The nurse is caring for a client diagnosed with endometriosis. Which statement by the client requires immediate follow-up?
1. "I've noticed my voice is lower since I started taking danazol."
2. "I am having many hot flashes since I had the Lupron injection."
3. "The pain I experience with intercourse is becoming more severe."
4. "My leg has become painful and swollen since I started taking birth control pills."
4
Explanation:
1. Danocrine (danazol) is a testosterone derivative that suppresses gonadotrophin-releasing hormone (GnRH) and has high-androgen and low-estrogen effects. A lowered voice is one side effect of danazol. This client is not experiencing a complication.
2. Leuprolide acetate (Lupron) is a GnRH agonist and causes symptoms of a hypoestrogenic state (hot flashes, vaginal dryness, decreased libido, and bone density loss). Hot flashes are expected and not a complication.
3. Dyspareunia is a common symptom of endometriosis and therefore is not a complication.
4. Combination oral contraceptive pills contain estrogen. A painful, swollen lower extremity can be a sign of deep vein thrombosis, which can cause thromboembolus, which is potentially life threatening. This is a complication and must be addressed immediately.
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