Which precautions are important for the nurse to teach a patient who is taking hormone replacement therapy (HRT) to reduce menopausal discomfort? (Select all that apply.)
a. Use oral contraceptives.
b. Avoid cigarette smoking.
c. Avoid drinking alcoholic beverages.
d. Obtain a yearly influenza vaccination.
e. Perform monthly breast self-examinations.
f. Go to the hospital immediately if chest pains or symptoms of a stroke occur.
B, E, F
HRT with estrogens increase the risk for clot formation that could cause venous thromboembol-ism, stroke, and heart attack. The risk is higher if the patient also smokes. Patients taking HRT should avoid cigarette smoking and should seek medical help immediately if chest pain or symptoms of a stroke occur. Hormones like estrogen can make breast cancers grow faster. The patient should perform monthly breast self-examinations to determine the presence of any lumps that could be cancerous. Although a yearly influenza vaccination is a good health promotion practice, HRT does not increase the risk for influenza. Oral contraceptives should not be used with HRT. There is no contraindication for drinking alcohol (in moderation) while taking HRT.
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