Final answer:
A nurse should instruct a client on hormone replacement therapy to report to their provider if they experience leg swelling, as this can indicate serious conditions such as blood clots. Other symptoms like weight gain, hot flashes, and breast tenderness are common side effects but require less urgent attention. The correct option is d) Leg swelling.
Step-by-step explanation:
A nurse instructing a client who is perimenopausal and has a prescription for hormone replacement therapy (HRT) should advise the client to notify their healthcare provider if they experience d) Leg swelling. This particular symptom can indicate a potentially serious adverse effect associated with HRT such as blood clots, which may lead to deep vein thrombosis (DVT) or a pulmonary embolism (PE). While other symptoms like weight gain, hot flashes, and breast tenderness may occur and are known side effects of HRT, leg swelling requires immediate medical attention.
HRT has been associated with an increased risk of several significant health concerns like stroke or heart attack, breast cancer, ovarian cancer, endometrial cancer, gall bladder disease, and dementia. These risks are part of the reason why HRT might be prescribed cautiously, tailored to the individual's needs, and regularly monitored. The potential for these adverse effects underpins the importance of the patient reporting any unusual or severe symptoms to their provider immediately.