The physiology of how the body maintains normal bone density.
1. Generalized Anxiety disorder (including Postpartum anxiety) is a mental health condition encountered by midwives. Discuss the etiology, components of assessing for this condition (including screening for them), when to refer, and patient health education points.
2. Case Study 1- Musculoskeletal Conditions
Irene is a 65 year old white woman who presents to you today to review her recent DEXA results, which you ordered as routine screening at her last annual exam.
PMH:
Menopause 52, never on hormone therapy
Seizure disorder since age 22
Asthma since childhood
FH:
Sister, paternal aunt- osteoporosis
Mother- breast cancer 58, HTN, borderline DM, died of lung cancer 69
Father- HTN, cholesterol, died MI 76
Social hx:
1 glass wine daily
4 cigs/d down from ½ ppd 8 yrs ago
Widowed for 1 year, one healthy son
Meds:
Phenytoin 100 mg pot id
Albuterol MDI 2 puffs bid prn
Triamcinolone MDI 2 puffs qid
Prednisolone 5 mg po bid prn
Vital Signs
BP 129/83
RR 20
Ht 5’3″
P 88
T 98.7
Wt 102
DEXA Scan Results
Site
T score
Lumbar spine L2-4
-2.8
R femoral neck
-2.1
Discuss, using the midwifery management process, answer the following:
Describe the physiology of how the body maintains normal bone density.
What are the authoritative bodies’ criteria for osteoporosis and osteopenia?
What components of the PE will you emphasize?
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