NR 566 Final
Mechanism of action of estrogen and progestin - Answer-Diffuses into cells to bind to their receptors in
the cell nucleus. A hormone-receptor complex is formed, which then binds to the target gene to alter
the rate of gene transcription
Estrogen and progestin baseline - Answer-HR
BP
Weight
Pregnancy test
Screen for breast cancer
Screen for cardiovascular disease
(estrogen-only) - TSH, triglycerides
Estrogen/progestin contraindications - Answer-Abnormal vaginal bleeding
Estrogen-dependent cancers
Breast cancer
Hx thrombus (DVT, PE, MI, CVA) - estrogen only
Abnormal liver function
Estrogen adverse effects - Answer-- Nausea
- Breast tenderness
- Bloating/Weight gain
,- Increased BP
- Thrombosis
Why should estrogen be taken with progestin in menopausal women? - Answer-If they take estrogen
alone, there is an increased risk of endometrial cancer
Role of progesterone in menstrual cycle - Answer-Secreted in 2nd half of menstrual cycle. If there is no
pregnancy, the levels will decrease
Role of progesterone in pregnancy - Answer-Helps maintain pregnancy by preventing uterine
contraction
Decreases GI muscle contraction (causes constipation)
Promotes breast milk production
Increases pH and suppresses pCO2
Suppresses maternal immune system (prevents attack on fetus)
Forms of contraception - Answer-etonogestrel implant (nexplanon) - top 3 are most effective
IUD
sterilization
oral contraceptive - adherence can be an issue
methodroxyprogesterone (depo-provera) - injection q3m
contraceptive ring
, contraceptive patch
barriers - protection against STDs
spermicide
withdrawal - least effective
When is it safe to prescribe progestin? - Answer-preferred with lactation
often taken in combination with estrogen to decrease risk of endometrial cancer
patients with hx of clots could use certain progestin-only contraceptives, like Nexplanon and Depo-
provera
progestin-only pills "mini pills" have less side effects but can be less effective d/t effects on cervical
lining - MUST TAKE AT SAME TIME EVERY DAY
Benefits of prescribing medroxyprogesterone acetate (depo-provera) - Answer-highly effective
injection every 3 months, so adherence is not a major issue
Patient teaching for testosterone therapy - Answer-risk for secondary exposure with the gel (careful
with kids and women)
tell females about signs of virilization
teach about signs of liver dysfunction (should d/c drugs of symptoms of liver issues)
use contraception d/t risk for fetal malformations
Therapeutic use of progestin - Answer-Counteracts endometrial hyperplasia caused by estrogen alone
Mechanism of action of estrogen and progestin - Answer-Diffuses into cells to bind to their receptors in
the cell nucleus. A hormone-receptor complex is formed, which then binds to the target gene to alter
the rate of gene transcription
Estrogen and progestin baseline - Answer-HR
BP
Weight
Pregnancy test
Screen for breast cancer
Screen for cardiovascular disease
(estrogen-only) - TSH, triglycerides
Estrogen/progestin contraindications - Answer-Abnormal vaginal bleeding
Estrogen-dependent cancers
Breast cancer
Hx thrombus (DVT, PE, MI, CVA) - estrogen only
Abnormal liver function
Estrogen adverse effects - Answer-- Nausea
- Breast tenderness
- Bloating/Weight gain
,- Increased BP
- Thrombosis
Why should estrogen be taken with progestin in menopausal women? - Answer-If they take estrogen
alone, there is an increased risk of endometrial cancer
Role of progesterone in menstrual cycle - Answer-Secreted in 2nd half of menstrual cycle. If there is no
pregnancy, the levels will decrease
Role of progesterone in pregnancy - Answer-Helps maintain pregnancy by preventing uterine
contraction
Decreases GI muscle contraction (causes constipation)
Promotes breast milk production
Increases pH and suppresses pCO2
Suppresses maternal immune system (prevents attack on fetus)
Forms of contraception - Answer-etonogestrel implant (nexplanon) - top 3 are most effective
IUD
sterilization
oral contraceptive - adherence can be an issue
methodroxyprogesterone (depo-provera) - injection q3m
contraceptive ring
, contraceptive patch
barriers - protection against STDs
spermicide
withdrawal - least effective
When is it safe to prescribe progestin? - Answer-preferred with lactation
often taken in combination with estrogen to decrease risk of endometrial cancer
patients with hx of clots could use certain progestin-only contraceptives, like Nexplanon and Depo-
provera
progestin-only pills "mini pills" have less side effects but can be less effective d/t effects on cervical
lining - MUST TAKE AT SAME TIME EVERY DAY
Benefits of prescribing medroxyprogesterone acetate (depo-provera) - Answer-highly effective
injection every 3 months, so adherence is not a major issue
Patient teaching for testosterone therapy - Answer-risk for secondary exposure with the gel (careful
with kids and women)
tell females about signs of virilization
teach about signs of liver dysfunction (should d/c drugs of symptoms of liver issues)
use contraception d/t risk for fetal malformations
Therapeutic use of progestin - Answer-Counteracts endometrial hyperplasia caused by estrogen alone
