A nurse is teaching a client who is to begin taking tamoxifen to treat breast cancer. The nurse should instruct the client to expect which of the following findings as an adverse effect of the medication?
A.
Constipation
B.
Clotting
C.
Tinnitus
D.
Urinary retention
The correct answer and Explanation is :
The correct answer is B. Clotting.
Explanation:
Tamoxifen is a selective estrogen receptor modulator (SERM) used primarily to treat and prevent breast cancer. It acts by binding to estrogen receptors, blocking the effects of estrogen in breast tissue, which is critical because many breast cancers grow in response to estrogen. Tamoxifen is effective, but like all medications, it has adverse effects, one of which is an increased risk of blood clotting.
Adverse Effects of Tamoxifen:
- Increased Risk of Thromboembolism (Clotting): Tamoxifen increases the risk of blood clots (venous thromboembolism), such as deep vein thrombosis (DVT) and pulmonary embolism (PE). This risk arises due to its estrogen-like effects on other tissues in the body, such as the liver, which can increase clotting factors. This is why clotting is a key adverse effect that patients should be informed about. The nurse should educate the client about recognizing symptoms of a blood clot, such as swelling in the legs, pain, shortness of breath, or chest pain, and to seek immediate medical attention if these occur.
- Hot Flashes: Tamoxifen can cause menopausal-like symptoms, including hot flashes, as it interferes with estrogen’s action in the body.
- Endometrial Changes: Since tamoxifen acts as an estrogen agonist on the uterus, there is an increased risk of endometrial hyperplasia, polyps, and even cancer.
Why Not Other Answers?
- A. Constipation: While gastrointestinal side effects like nausea are possible, constipation is not a typical adverse effect of tamoxifen.
- C. Tinnitus: This refers to ringing in the ears, which is not associated with tamoxifen.
- D. Urinary retention: This is not a known adverse effect of tamoxifen therapy.
Hence, the nurse should emphasize the increased risk of clotting and educate the client on how to recognize signs and symptoms of blood clots.