NURS 6521 Module 7 Week 9 Discussion
NURS 6521 Module 7 Week 9 Discussion
NURS 6521 Module 7 Week 9 Discussion
Module 7 Week 9 Discussion
The chief complaints of hot flushing, night sweats, and genitourinary symptoms indicate that the patient grapples with menopause. According to Peacock & Ketvertis (2022), menopause is a normal process characterized by the diminishing number of ovarian primary follicles and their subsequent inability to respond to the effects of follicle stimulating hormones (FHS). The common symptoms for estrogen deficiency and the cessation of menses are vasomotor symptoms like night sweats, migraines, and hot flashes, urogenital signs, such as vaginal atrophy and sexual dysfunction, and psychogenic symptoms, including irritability, anxiety, sleep disturbance, loss of concentration, and loss of self-esteem. The prevalence of these symptoms can compromise the quality of life for patients.
Brief Description of Patient’s Health Needs
Besides exhibiting various symptoms of menopause, the patient has a history of underlying conditions, including ASCUS and hypertension. Further, she has a family history of breast cancer. The patient is currently taking two medications for hypertension; Norvasc 10 mg and HCTZ 25 mg. Her struggle with hypertension and a family history of breast cancer can influence the decision on ideal pharmacological options for treating menopause symptoms. More essentially, the patient requires frequent monitoring of vital signs, such as blood pressure, PAP smear exams, and weight.
Treatment Regimen
The primary treatment option for the patient should focus on addressing the symptoms of menopause, while considering her current medication trials and a family history of breast cancer. According to Fait (2019), menopause hormone therapy is the most effective and efficient treatment for acute climacteric symptoms and prevention of estrogen deficiency. In this sense, low doses of estrogen can prevent urogenital atrophy and its ramifications. However, this treatment option is controversial in patients with a history of breast cancer. Cagnacci & Venier (2019) argue that hormonal replacement therapy (HRT) can increase risk of breast cancer in women treated with conjugated estrogen and medroxyprogesterone acetate. Therefore, I would not recommend this treatment option for the patient because of her susceptibility to breast cancer and cardiovascular disease (Rosenthal & Burchum, 2021). As a result, I would suggest a low dose of selected serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) for the treatment of menopause symptoms. Equally, low doses of antidepressants like sertraline, paroxetine, and clonidine can reduce hot flashes (Biglia et al., 2019). Frequent monitoring of the patient’s response to these medications is vital in preventing their contradictions and subsequent side effects.
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Patient Education Strategy
The patient requires educational interventions to understand self-management approaches for body mass index (BMI). According to Mayo Clinic (2022), obesity is a risk factor for menopause symptoms, such as hot flashes. Education programs should focus on healthy diet plans and physical exercise, including the importance of physical activeness and low sodium diets. Finally, it would be crucial to educate the patient on vital sign monitoring and timely communication with healthcare professionals.
References
Biglia, N., Bounous, V. E., De Seta, F., Lello, S., Nappi, R. E., & Paoletti, A. M. (2019). Non-hormonal strategies for managing menopausal symptoms in cancer survivors: An update. Ecancermedicalscience, 13. https://doi.org/10.3332/ecancer.2019.909
Cagnacci, A., & Venier, M. (2019). The controversial history of hormone replacement therapy. Medicina, 55(9). https://doi.org/10.3390/medicina55090602
Fait, T. (2019). Menopause hormone therapy: Latest developments and clinical practice. Drugs in Context, 8, 1–9. https://doi.org/10.7573/dic.212551
Mayo Clinic. (2022). Hot flashes – symptoms and causes. https://www.mayoclinic.org/diseases-conditions/hot-flashes/symptoms-causes/syc-20352790#
Peacock, K., & Ketvertis, K. M. (2022). Menopause. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK507826/
Rosenthal, L., & Burchum, J. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.). Saunders.
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Module 7
Women’s and Men’s Health, Infections, and Hematologic Systems. In this module, you will examine women’s and men’s health, infectious diseases, and hematologic disorders as well as the types of drugs used to treat aspects of these disorders or health systems.
You will likely experience patient encounters with complex comorbidities. For example, consider a female patient who is pregnant who also presents with hypertension, diabetes, and has a recent tuberculosis infection. How might the underlying pathophysiology of these conditions affect the pharmacotherapeutics you might recommend helping address your patient’s health needs? What education strategies might you recommend for ensuring positive patient health outcomes?
For this Discussion, you will be assigned a patient case study and will consider how to address the patient’s current drug therapy plans. You will then suggest recommendations on how to revise these drug therapy plans to ensure effective, and safe care. Consider how you will practice critical decision making for prescribing appropriate drugs and treatment to address the complex patient health needs in the patient case study you selected, and quality patient care for positive patient health outcomes.
CASE STUDY 2
A 46-year-old, 230lb woman with a family history of breast cancer. She is up to date on yearly mammograms. She has a history of HTN. She complains of hot flushing, night sweats, and genitourinary symptoms. She had felt well until 1 month ago and she presented to her gynecologist for her annual gyn examination and to discuss her symptoms. She has a history of ASCUS about 5 years ago on her pap, other than that, Pap smears have been normal. Home medications are Norvasc 10mg qd and HCTZ 25mg qd. Her BP today is 150/90. She has regular monthly menstrual cycles. Her LMP was 1 month ago.
Your discussion post this week 9 should include a brief description of this patient’s health needs. Be specific. Then, explain the type of treatment regimen you would recommend for treating your patient, including the choice or pharmacotherapeutics you would recommend and explain why. Be sure to justify your response. Explain a patient education strategy you might recommend for assisting your patient with the management of their health needs. Be specific and provide examples.
