Men and Woman’s Health Discussion
Please construct a 1-page initial discussion that follows the instructions provided in this instruction sheet. A minimum of 3 scholarly references written within the last 5 years is required. I have included a few but please add what you need to develop a well-constructed discussion. I have also included an EXAMPLE discussion post at the bottom of these instructions for ideas only. Please be cautious of plagiarism!
Case Study: 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.
Section 1: Describe your patient’s health needs from the patient case study.
Please begin with a summary or explanation of the onset of menopause linking that this patient is of age and how her symptoms fit the diagnosis (be as specific as possible by listing some genitourinary symptoms etc). Explain the loss of hormones hypertension and weight and how they are impacted by menopause.
Section 2: 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.
Please focus on low dose hormone replacement therapy and control of her blood pressure (adjusting the dose of HCTZ with cited information as to why this is an appropriate approach). Discuss why this is the first step versus changing the dose of Norvasc (top of dosing recommendation with citation). Include any treatment that may help with the genitourinary symptoms even if they are over the counter medications that help with symptoms.
Section 3: Explain a patient education strategy you might recommend for assisting your patient with the management of their health needs. Be specific and provide examples.
Focus on education that teaches the patient about hormone therapy, the importance of healthy living habits to incorporate that address weight loss and blood pressure control due to the challenge of these issues during menopause. Also include the need to remain consistent with wellness checks and screenings like pap and mammogram due to her history and family history.
References
Ozcan, H. (2019). Healthy life style behaviors and quality of life at menopause [PDF]. International Journal of Caring Sciences. http://www.internationaljournalofcaringsciences.org/docs/55_ozcan_12_1.pdf
Roberts, H., & Hickey, M. (2016). Managing the menopause: An update. Maturitas, 86, 53–58. https://doi.org/10.1016/j.maturitas.2016.01.007
Rosenthal, L. D., & Burchum, J. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.). Elsevier.
EXAMPLE
The purpose of this discussion post is to analyze a women’s health case study that is reflective if menopause and suggest a treatment plan for the patient.
BR is a 46-year-old woman who presents with complaint of not feeling well the past month. She complains having hot flashes, night sweats, and genitourinary symptoms. She has a history of hypertension, ASCUS five years ago on her pap but her most recent pap smear was normal. She has regular menstrual cycles with the last one being a month ago. Her family history consists of breast cancer. BR is up to date with her mammograms. Home medications are as followed: Norvasc 10mg daily, and HCTZ 25mg daily. Weight is 230lbs. Her BP today is 150/90. Menopause The diagnosis that could be given to BR is perimenopause which is the early stages of menopause.
Menopause is a female disorder that affects every woman at some point in their life. According to Ozcan (2019), menopause occurs between the ages of forty and fifty and is when a woman’s reproductive ability ends. Menopause is also described as the absence of a menses over twelve consecutive months and is a natural response to a woman aging (Zhu et al., 2018). The symptoms of menopause can vary but perimenopausal symptoms include hot flashes, cold sweats, irregular menstrual bleeding, vaginal dryness, and cognitive troubles (Bhatt, 2019).
Treatment Regimen
Based on the symptoms BR is exhibiting, it may be beneficial to start her on hormone replacement therapy (HRT). According to Akter and Shirin (2018), HRT is considered the most effective treatment for women who are suffering from perimenopausal and menopausal symptoms. HRT should be discussed thoroughly with patient and is individualized to each woman based on history and symptoms. The recommended HRT for BR would be start her on an estrogen and progestin combination daily. The estrogen would be prescribed for the treatment of BR’s symptoms of hot flashes and night sweats. According to Rosenthal and Burchum (2018), low dose estrogen is given to replace the loss of estrogen from perimenopause and reduce the symptoms of hot flashes and night sweats. Progestin is giving in combination with estrogen because BR still has her uterus. Progestin is needed to prevent endometrial cancer during menopause because it offsets the estrogen-mediated stimulation of the endometrium (Rosenthal & Burchum, 2018). The patient should be aware of the risk related to HRT and whether the risk outweighs the benefit of the relief of symptoms associated with menopause.
Education Strategy
BR has a history of hypertension which needs to be considered when educating the patient about HRT. According to Rosenthal and Burchum (2018), HRT can help with reducing cardiovascular disease (CD), but it is important that HRT is not used for that purpose and the patient continues to take prescribed medications related to CD. BR takes medications for her hypertension and her current blood pressure is elevated. The education of continuing to take her antihypertensive medications and maintaining a healthy diet is important in maintaining her cardiovascular health. According to Ozcan (2019), healthy lifestyle behaviors such as physical activity, healthy diet, and stress management can reduce the menopausal symptoms. BR also has a family history of breast cancer, and the risk of harm could increase with HRT (Rosenthal & Burchum, 2018). BR should be informed of the risk and educated about the importance of breast screenings.
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