NSG 6005 Week 7 – Assignment 1 Discussion

EP is a fifty-year-old woman who reports experiencing two to three hot flashes

Select one of the two questions from the discussion questions listed below .By Week 7, Day 3, respond to the selected discussion question and submit your response to this Discussion Area .

Be sure to respond to the question using the lessons and vocabulary found in the reading .Justify your answers using examples and reasoning .Support your answers with examples and research and cite your research using APA format .

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ posts .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. EP is a fifty-year-old woman who reports experiencing two to three hot flashes.

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NSG 6005 Week 7 – Assignment 1 Discussion Question 1

EP is a fifty-year-old woman who reports experiencing two to three hot flashes per day, occasionally associated with insomnia .She also states she is awakened from sleep about two to three times per week, needing to change her bedclothes and linens due to sweating .Her symptoms began about three months ago, and over that time, her symptoms have worsened to the point where they have become very bothersome .She is concerned about starting any hormonal treatment because she has read news stories that the medication is not safe .She has been successfully treated for depression and is currently doing well on paroxetine .Her current medications include omeprazole 20 mg daily, paroxetine 20 mg, Synthroid 0 .075 mg daily, and hydrochlorothiazide 25 mg daily .Her physical exam is normal; her blood pressure is 128/86, her pulse is 78, and her body mass index (BMI) is 30 .5 .Answer the following questions:

• Is there any additional information you would want to collect?
• What are the variables you would take into account before deciding how to help her?
• What treatment will you recommend?
• What nonpharmacological treatment would you suggest?
• For medications, include dosages and schedules .Include highlights of patient teaching and/or lifestyle alterations .Support your decisions with at least one reference to a published clinical guideline and one peer-reviewed publication. EP is a fifty-year-old woman who reports experiencing two to three hot flashes
  

NSG 6005 Week 7 Assignment 2 Quiz

1 .Question : A twenty-two-year-old woman receives a prescription for oral contraceptives. Education for this patient includes:

• Counseling regarding decreasing or not smoking while taking oral contraceptives
• Advising a monthly pregnancy test for the first three months she is taking the contraceptive
• Advising that she may miss two pills in a row and not be concerned about pregnancy
• Informing her that her next follow-up visit is in one year for a refill and “annual exam”

Question 2 .Sallie has been diagnosed with osteoporosis and is asking about the once-a-month pill to treat her condition .How do bisphosphonates treat osteoporosis?

• By selectively activating estrogen pathways in the bone
• By reducing bone resorption by inhibiting PTH
• By reducing bone resorption and inhibiting osteoclastic activity
• By increasing PTH production

Question 3 .Elderly patients who are started on levothyroxine for thyroid replacement should be monitored for:

• Excessive sedation
• Tachycardia and angina
• Weight gain
• Cold intolerance

Question 4. Intranasal calcitonin is used in the treatment of osteoporosis .For which patient is Calcitonin therapy appropriate?

• Thin, Caucasian perimenopausal women
• Men over the age of sixty-five years with osteoporosis
• Women over the age of sixty-five years with osteopenia
• Women over the age of sixty-five years with severe osteoporosis

Question 5. The ongoing monitoring of patients over the age sixty-five years taking alendronate (Fosamax) or any other bisphosphonate is:

• Annual dual energy X-ray absorptiometry (DEXA) scans
• Annual vitamin D level
• Annual renal function evaluation
• Electrolytes every three months

NSG 6005 Week 7 – Assignment 1 Discussion Question 2

VG is a thirty-one-year-old female who comes in for a routine follow-up .She reports that she has been feeling excessive fatigue over the last month .She also notes that she is having some problems at work, not only because of her fatigue but also because of difficulty concentrating .She also notes that she has gained 10 pounds over the last month, and she is unable to identify the cause of the weight gain .She also notes that her periods are a little heavier and more irregular .She is currently taking daily ferrous sulfate and over-the-counter calcium .According to her medical record, she had a TSH level of 4 .2 mIL/L about a year ago .Although this is slightly elevated, no further follow-up was deemed necessary at the time .Repeat blood work today reveals a TSH level of 9 .8 mIL/L and a free T4 of 0 .72 ng/dL .Answer the following questions:

• What additional findings on the physical exam would you look for?
• What implication does the previous TSH level have?
• What therapy would you institute?
• If VG becomes pregnant, what adjustment, if any, would be needed in her thyroid medication?

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