Pharmacology Endocrine Miscellaneous #2

Question

The nurse is providing instruction on use of estrogen therapy for a patient diagnosed with menopause. Which statement by the patient indicates understanding of the adverse side effects of conjugated estrogens?

Answers

  1. "I may cause some swelling, weight change, hypertension, and breast tenderness."
    • Rationale:

      This answer is correct because conjugated estrogen has the side effects of swelling, weight change, hypertension, and breast tenderness. The blood pressure should be monitored and treated as necessary. There is also the risk of blood clots in the legs (deep vein thrombosis) or lungs (pulmonary embolism). The symptoms of deep vein thrombosis (DVT) include unilateral leg or calf redness, swelling, warmth, and pain. Pulmonary embolism (PE) symptoms include shortness of breath, chest pain, and a sense of impending doom. The patie

  2. "I will not exercise regularly because I might overtax my heart."
    • Rationale:

      This answer is not correct because exercise is important to help decrease blood pressure, weight, circulation, the risk of blood clots in the legs and heart, and general health and well-being. The patient should be encouraged to exercise, unless otherwise contraindicated. .

  3. "I can take the medication with grapefruit juice."
    • Rationale:

      This answer is not correct because grapefruit juice is not recommended during intake of conjugated estrogen. Grapefruit juice may make it harder for the body to break down the medication.

  4. "I will take aspirin instead of acetaminophen for pain."
    • Rationale:

      This answer is not correct because aspirin can lower estrogen levels. However, aspirin has been shown to decrease the risk of breast cancer due to its tendency to decrease estrogen levels.

Overview

Conjugated estrogens treat various symptoms associated with menopause but have various side effects, including swelling, weight change, hypertension and breast tenderness.

Explanation

Premarin and other estrogen preparations may cause swelling, weight changes, hypertension, and breast tenderness. Risks of thrombus is higher while on estrogen. The other selections do not reflect understanding. Exercise is beneficial, and grapefruit juice with estrogens may make it harder for the body to break down the medication. Taking estrogen with blood thinners or aspirin may increase the risk for bleeding.

Learning Outcomes

Menopausal symptoms include hot flashes, vaginal dryness, and bone loss (osteoporosis) and can be effectively treated with conjugated estrogen. Nevertheless, conjugated estrogen has some notable side effects, such as swelling, weight change, hypertension, and breast tenderness. There is also the risk of blood clots in the legs (deep vein thrombosis) or lungs (pulmonary embolism). The symptoms of deep vein thrombosis (DVT) include unilateral leg or calf redness, swelling, warmth, and pain. Pulmonary embolism (PE) symptoms include shortness of breath, chest pain, and a sense of impending doom. The patient should be taught each of these side effects and to report symptoms of DVT or PE.

Test Taking Tip

Estrogen therapy can increase the risk of DVT or PE in women, whether taking as birth control or hormone replacement. Signs and symptoms should be taught and to report these signs and symptoms immediately.

Video Rationale