervical, or endometrial cancer

Cabergoline adverse effect

orthostatic hypotension

A nurse is teaching a client who has new prescription for transdermal testoerone gel to treat delayed puberty. Which of the following instructions should the nurse include? a. apply the gel to the scrotum b. cover the area of application with clothing c. wash your hands after applying the gel d. do not shower for several hours after applying the gel e. apply the gel to the gums above an upper incisor

cover the area of application with clothing - let the gel dry before covering application site with a shirt wash your hands after applying the gel do not shower for several hours after applying the gel - clients should not shower or swim to avoid washing off apply to upper arm, shoulders, or abdomen

After administering terbutaline to a client to inhibit preterm labor, the nurse should assess which of the following? a. peripheral pulses b. temperature c. vision d. HR

heart rate can cause tachycardia, chest pain, palpitations, hypokalemia, and muscle weakness

Ethinyl estradiol and drospirenone adverse effects

hyperkalemia

A nurse should question the use of ethinyl estradiol and drospirenone by a client who has renal disease due to the increased risk of which of the following? a. hyperkalemia b. hyponatremia c. hypoglycemia d. respiratory alkalosis

hyperkalemia can develop hypernatremia, hyperglycemia, and metabolic acidosis

A nurse is providing teaching to client about using leuprolide to treat endometriosis. Which of the following instructions should the nurse include? a. perform weight-bearing activities b. wear sunscreen or protective clothing c. take the drug with food to increase absorption d. avoid drinking grapefruit juice

perform weight bearing activities - Leuprolide suppresses estrogen and can cause bone loss. Patient should also increase intake of calcium and VD taken IM only monthly or every 3-4 mo

A nurse is caring for a client who has a new prescription for transdermal conjugated estrogen and medroxyprogesterone to treat postmenopausal symptoms. The nurse should explain to the client that this drug combination includes which of the following therapeutic effects? a. reduces the risk of ovarian cancer b. relieves hot flashes c. prevents osteoporosis d. reduces risk of breast cancer e. reduces risk of thromboembolism

reduces risk of ovarian cancer, relieves hot flashes, prevents osteoporosis increases risk of breast cancer - should perform self breast examinations increases risk of thromboembolism

a nurse is assessing a client who has a new prescription for the combination oral contraceptive ethinyl estradiol and drospirenone. Which of the following findings should the nurse identify as a contraindication to use of this medication? a. drinks a glass of wine each night b. smokes half a pack of cigarettes a day c. runs marathons regularly d. drives a school bus

smokes half a pack of cigarettes a day grapefruit juice can increase risk of toxicity

A nurse is caring for a client who missed a dose of her oral contraceptive. Which of the following instructions should the nurse give the client? a. take a pregnancy test b. double up on pills for remainder of pack c. take the missed dose asap d. stop oral contraceptives and use a different contraceptive

take missed dose asap

Cabergoline

inhibits prolactin secretion

Tamsulosin contraindications

erectile dysfunction drugs

A nurse is caring for a client who has BPH and is taking tamsulosin. The nurse should question the use of the drug if the client also has which of the following? a. a seizure disorder for which he takes carbamazepine b. erectile dysfunction for which he takes sildenafil c. DM for which he takes glyburide d. Angle-closure glaucoma for which he takes pilocarpine

erectile dysfunction for which he takes sildenafil - drugs that lower BP such as sildenafil, can exacerbate hypotension in combination with tamsulosin. Clients who take sildenafil should not take tamsulosin.