Women's Health

Question 1

Estrogens
medications
expected action

Answer 1

1) prototype =
conjugated equine estrogens (Premarin)
2) other medications = 
-estradiol (Estrace)
-Estradiol hemihydrate (Vagifem)
3) supports the development and maintenance of the female reproduction system

Question 2

Estrogens:

therapeutic uses

Answer 2

1) contraception
2) relief of postmenopausal symptoms
- hot flushes
- night sweats
- vaginal dryness
- sleep disorder
3) prevention of postmenopausal osteoporosis
4) dysfunctional uterine bleeding and endometriosis

Question 3

Estrogens:

side/adverse effects

Answer 3

1) endometrial and ovarian cancers
- w/ prolonged use
2) potential risk for estrogen-dependent breast cancer
3) embolic events such as MI, PE, DVT, cerbrovascular accident

Question 4

Estrogens:

contraindications

Answer 4

1) can reduce effectiveness of warfarin (Coumadin)
2) concurrent use w/ phenytoin (Dilantin) can increase risk of phenytoin toxicity
3) corticosteroids increase the effects
4) may alter the effects of tamoxifen
5) smoking increases risks for thrombophlebitis

Question 5

Estrogens:

nursing administration

Answer 5

1) take medication at same time each day
2) apply estrogen patches to skin of the trunk
3) instruct to report any bleeding
4) perform monthly self-examinations and schedule annual gynecologic and breast exams
5) notify the provider of any swelling or redness in legs
6) do not smoke

Question 6

Progesterones:
medications
expected action

Answer 6

1) prototype = medroxyprogesterone acetate (Provera)
2) other medications = -norethindrone (Micronor)
- megestrol acetate (Megace)
3) -favorable conditions for fetal growth and development and to maintain pregnancy
- a drop causes menstruation

Question 7

Progesterones:
therapeutic uses
interactions

Answer 7

1) -dysfunctional uterine bleeding due to hormonal imbalance
- amenorrhea due to hormonal imbalance
- endometriosis
2) -decreases effectiveness of carbamazepine (Tegretol), dilantin, and rifampin
- bromocriptine (Parlodel) may cause amenorrhea
- smoking increases risk for thrombophlebitis

Question 8

Progesterones:

side/adverse effects

Answer 8

1) breast cancer
2) thromboembolic events
3) breakthrough bleeding
4) edema
5) jaundice
6) migraine headaches

Question 9

Progesterones:

nursing interventions

Answer 9

1) avoid smoking
2) monitor BP
3) report warmth, edema, tenderness, and pain in legs
4) monitor for sings of jaundice such as yellowing of the skin and sclera of the eyes
5) notify the provider of severe headaches

Question 10

Hormonal Contraceptives:

medications

Answer 10

1) prototype = combination oral contraceptives: ethinyl estradiol and norethindrone (Ovcon 35, Necon 1/35)
2) other medications =
- transdermal patch: ethinyl estradiol and norelgestromin (Ortho Evra)
- vaginal contraceptive ring: ethinyl estradiol and etonogestrel (NuvaRing)
- parenteral: depot medroxyprogesterone acetate (DMPA) available as Depo-Provera for IM use; Depo-subQ for SC use

Question 11

Hormonal Contraceptives: expected action

therapeutic uses

Answer 11

1) oral contraceptives stop conception by preventing ovulation. They also thicken the cervical mucus and alter the endometrial lining to reduce the chance of fertilization
2) hormonal contraceptive prevent pregnancy

Question 12

Hormonal Contraceptives: side/adverse effects

Answer 12

1) thromboembolic events
2) hypertension
3) breakthrough or abnormal uterine bleeding
4) breast cancer

Question 13

Hormonal Contraceptives: nursing interventions

Answer 13

1) encourage client to stop smoking
2) report warmth, tenderness, redness, edema, and pain in lower legs
3) instruct clients to record duration and frequency of bleeding
4) tell clients that contraceptives may increase growth of pre-existing breast cancer