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Case Study

1.
c. Smoking is the most important because an estrogen-containing contraceptive can increase the likelihood of developing thrombophlebitis or thromboembolism.
2.
d. The copper IUD is the longest-lasting contraceptive device and does not contain hormones. Because Susan is slightly overweight, has a smoking history, and has migraine headaches, any hormonal contraceptive may cause serious side effects.

Review Questions

1.
a. Migraine headaches are a concern with contraceptive medications that contain progestins because they may exacerbate the headaches.
2.
b. Oxytocin’s effect on the kidneys can cause water intoxication and dilutional hyponatremia, which are considered significant side effects. Signs and symptoms of hyponatremia are related to the central nervous system (CNS) and musculoskeletal system.
3.
d. Nitroglycerin is contraindicated when a client is using drugs for ED. The combination can cause significant hypotension and possible cardiac arrest.
4.
a. Prepubescent clients on testosterone therapy may develop early closure of epiphyseal growth plates and stunted growth. Testosterone therapy may need to be decreased or stopped.
5.
a. MgSO4 can cause serious life-threatening cardiac rhythm changes and circulatory collapse. Therefore, continuous cardiac monitoring is the most important order to implement.
6.
c. Given the context of a high school football player with these signs and symptoms, the nurse should recognize that the student may be misusing steroids. This question can help the nurse further assess the situation.
7.
d. Invasive dental procedures should not be planned during bisphosphonate therapy because of the high risk of developing bisphosphonate-induced osteonecrosis of the jaws (BIONJ).
8.
a. Impaired liver function is a serious side effect of antiandrogen medications. Clients on bicalutamide have developed liver failure and died. Liver function must be monitored closely.
9.
b. Bone density testing should be scheduled routinely to determine the effectiveness of the drug therapy.
10.
a. In this case, the anabolic steroid would be used to improve health status, indicated by increased hemoglobin.
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