NURSING NR 508 QUIZ 2 2020 Men who use transdermal testosterone gel (AndroGel) should be advised to avoid: • Washing their hands after applying the gel • Wearing occlusive clothing while using the gel • Exposure to estrogens while using the gel • Skin-to-skin contact with pregnant women while using the gel Education when prescribing androgens to male patients includes advising that: • Short -term use places the patient at risk for hepatocellular carcinoma. • Cholestatic hepatitis and jaundice may occur with low doses of androgens. • Gynecomastia is a rare occurrence with the use of androgens. • Low sperm levels only occur with long -term use of androgens. Patients who are prescribed exogenous androgens need to be warned that decreased libido: • Is an unusual side effect of androgens and should be reported to the provider • Is treated with increased doses of androgens, so the patient should let the provider know if he is having problems • May be a sign of early prostate cancer and he should make an appointment for a prostate screening exam • May occur with androgen therapy The U.S. Food and Drug Administration warns that androgens may cause: • Peliosis hepatis • Orthostatic hypotension • Menstrual irregularities • Acne Monitoring for a patient who is using androgens includes evaluation of: • Complete blood count and C-reactive protein levels • Lipid levels and liver function tests • Serum potassium and magnesium levels • Urine protein and potassium levels Male patients require before and during androgen therapy. • A digital prostate exam • A Doppler exam of testicular blood flow • Urine analysis for proteinuria • Serial orthostatic blood pressures Absolute contraindications to estrogen therapy include: • History of any type of cancer • Clotting disorders • History of tension headaches • Orthostatic hypotension Postmenopausal women with an intact uterus should not be prescribed: • Estrogen/progesterone combination • IM medroxyprogesterone (Depo Provera) • Estrogen alone • Androgens Women who have migraines with an aura should not be prescribed estrogen because of: • The interaction between triptans and estrogen, limiting migraine therapy choices • An increased incidence of migraines with the use of estrogen • An increased risk of stroke occurring with estrogen use • Patients with migraines may be prescribed estrogen without any concerns A 22-year -old woman receives a prescription for oral contraceptives. Education for this patient includes: • Counseling regarding decreasing or not smoking while taking oral contraceptives • Advising a monthly pregnancy test for the first 3 months she is taking the contraceptive • Advising that she may miss two pills in a row and not be concerned about pregnancy • Recommending that her next follow -up visit is in 1 year for a refill and annual exam A 19-year -old female is a nasal Staph aureus carrier and is placed on 5 days of rifampin for treatment. Her only other medication is combined oral contraceptives. What education should she receive regarding her medications? • Separate the oral ingestion of the rifampin and oral contraceptive by at least an hour. • Both medications are best tolerated if taken on an empty stomach. • She should use a back -up method of birth control such as condoms for the rest of the current pill pack. • If she gets nauseated with the medications she should call the office for an antiemetic prescription. A 56-year -old woman is complaining of vaginal dryness and dyspareunia. To treat her symptoms with the lowest adverse effects she should be prescribed: • Low-dose oral estrogen • A low-dose estrogen/progesterone combination • A vaginal estradiol ring • Vaginal progesterone cream
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