Question

What are the lifespan considerations for adults with the use of drugs that affect the female reproductive system? What is the nursing implementation considerations for patients receiving drugs used to affect the female reproductive system? I

Answer 1

Ans) 1) Oxytocin has caused severe water intoxication with coma and even maternal death when used for a prolonged period.

- HRT is no longer commonly used by postmenopausal women.

- Women taking estrogen should be advised not to smoke because of the increased risk of thrombotic events.
- Women who are receiving these drugs for fertility programs should receive a great deal of psychological support and comfort measures to cope with the many adverse effects associated with these drugs. The risk of multiple births should be explained.D

- Drugs are used in treatment of specific cancers in males and they should be advised about the possibility of estrogenic effects.

- Not indicated during pregnancy or lactation because of potential for adverse effects on the fetus or neonate.

2) Important nursing considerations when administering female sex hormones and estrogen receptor modulators:

Nursing Assessment
These are the important things the nurse should include in conducting assessment, history taking, and examination:

Assess for the mentioned cautions and contraindications (e.g. drug allergies, cardiovascular diseases, metabolic bone disease, history of thromboembolism, etc.) to prevent any untoward complications.
Perform a thorough physical assessment (e.g. bowel sounds, skin assessment, vital signs, mental status, etc.) to establish baseline data before drug therapy begins, to determine effectiveness of therapy, and to evaluate for occurrence of any adverse effects associated with drug therapy.
Assist with pelvic and breast examinations. Ensure specimen collection for Pap smear and obtain a history of patient’s menstrual cycle to provide baseline data and to monitor for any adverse effects that could occur.
Arrange for ophthalmic examination especially for patients who are wearing contact lenses because hormonal changes can alter the fluid in the eye and curvature of the cornea, which can change the fit of contact lenses and alter visual acuity.
Monitor laboratory test results (e.g. urinalysis, renal and hepatic function tests, etc.) to determine possible need for a reduction in dose and evaluate for toxicity.
Nursing Diagnoses
Here are some of the nursing diagnoses that can be formulated in the use of this drug for therapy:

Ineffective tissue perfusion related to changes in the blood vessels brought about by drug therapy and risk of thromboemboli
Excess fluid volume related to fluid retention
Acute pain related to systemic side effects of gastrointestinal (GI) pain and headache
Implementation with Rationale
These are vital nursing interventions done in patients who are taking female sex hormones and estrogen receptor modulators:

Administer drug with food to prevent GI upset.
Provide analgesic for relief of headache as appropriate.
Provide small, frequent meals to assist with nausea and vomiting.
Monitor for swelling and changes in vision or fit of contact lenses to monitor for fluid retention and fluid changes.
Provide comfort measures to help patient tolerate drug effects.
Provide safety measures (e.g. adequate lighting, raised side rails, etc.) to prevent injuries.
Educate client on drug therapy to promote understanding and compliance.
Evaluation
Here are aspects of care that should be evaluated to determine effectiveness of drug therapy:

Monitor patient response to therapy (palliation of signs and symptoms of menopause, prevention of pregnancy, decreased risk factors for coronary artery disease, and palliation of certain cancers).
Monitor for adverse effects (e.g. GI upset, edema, changes in secondary sex characteristics, headaches, thromboembolic episodes, and breakthrough bleeding).
Evaluate patient understanding on drug therapy by asking patient to name the drug, its indication, and adverse effects to watch for.
Monitor patient compliance to drug therapy.