Author Question: A nurse provides teaching to a patient who has had a hysterectomy and is about to begin hormone ... (Read 33 times)

maychende · **on:** Jul 23, 2018

A nurse provides teaching to a patient who has had a hysterectomy and is about to begin hormone therapy to manage menopausal symptoms. Which statement by the patient indicates understanding of the teaching?

a. Because I am not at risk for uterine can-cer, I can take hormones indefinitely.
b. I can take estrogen to reduce my risk of cardiovascular disease.
c. I should take the lowest effective dose for the shortest time needed.
d. I will need a progestin/estrogen combi-nation since I have had a hysterectomy.

Question 2

A patient is being treated for chemotherapy-induced nausea and vomiting (CINV) with ondansetron Zofran and dexamethasone.

The patient reports getting relief during and imme-diately after chemotherapy but has significant nausea and vomiting several days after each che-motherapy treatment. What will the nurse do? a. Contact the provider to discuss increasing the dose of ondansetron.
b. Suggest giving prolonged doses of dex-amethasone.
c. Suggest adding aprepitant Emend to the medication regimen.
d. Tell the patient to ask the provider about changing the ondansetron to aprepitant.

missalyssa26 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

C
For patients who have undergone hysterectomy, progestin is unnecessary; estrogen-only prepara-tions still carry increased risk of breast cancer and should be taken in the lowest effective dose for the shortest time possible. Even though uterine cancer is no longer a possibility, breast cancer is still a risk. Studies have shown no protection against coronary heart disease but increased risk of stroke and breast cancer with estrogens.

Answer to Question 2

C
The current regimen of choice for patients taking highly emetogenic drugs consists of three agents: aprepitant plus dexamethasone plus a 5-HT3 antagonist, such as ondansetron. Aprepitant has a prolonged duration of action and can prevent delayed CINV as well as acute CINV. In-creasing the dose of ondansetron will not help treat the delayed CINV. Glucocorticoids should be given intermittently and for short periods to avoid side effects. Changing the ondansetron to aprepitant is not recommended.