Page 1451 - Saunders Comprehensive Review For NCLEX-RN

with hypertension, gallbladder disease,
or liver or kidney dysfunction.
c. Estrogens increase the risk of toxicity
when used with hepatotoxic
medications.

d. Barbiturates, phenytoin, and

rifampin decrease the effectiveness of
estrogen.
2. Progestins are contraindicated in clients with
thromboembolic disorders and should be avoided in
clients with breast tumors or hepatic disease.
C. Side and adverse effects
1. Breast tenderness, menstrual changes
2. Nausea, vomiting, and diarrhea
3. Malaise, depression, excessive irritability
4. Weight gain
5. Edema and fluid retention
6. Atherosclerosis

7. Hypertension, stroke, myocardial infarction

8. Thromboembolism (estrogen)

9. Migraine headaches and vomiting (estrogen)

D. Interventions

1. Monitor vital signs.
2. Monitor for hypertension.
3. Assess for edema and weight gain.
4. Advise the client not to smoke.
5. Advise the client to undergo routine breast and pelvic
examinations.
X. Medications for Diabetes Mellitus

A. Insulin and oral antidiabetic medications

1. Description
a. Insulin increases glucose transport into
cells and promotes conversion of
glucose to glycogen, decreasing serum
glucose levels.
b. Oral antidiabetic agents act in a number
of ways: stimulate the pancreas to
produce more insulin, increase the
sensitivity of peripheral receptors to
insulin, decrease hepatic glucose
output, delay intestinal absorption of

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