COLLAPSE
Background of Patient’s Health Needs
The case study patient is a 46-year-old female who presents with complains of hot flushing, night sweats, and genitourinary symptoms. Patient has a past medical history of hypertension. Patient has drug prescription of Norvasc 10 mg by mouth daily and HCTZ 25 mg daily. Patient is on two different BP medications, however her BP this visit is 150/90 indicating she is either not compliant with medications or needs dosage increase. The case study patient likely has uncontrolled hypertension and early menopause.
Menopause is defined as the cessation of spontaneous menses for 12 months, marking the end of a woman’s reproductive life, and it typically occurs between the ages of 49 and 52 years (Huan, Deng, He, Chen & Niu 2021). Early or premature menopause happens when ovaries stop making hormones and periods stop at a younger age than usual. When menopause happens before age 40 it is called premature menopause and when it happens between 40 and 45 is called early menopause. According to the US Department of Health and Human Services (n.d.), About 5% of women naturally go through early menopause. Early or premature menopause can happen on its own for no clear reason, or it can happen because of certain surgeries, medicines, or health conditions. According to Gosset, Robin, Letombe, Pouillès & Trémollieres (2021) Risk factors responsible for premature or early menopause include: Family history, smoking, chemotherapy or pelvic radiation treatments for cancer, surgery to remove the ovaries and uterus.
Treatment
Usually menopause does not require medical treatment. Instead, treatments focus on relieving your signs and symptoms and preventing or managing chronic conditions that may occur with aging. There are however treatments options that are now available to relieve signs and symptoms and they include: Hormone therapy example would be the Estrogen therapy (Lello, Capozzi & Scambia, 2017). This type of treatment option is the most effective treatment for relieving menopausal hot flashes. Because our case study patient is just starting to experience early symptoms, I will put her on low dose estrogen for short period to relieve symptom and then see her after couple weeks to review her the signs and symptoms. Because she has family history of cancer and HTN estrogen may be recommended for just short time frame. The other medication I will prescribe is Gabapentin. According to (Huan, Deng, He, Chen & Niu 2021) Gabapentin is approved to treat seizures, but it has also been shown to help reduce hot flashes. This drug is useful in women who can’t use estrogen therapy and in those who also have nighttime hot flashes.
Patient Education
Educating the patient on the risks associated with HTN is important. High blood pressure has been found to increase the risk for heart disease and stroke, which are the two leading causes of death for Americans. As the provider for this patient, I will also explain to her that high blood pressure usually has no symptoms, and that she needs to measure her blood pressure and keep a daily log of the BP readings. Increasing medication may be necessary after establishing that she is compliant. Non-compliance with BP medications is high in most patients. At this time I will stop Norvasc because of its known side effects which include flushing. Other common side effects of Norvasc a calcium channel blockers include headache, swelling of the lower extremities, dizziness, flushing, fatigue, nausea, and palpitations (Drugs.com, 2020). Starting patient on beta blocker and teaching patient on new medication will be the next action.
References
Drugs.com (2020) Norvasc Side Effects. Retrieved from:
https://www.drugs.com/sfx/norvasc-side-effects.html
Gosset, A., Robin, G., Letombe, B., Pouillès, J.-M., & Trémollieres, F. (2021). Menopause
hormone treatment. Postmenopausal women management – CNGOF and GEMVi clinical practice guidelines]. Gynecologie, Obstetrique, Fertilite & Senologie. https://doi-org.ezp.waldenulibrary.org/10.1016/j.gofs.2021.03.019
Huan, L., Deng, X., He, M., Chen, S., & Niu, W. (2021). Meta-analysis: Early Age at Natural
Menopause and Risk for All-Cause and Cardiovascular Mortality. BioMed Research International, 1–14. https://doi-org.ezp.waldenulibrary.org/10.1155/2021/6636856
Lello, S., Capozzi, A., & Scambia, G. (2017). The Tissue-Selective Estrogen Complex
(Bazedoxifene/Conjugated Estrogens) for the Treatment of Menopause. International Journal of Endocrinology, 1–9. https://doi-org.ezp.waldenulibrary.org/10.1155/2017/5064725
US Department of Health and Human Services (n.d.) Early or premature menopause
Retrieved from https://www.womenshealth.gov/menopause/early-or-premature-menopause
In the above discussion post, respond to it and provide recommendations for alternative drug treatments to address the patient’s pathophysiology. Be specific and provide examples.
Last Completed Projects
| topic title | academic level | Writer | delivered |
|---|
