Pharm 34 womens health
Be familiar with how to administer and education patients on administration of the oral bisphosphonate alendronate (Fosamax)
*Take with full glass 6 to 8 oz of water when waking up in morning *at least 30min before intake of any food *emphasize standing or siting position for ~30min after taking the drug to avoid esophageal erosion or irritation
The nurse is educating a client about medroxyprogesterone (Depo-Provera). The nurse should provide the client with which information about the medication? 1. Should be taken once daily by mouth 2. Should be administered intramuscularly every 3 months 3. Should be taken immediately following sexual intercourse 4. Provides some protection against sexually transmitted infections
2. Should be administered intramuscularly every 3 months
The nurse is assigned to care for several male and female clients who take estrogen or progestins. The nurse knows that this group of clients is at increased risk for which complication of the medications? 1. Sepsis 2. Dehydration 3. Deep vein thrombosis (DVT) 4. Electrocardiographic changVes
3. Deep vein thrombosis (DVT)
The nursing instructor is discussing COX-2 inhibitors with her nursing students. Where would the instructor tell her students that COX-2 inhibitors work? A) At sites of trauma and injury B) Wherever prostaglandins are present C)At the sites of blood clotting D) In the kidney
A) At sites of trauma and injury The COX-2 inhibitors are thought to act only at sites of trauma and injury to more specifically block the inflammatory reaction. COX-1 is present in all tissues and seems to be involved in many body functions including blood clotting, protecting the stomach lining, and maintaining sodium and water balance in the kidney.
. Which type of drug is most effective in the treatment of erectile dysfunction (ED)? a. Phosphodiesterase inhibitors b. Antiandrogen agents c.Sympathomimetic agents d.Alpha 1 adrenergic blocking agents
ANS: A Sildenafil (Viagra), a phosphodiesterase inhibitor, increases cyclic guanosine monophosphate concentrations in the corpus cavernosum, which results in smooth muscle relaxation and greater blood flow into the corpus cavernosum, producing an erection. Antiandrogen agents, sympathomimetic agents, and adrenergic blocking agents are not effective in treating ED.
Which drug is administered after delivery to reduce the risk of postpartum hemorrhage after the placenta has been delivered? a. Oxytocin (Pitocin) b. Magnesium sulfate c. Vitamin K d. Dopamine
ANS: A Uterine stimulants, primarily oxytocin, given in low dose infusions after delivery of the fetus and placenta, help stimulate firm uterine contractions to reduce the risk of postpartum hemorrhage from an atonic uterus. Magnesium sulfate is given to treat eclampsia and preeclampsia. Vitamin K is given to prevent hemorrhage. Dopamine is given to treat hypotension.
9. What is the mechanism whereby estrogen functions as a contraceptive? a. Inhibiting luteinizing hormone (LH), blocking release of ovum from a follicle b. Thinning cervical mucus, which inhibits sperm migration c. Trapping the ovum in the endometrial wall, preventing its growth d. Blocking follicle-stimulating hormone (FSH), thereby preventing release of ovum
ANS: D Estrogens block pituitary release of FSH, preventing the ovaries from developing a follicle from which the ovum is released. Progestins inhibit pituitary release of LH, the hormone responsible for releasing an ovum from a follicle. Estrogens and progestins alter cervical mucus by making it thick and viscous, inhibiting sperm migration. Hormones also change the endometrial wall, impairing implantation of the fertilized ovum.
What drug would the nurse administer orally without the need to question when treating infections caused by Candida albicans? A) Amphotericin B (Abelcet) B) Tolnaftate (Tinactin) C) Griseofulvin (Fulvicin) D)Fluconazole (Diflucan)
D)Fluconazole (Diflucan) Fluconazole is available for oral use and is effective in treating C. albicans. Amphotericin B is reserved for severe and potentially fatal infections, so it would not be used for a C. albicansinfection. Tolnaftate is used to treat athletes foot and is applied topically, not given orally. Griseofulvin is applied topically and is used to treat tinea, not C. albicans.
What patient education is included for dosing and contraindications of selective estrogen receptor modulators (SERMs)? Dont take and travel to f**king Asia Not to use in DVT or women who may become pregnant
Education SERMs: DISCONTINUE 72 hours before and during immobility Contraindications SERMs: Drug allergy, thomboembolic disorder, DVT, PE,
The nurse admits a 1-year-old child to the pediatric intensive care unit (ICU) with cryptococcal meningitis. What drug will the nurse anticipate receiving an order for to treat this child? A) Amphotericin B (Fungizone) B) Fluconazole (Diflucan) C) Griseofulvin (Fulvicin) D) Ketoconazole (Nizoral)
Fluconazole (Diflucan) Fluconazole is used in the treatment of cryptococcal meningitis and is safe to use in a 1-year-old child. Amphotericin B has many unpleasant adverse effects and is very potent, so it would not be the first or best medication to administer initially but would be reserved for use if fluconazole was not effective. Griseofulvin is given to treat tinea pedis and tinea unguium in children. Ketoconazole is not given to children younger than 2 years because safety has not been established.
Uterine tocolytics: what are the indications and effects? ex. terbutaline, a beta-adrenergic drug Magneusium sulfate
They inhibit labor and maintain pregnancy works by relaxing uterine smooth muscle
What type of OCP most closely matches the normal hormonal cycle?
Triphasic products most closely duplicate the normal hormonal levels of the female cycle
A client is admitted for induction of labor. An intravenous infusion of oxytocin is started. When the client's contractions begin they are 1.5 to 2 minutes in duration. While the nurse is in the room, one contraction lasts 3 minutes. What should the nurse do first?
Turn off the oxytocin infusion
The nurse is reviewing the patients medications and sees fluconazole has been ordered. The nurse will question this order when finding the patient is taking what other medication? A) Digoxin B) Humulin insulin C) Acetaminophen D) Hydrochlorothiazide
a Fluconazole strongly inhibit the cytochrome P450 (CYP450) enzyme system in the liver and are associated with many drugdrug interactions, such as increased serum levels of the following agents: cyclosporine, digoxin, oral hypoglycemics, warfarin, oral anticoagulants, and phenytoin. Diphenhydramine, acetaminophen, and hydrochlorothiazide have no impact on fluconazole. There is no indication that humulin insulin, acetaminophen, and hydrochlorothiazide are contraindicated when taking fluconazole.
During a postpartum patient assessment, the nurse notes a boggy uterus and increased vaginal bleeding. Based on this assessment data, the nurse prepares to administer which medication? a Oxytocin (Pitocin) b Clomiphene (Clomid) c Terbutaline (Brethine) d Dinoprostone (Prostin E2)
a oxytocin (pitocin) Oxytocin is a uterine stimulant that causes uterine contractions, which would decrease the vaginal bleeding.
While taking a history of a 68-year-old female patient who is receiving estrogen therapy as part of palliative treatment for advanced breast cancer, which assessment finding would be of most concern to the nurse? A.The patient is on transdermal opioids for cancer pain. b. The patient smokes 1 pack of cigarettes a day. C. The patient drinks a glass of wine one evening a week. d. The patient has a history of osteoporosis
b. The patient smokes 1 pack of cigarettes a day. Smoking should be avoided during estrogen therapy because it adds to the risk for thrombosis.
A 36-week primigravida patient has been admitted to the unit with a blood pressure of 200/120 mm Hg, severe headache, and edema. Which medication does the nurse anticipate that the health care provider will order? a. Nifedipine (Procardia) b. Furosemide (Lasix) c. Magnesium sulfate d. Terbutaline (Brethine)
c. Magnesium sulfate Magnesium sulfate depresses the central nervous system and blocks peripheral nerve transmission, which produces anticonvulsant effects and smooth muscle relaxation. In cases of preeclampsia or eclampsia, magnesium sulfate is used to control seizure activity. Hypertension, headache, and edema are signs of preeclampsia in a pregnant woman. Calcium channel blockers, such as nifedipine, are sometimes given as tocolytic agents. Furosemide is given for diuresis; it may be used in the treatment of hypertension, but not eclampsia. Terbutaline is given as a tocolytic agent.
When patient teaching is appropriate for a patient taking alendronate (fosamax)? (select all that apply) a. Take on an empty stomach. b. take at night just before going to bed. c. take with an 8 oz glass of water d. take with a sip of water e. take first thing in the morning upon arising f. do not lie down for at least 30 minutes after taking.
c. take with an 8 oz glass of water e. take first thing in the morning upon arising f. do not lie down for at least 30 minutes after taking.
The combined continuous administration of progestin and estrogen reduces the risk of which cancer? a Breast b Vaginal c Ovarian d Endometrial
d endometrial Estrogen, given alone, has been associated with an increased risk of endometrial hyperplasia, which can lead to endometrial cancer. Progestin reduces the incidence of endometrial hyperplasia.
Be familiar with the indicated uses of uterine stimulant drugs, and how these infusions should be administered and managed. Oxytocin -always monitor vitals with oxytocin since it has vaspressive effects and antidiuretic properties. Patient is at risk for hypertensive episodes as well as fluid retention; continuously monitor maternal blood pressure and pulse rate as well as fetal heart rate -PIGGYBACK dosing is often order so it can be discontinued if needed -if labor progresses 1cm/hr it may not be needed
induce labor at near or full-term gestation (e.g. oxytocin{pitocin]) -when uterine contractions are weak and ineffective The prostaglandins may be used therapeutically to induce labor by softening the cervix (cervical ripening) and enhancing uterine muscle tone. They may also be used to stimulate the myometrium to induce abortion during the second trimester when the uterus is resistant to oxytocin
A 60-year-old woman is taking a bisphosphonate. She calls the clinic and tells the nurse that her stomach has been bothering her and wants to know what she should do. The nurse will instruct her to A. take the medication with milk. B. take the medication with breakfast. C. remain upright in a sitting position for at least 10 minutes after taking the medication. D. stop the medication and to come in for an evaluation
stop the medication and to come in for an evaluation. Rationale: Bisphosphonates (e.g., alendronate) are to be taken exactly as prescribed; that is, the drug is taken at least 30 minutes before the first morning beverage, food, or other medication and with at least 6 to 8 oz of water. Emphasize the importance of remaining upright for at least 30 minutes after taking the medication to prevent esophageal and GI adverse effects. Esophageal irritation, dysphagia, severe heartburn, and retrosternal pain must be reported to the prescriber immediately to help prevent severe reactions.
Estrogens: Indications
tx or prevention of variety of disorders which result primarily from estrogen therapy. Hormone replacement therapy (HRT) to counter such estrogen deficiency is most commonly known for its benefits in treating menapausal symptoms (e.g. hot flashes may increase risk of breast cancer? and blood clots
