The nurse is caring for a client diagnosed with endometriosis. ...

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The nurse is caring for a client diagnosed with endometriosis. Which statement by the client requires immediate follow-up?
 
  1. I've noticed my voice is lower since I started taking danazol.
  2. I am having many hot flashes since I had the Lupron injection.
  3. The pain I experience with intercourse is becoming more severe.
  4. My leg has become painful and swollen since I started taking birth control pills.

Question 2

The nurse is teaching a class to women who were recently diagnosed with benign breast disease (BBD), commonly known as fibrocystic breast disease. One of the participants reports increased swelling, pain, and pressure in her breasts just before menstruation. What is the best response by the nurse?
 
  1. It's best to make an appointment with an oncologist.
  2. The pain may be caused by thinning of the normal breast tissue.
  3. Consider asking your healthcare provider about adding a mild diuretic to your regimen.
  4. Breast swelling and pressure are expected symptoms, but pain is abnormal and should be evaluated by your physician.

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Answer to Question 1

4
Explanation:
1. Danocrine (danazol) is a testosterone derivative that suppresses gonadotrophin-releasing hormone (GnRH) and has high-androgen and low-estrogen effects. A lowered voice is one side effect of danazol. This client is not experiencing a complication.
2. Leuprolide acetate (Lupron) is a GnRH agonist and causes symptoms of a hypoestrogenic state (hot flashes, vaginal dryness, decreased libido, and bone density loss). Hot flashes are expected and not a complication.
3. Dyspareunia is a common symptom of endometriosis and therefore is not a complication.
4. Combination oral contraceptive pills contain estrogen. A painful, swollen lower extremity can be a sign of deep vein thrombosis, which can cause thromboembolus, which is potentially life threatening. This is a complication and must be addressed immediately.

Answer to Question 2

3
Explanation:
1. Cyclic breast pain, swelling, and tenderness are common symptoms associated with BBD. Generally, fibrocystic changes are not a risk factor for breast cancer.
2. The pathology of BBD involves fibrosis, which is a thickening of the normal breast tissue.
3. Treatment of BBD may include taking a mild diuretic during the week prior to the onset of menses to counteract fluid retention, relieve pressure in the breast, and help decrease pain.
4. Common symptoms associated with BBD include cyclic breast pain, tenderness, and swelling.