Summary NR 566 Final Exam Study Guide Complate Latest 2023/2024

NR 566 Final Exam Study Guide Complate Latest 2023/2024. When is it safe and not safe to prescribe progesterone (AKA: progestin) o Therapeutic uses -  Counteract endometrial hypoplasia caused by unopposed estrogen during hormone therapy  Management of dysfunctional uterine bleeding  Amenorrhea and endometriosis  Supportive for pregnancy in women with corpus luteum deficiency  In vitro fertilization  Prevent prematurity in women at high risk for pre-term birth  Necessary to reduce the risk of endometrial cancer o CONTRAINDICATIONS -  Undiagnosed abnormal vaginal bleeding  Progestin can cause breakthrough spotting and amenorrhea  ^educate patients that this may occur but to report prolonged vaginal bleeding  Active thrombophlebitis or hx of thromboembolic disorders  Active liver disease  Carcinoma of the breast o Side effects of progestin-only oral contraceptives: o Excess –  Increased appetite  Weight gain  Depression  Tiredness  Fatigue  Hypomenorrhea  Breast regression  Monilial vaginitis  Acne, oily scalp  Hair loss  Hirsutism (excessive growth or dark or coarse hair in male-like pattern) o Deficiency –  Late breakthrough bleeding NR566 Final Study Guide  Amenorrhea  Hypermenorrhea  Benefits of prescribing medroxyprogesterone acetate  Testosterone therapy o Patient teaching in general and consider teaching specific to different routes  May take 1 month to take effect  LOOK AT NOTES o When is androgen therapy appropriate vs. not needed related to puberty?  Delayed puberty -  Providers will prescribe limited therapy if causing boy significant psychological distress  If due to true hypogonadism -> long-term therapy indicated  Not approved for testosterone therapy in the US  When prescribed off-label, must be prescribed at doses lower than those used for men  Goal = 300 mcg/day o Common side effects –  LOOK AT NOTES  Alprostadil (Papaverine/phentolamine) - o Benefits of various routes  Transurethral -> fewer side effects  Higher dose  Erection develops 5-10 minutes after drug administration and lasts 30-60 minutes  Intracavernous  ^ both lead to increased arterial blood flow to penis  Contraception o How does carbamazepine impact oral contraceptives and what symptoms may be associated with that?  How might this affect which OCP is prescribed?  Carbamazepine is an inducer, so it may make the OCP not as effective.  It would be recommended to prescribe a longer-lasting contraceptive o Benefits of Etonogestrel subdermal implant [Nexplanon]  MOST EFFECTIVE method of contraception (:  Alprostadil (Papaverine plus phentolamine) - o Patient education:  Adverse effects -  Orthostatic hypotension  Fibrotic nodules in the corpus cavernosum