When teaching a patient about estrogen therapy, which drug(s) ...

[bcretired]

When teaching a patient about estrogen therapy, which drug(s) will the nurse identify as causing drug interactions? (Select all that apply.)
 
  a. Diazepam (Valium)
  b. Warfarin (Coumadin)
  c. Thyroid hormones
  d. Phenytoin (Dilantin)
  e. Acetaminophen (Tylenol)

Question 2

Which condition(s) would be of special concern when evaluating a patient for treatment with gonadal hormones? (Select all that apply.)
 
  a. Sexually transmitted disease
  b. Hypertension
  c. Liver disease
  d. Cancer of the reproductive organs
  e. Smoking

[fromAlphatoOmega22]

Answer to Question 1

ANS: B, C, D
Estrogen may diminish the anticoagulant effects of warfarin. Monitor the prothrombin time and increase the dosage of warfarin, if necessary. Patients who have no thyroid function and who start estrogen therapy may require an increase in thyroid hormone dosage. Estrogens increase thyroid-binding globulin levels, which reduce the level of circulating free T4. The total level of T4 is either normal or increased. Do not adjust the thyroid dosage until the patient shows clinical signs of hypothyroidism. Estrogens may inhibit the metabolism of phenytoin, resulting in phenytoin toxicity. Monitor patients with concurrent therapy for signs of phenytoin toxicity (e.g., nystagmus, sedation, lethargy). Serum levels may be ordered, and a reduced dosage of phenytoin may be required. There are no drug interactions with estrogen and diazepam or acetaminophen.

Answer to Question 2

ANS: B, C, D, E
Hypertension, liver disease, and cancer of the reproductive organs may be contraindications for treatment with gonadal hormones. Smoking increases the risk of heart attacks, stroke, and embolic disorders in patients taking gonadal hormones. Sexually transmitted diseases are not affected by treatment with gonadal hormones.