A client with osteoporosis has been prescribed raloxifene (Evista). Which question should the nurse ask to determine the client's risks for complications with this drug?
1. "Have you ever had esophageal or ulcer disease?"
2. "Do you have a history of abnormal breast biopsies?"
3. "Have you ever had or been treated for blood clots?"
4. "Have you ever had any broken bones?"
Correct Answer: 3
Rationale 1: Gastrointestinal problems with raloxifene are rare.
Rationale 2: Raloxifene has been approved for prophylaxis of breast cancer in postmenopausal women. It is not a contraindication.
Rationale 3: Raloxifene increases the risk of deep vein thrombosis and resulting pulmonary embolism. This history would contraindicate the use of raloxifene.
Rationale 4: A client with osteoporosis might have a history of fractures. Raloxifene increases bone mass density and would be useful to treat osteoporosis. Raloxifene should decrease the risk of fractures.
Global Rationale: Raloxifene increases the risk of deep vein thrombosis and resulting pulmonary embolism. This history would contraindicate the use of raloxifene. Gastrointestinal problems with raloxifene are rare. Raloxifene has been approved for prophylaxis of breast cancer in postmenopausal women. It is not a contraindication. A client with osteoporosis might have a history of fractures. Raloxifene increases bone mass density and would be useful to treat osteoporosis. Raloxifene should decrease the risk of fractures.
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