Drugs for Menopause
For women with intact uterus
Estrogen-progestin
These drugs improve vasomotor symptoms and vaginal dryness
Hormone Therapy in menopause
Benefits
symptom control
skeletal benefit
SSRI's
Reduces vasomotor symptoms
Reduces depression, irritability and mood changes
1. The nurse is preparing a teaching plan for combined hormonal contraceptive use. Which information should the nurse include in the teaching plan? (Select all that apply.)
a. The patient should report abdominal pain, chest pain, headaches, blurred vision and visual disturbances, and severe leg pain.
b. Combined hormonal contraceptives are safe for smokers older than 35 years who smoke fewer than 20 cigarettes per day.
c. Combined hormonal contraceptive use will not protect patients from sexually transmitted infections.
d. The pills can be missed but not for more than 12 hours.
e. Vaginal spotting after starting combined hormonal contraceptives is a sign that the method is not effective in preventing pregnancy.
A, C
6. The nurse is counseling a 62-year-old patient with a T score of −2.0 after her dual-energy x-ray absorptiometry scan. What is the best advice for this patient?
a. The patient should take a daily calcium supplement, 1200 to 1500 mg orally in the morning.
b. The patient’s exercise program will include weight-bearing exercises like swimming and cycling.
c. The patient most likely will be prescribed a drug of the bisphosphonate classification by the health care provider.
d. The patient should supplement her diet with 1200 mg of calcium with vitamin D 600 IU orally once daily.
D
For women with a hysterectomy
Estrogen
These drugs improve vasomotor symptoms and vaginal dryness
Hormone Therapy in menopause
Risks
Clots
Stroke
Breast cancer
Gallstones
Dementia
Gabapentin
Reduces vasomotor symptoms
2. A 54-year-old menopausal patient comes into the gynecology office and is interested in hormone therapy. Which are indications for prescribing hormone therapy? (Select all that apply.)
a. Assists in relief of hot flashes
b. Prevention of breast cancer
c. Prevention of cardiovascular disease
d. Prevention of osteoporosis in at-risk patients
e. Assists in relief of vaginal dryness
A, D, E
7. A 48-year-old patient arrives at the clinic to discuss her perimenopausal symptoms. She states that her last menstrual period was 8 months ago, and before that, her periods had been irregular. What is the most important nursing advice to give this patient?
a. Hormone therapy is only used for hot flashes and vaginal dryness.
b. The patient should be using some form of contraception to avoid pregnancy.
c. The patient should have a dual-energy x-ray absorptiometry scan to test for osteopenia.
d. At this time, herbal supplementation is probably best to relieve her perimenopausal symptoms.
B
Hormone Therapy Pt Teaching:
Dose should be given with food to reduce
nausea
Progressive, debilitating skeletal disease that affects older men and women
Osteoporosis
Clonidine
Reduces vasomotor symptoms
3. A 24-year-old patient tells the nurse that she would like to use the progestin-only pill for contraception. Nursing evaluation of this patient as a candidate for the progestin-only pill includes what?
a. Ask the patient if she has given birth in the past
b. Assess whether or not the patient has regular periods
c. Assessing patient reliability in taking an oral pill daily
d. Interviewing the patient about past smoking habits
C
8. A patient has been prescribed clomiphene citrate therapy by her doctor. The patient asks the nurse, “How does my new medicine work?” What can the nurse say to convey the mechanism of action of clomiphene citrate therapy to this patient? (Select all that apply.)
a. This drug stimulates the ovaries, increasing the chance of ovulation.
b. This drug increases circulating progesterone levels.
c. This drug usually does not work on the first cycle.
d. This drug helps the ovaries form multiple follicles.
A, B, D
Hormone Therapy Pt Teaching:
Decreases the risk of
Osteoporosis; does not treat it
Hormonal therapy is no longer recommended for treatment of osteoporosis but should be considered as a
preventative measure in postmenopausal women at risk
4. A 39-year-old patient who smokes one pack of cigarettes (20) per day asks about a contraception method that is best for her. She is normotensive and has used combined hormonal contraceptives in the past. She is in a monogamous relationship and has had two children with no complications during pregnancy. She is not planning any more pregnancies. The nurse determines that which method would be best for this patient?
a. Combined hormonal contraceptives
b. A levonorgestrel intrauterine system
c. Contraceptive that contain progestin only
d. Levonorgestrel (systemic) progestin
B
Hormone Therapy Pt Teaching:
Black Box Warning: ******
Should only be used for menopausal symptoms at the lowest dose possible for the shortest duration possible
USUALLY LESS THAN 5 YEARS
Two treatment options for osteoporosis
Bisphosphonates
Selective estrogen receptor modulators
5. The nurse is instructing a patient on the use of depot medroxyprogesterone acetate. Which statements are correct? (Select all that apply.)
a. Patients usually do not have any changes in their periods.
b. Patients should increase their intake of calcium.
c. Patients can expect some irregular bleeding at first.
d. Patients may use this contraceptive when breastfeeding.
B, C, D