The nurse teaches the client about a new prescription for hormone replacement therapy. Which information in the client history most concerns the nurse?

Question

1. Mother had breast cancer
2. History of oral contraceptives for fifteen years
3. Anticoagulant therapy for the past six months
4. Treatment for hypercholesterolemia

Answer 1

3. Anticoagulant therapy for the past six months

Explanation: 1. Most breast cancers are not hereditary. The client's personal risk for breast cancer does increase with HRT, though. A personal history of breast cancer is a contraindication to HRT.
2. Prolonged exposure to oral contraceptives can increase the risk of breast cancer, particularly in estrogen-progesterone therapies. This risk is not the most concerning.
3. Thromboembolic disease is a direct contraindication to HRT. The client who is on anticoagulants has either had a clot or is at high risk for clots due to something like atrial fibrillation. The nurse must ensure the client does not have direct contraindication to therapy.
4. Hormone replacement therapy is contraindicated in coronary heart disease. Though heart disease and hypercholesterolemia are closely related, they are not the same. This client can proceed with HRT with caution.