The client has smoked a pack of cigarettes per day for 20 years. The client also takes oral contraceptives. In implementing a teaching plan, what is the most important information for the nurse to include?
1. "You are at a greater risk for emphysema than are nonsmokers."
2. "You are at a greater risk for developing diabetes than are smokers who do not use birth control pills."
3. "You are at a greater risk for a heart attack than are nonsmokers."
4. "The nicotine will decrease the effectiveness of your birth control pills."
Correct Answer: 3
Rationale 1: Smokers are at greater risk for emphysema, but this has nothing do with the client's use of oral contraceptives.
Rationale 2: There is no evidence to support a correlation between diabetes, smoking, and oral contraceptives.
Rationale 3: Cardiovascular effects can be particularly serious in clients taking oral contraceptives if they also smoke. The risk of a fatal heart attack is five times greater in smokers who also use oral contraceptives than in nonsmokers.
Rationale 4: There is no evidence to support that nicotine decreases the effectiveness of oral contraceptives.
Global Rationale: Cardiovascular effects can be particularly serious in clients taking oral contraceptives if they also smoke. The risk of a fatal heart attack is five times greater in smokers who also use oral contraceptives than in nonsmokers. Smokers are at greater risk for emphysema, but this has nothing do with the client's use of oral contraceptives. There is no evidence to support a correlation between diabetes, smoking, and oral contraceptives. There is no evidence to support that nicotine decreases the effectiveness of oral contraceptives.
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