—Lynn Goddess, Founder of the Hazel K. Goddess Fund for Stroke Research in Women

Stroke is among the leading causes of death for women in the United States (CDC, 2008b). This common health condition has severe implications for women, yet it is frequently misdiagnosed because the female presentation of stroke often differs from the typical recognized male presentation. Like stroke, many other common cardiovascular and neurologic health conditions also present differently and progress differently in women. As an advanced practice nurse providing care for women, you must be able to quickly identify the unique signs and symptoms of these common health conditions in women.

This week you examine common cardiovascular and neurologic conditions that impact women. You consider differential diagnoses, treatment and management plans, and patient education strategies for women with these conditions. You also examine the Women’s Health Initiative study and research current best practices for assessing and managing common health conditions in women.

Learning Objectives – NURS 6551:Week 10: Common Health Conditions with Implications for Women, Part 1

By the end of this week, students will:

• Assess patients with common cardiovascular and neurologic conditions
• Evaluate differential diagnoses for common cardiovascular and neurologic conditions
• Analyze treatment and management plans for patients with common cardiovascular and neurologic conditions
• Analyze strategies for educating patients on the treatment and management of common cardiovascular and neurologic conditions
• Compare the diagnosis and management of female and male patients with the same conditions
• Evaluate best practices for assessing and managing conditions related to women’s health
• Evaluate the impact of differences in best practices on women’s health
• Understand and apply key terms, principles, and concepts related to common health conditions with implications for women
• Evaluate body system conditions

Learning Resources

Required Readings

Tharpe, N. L., Farley, C., & Jordan, R. G. (2017). Clinical practice guidelines for midwifery & women’s health (5th ed.). Burlington, MA: Jones & Bartlett Publishers.

• • Chapter 8, “Primary Care in Women’s Health” (pp. 457-616)

This chapter explores health promotion and disease prevention in women’s health. It also describes the presentation, assessment, diagnosis, and management of various systemic conditions, including cardiovascular and neurologic conditions.

McSweeney, J. C., Pettey, C. M., Souder, E., & Rhoads, S. (2011). Disparities in Women’s cardiovascular health. Journal of Obstetric, Gynecologic & Neonatal Nursing, 40(3), 362–371.

This article explores health disparities in cardiovascular disease, including gender and racial disparities related to the diagnosis, treatment, and outcomes of patients with this disease.

Department of Health and Human Services, National Institutes of Health, & National Heart, Lung, and Blood Institute. (n.d.). Women’s Health Initiative: WHI background and overview. Retrieved March 20, 2013, from http://www.nhlbi.nih.gov/whi/background.htm

This website outlines details of the Women’s Health Initiative (WHI) and introduces the various health issues addressed by the WHI.

Optional Resources – NURS 6551:Week 10: Common Health Conditions with Implications for Women, Part 1

Centers for Disease Control and Prevention. (2012b). Women’s health. Retrieved from http://www.cdc.gov/women/

National Institutes of Health. (2012). Office of Research on Women’s Health (ORWH). Retrieved from http://orwh.od.nih.gov/

U.S. Department of Health and Human Services. (2012a). Womenshealth.gov. Retrieved from http://www.womenshealth.gov/

Discussion: Diagnosing and Managing Common Cardiovascular and Neurologic Conditions

Cardiovascular and neurologic conditions are among the leading causes of death and hospitalization of women in the United States (Centers for Disease Control and Prevention, 2008a). As an advanced practice nurse, you must routinely monitor patients at risk of these conditions and recommend the appropriate health screenings and preventive services. When assessing patients for these conditions, it is important to keep in mind that while some female patients might present with typical signs and symptoms, others might present with atypical signs and symptoms that are unique to women. For this Discussion, consider signs and symptoms presented by the women in the following case studies and develop differential diagnoses:

Case Study 1

A 48-year-old overweight African American female is in the clinic for a wellness visit. A routine fasting lipid panel returned with the following results:

• Total cholesterol: 305 mmol/L
• Low-density lipoprotein (LDL): 180 mg/dl
• High-density lipoprotein (HDL): 30 mg/dl
• Triglycerides: 165 mg/dl

Case Study 2

You are seeing a 63-year-old African American female for a two-week history of intermittent chest pain. The pain varies in intensity and resolves with rest. She does not believe it has increased over time. She is a nonsmoker with a history of hypertension treated with Lisinopril 10 mg once daily. She had an exercise stress test one year ago that was within normal limits. Her physical exam findings are as follows: HR–90, BP–150/92, R–22, O2Sat 98% RA; lungs: clear to auscultation bilaterally; cardiovascular: apical pulse of 90 RRR, no rubs, murmurs, or gallops. Chest wall mildly tender to palpation that reproduces her complaint of pain. Extremities include no clubbing, cyanosis, or edema. The remainder of the exam is within normal limits.

Case Study 3

A 32-year-old Asian American female is in the clinic for a history of recurrent headaches for the past year, occurring monthly, lasting up to 12–18 hours. The headaches are sometimes associated with photophobia, nausea, and vomiting. She takes either acetaminophen or ibuprofen for relief that is not always successful. She uses Ortho Tricyclin for birth control. Her physical exam is within normal limits.

To prepare:

• Review Chapter 8 of the Tharpe et al. text and the McSweeney et al. article in this week’s Learning Resources.
• Review and select one of the three provided case studies. Analyze the patient information.
• Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
•  
• Reflect on the appropriate clinical guidelines. Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments.
• Consider strategies for educating patients on the treatment and management of the disorder you identified as your primary diagnosis.

By Day 3

Post an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Then, based on the appropriate clinical guidelines, explain a treatment and management plan for the patient, including proper dosages for any recommended treatments. Finally, explain strategies for educating patients on the disorder.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days who selected different case studies than you did. Keep in mind the conditions your colleagues identified as their primary diagnoses. Explain signs and symptoms of these conditions that are unique to women or are more commonly seen in women. Then, explain how the assessment, diagnosis, treatment, and management of female patients might differ from male patients with the same conditions.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit! NURS 6551:Week 10: Common Health Conditions with Implications for Women, Part 1.

 

 

ADDITIONAL INFO 

Common Health Conditions with Implications for Women

Introduction

Women are more likely than men to experience certain health conditions. This is due to the fact that women, on average, have estrogen and progesterone circulating in their bodies. These hormones can affect how the body absorbs nutrients from food and utilizes them for growth (in children), maintenance (in adults) and repair (both). Women may also be more susceptible to certain diseases because of hormonal changes during pregnancy or after childbirth. Some examples include:

High Cholesterol

Cholesterol is a waxy substance that is produced by the liver. It’s used to make hormones and vitamin D, as well as bile acids. Cholesterol also plays a role in maintaining your cells’ structure and structure, so if you have high levels of cholesterol in your blood, it could indicate an underlying medical condition like diabetes or heart disease. High levels of LDL (bad) cholesterol can lead to plaque build-up on artery walls—this can cause blood clots that may cause heart attacks or stroke if left untreated for too long.

There are several types of dietary changes you can make to help reduce these risks:

• Cut down on saturated fats—the most common source being meat products with lots more than 10 grams per day; dairy products also contain large amounts so try cutting out dairy altogether unless there’s a specific reason not too (e., allergies). Instead choose unsaturated fats like olive oil instead!

• Limit sweets/sweets such as cakes etc., especially those high in sugar content because they increase triglycerides which raises risk factors further still!

Osteoporosis

Osteoporosis is a disease that causes bones to weaken and break easily. It’s common in women over 50, but some men also develop it.

Osteoporosis can be prevented by eating a healthy diet, getting enough calcium and vitamin D, and exercising regularly. If you have osteoporosis or are at risk of developing it, talk with your doctor about taking medications like Fosamax (alendronate), Teriparatide (recombinant parathyroid hormone), or Denosumab (Prolia).

Thyroid Disease

The thyroid gland, located in your neck, produces hormones that regulate metabolism and growth. When the thyroid becomes overactive or underactive, you may experience symptoms such as fatigue, weight gain and irregular menstrual periods.

The most common form of thyroid disease is hyperthyroidism (overactive), which occurs when the gland produces too much thyroid hormone but doesn’t have an adequate response from your body. This can cause an increase in heart rate and blood pressure; rapid breathing; tremors (shaking); nervousness; irritability; insomnia or excessive sleepiness; frequent bowel movements or constipation; headache/migraine headaches that do not respond to medication prescribed by a physician (although some people who have migraines may actually have hyperactivity); anxiety attacks caused by increased levels of adrenaline released during stress situations like public speaking events at work where you need to address important issues related to company performance outcomes for example.”

Chronic Hepatitis C Virus (HCV)

HCV is a blood-borne virus and the most common chronic blood-borne infection in the United States. The viruses are transmitted through a variety of ways, including:

• Blood transfusion

• Sexual contact (including oral sex)

• Sharing needles to inject drugs or medications

Coronary Artery Disease

Coronary artery disease is the most common type of heart disease, affecting more than 40 million Americans. It occurs when there is a build-up of fatty deposits on the walls of arteries that supply blood to your heart. The result can be a narrowing or blockage in these arteries, which prevents enough oxygen-rich blood from reaching areas like your brain or heart muscle.

Coronary artery disease can lead to chest pain (angina), shortness of breath and feeling tired all day long. If left untreated, it can lead to stroke or heart attack—the two leading causes for death in this country—and even sudden cardiac arrest if you don’t get help quickly enough!

Stroke

Stroke is a disease that affects the brain, causing damage to the tissue and nerve cells. It can be caused by a blood clot or hemorrhage, or it may result from an infection or other condition affecting the blood vessels.

Symptoms of stroke include:

• Problems with vision or speech (facial paralysis)

• Trouble walking (ataxia)

• Loss of consciousness for several minutes or longer

Autoimmune Diseases

Autoimmune diseases are conditions where the immune system attacks your own body. Autoimmune diseases can be serious and life threatening, so it’s important to know what you’re up against. They include arthritis, lupus (the most common autoimmune disease in women), celiac disease (a digestive disorder that affects roughly 1% of adults) and others like rheumatoid arthritis or multiple sclerosis.

Autoimmunity is more common in women than men; however it still occurs in both sexes at different rates depending on the type of autoimmunity they have.

Takeaway:

There are some major differences between women and men when it comes to health. The following are some of the most common conditions that affect women, but they do not apply equally to both genders:

• Women are more likely to suffer from certain health conditions such as heart disease, stroke and diabetes than men.

• Women are also more prone to autoimmune diseases such as Hashimoto’s thyroiditis or rheumatoid arthritis (RA). This can be caused by an inflammatory response in your body which damages tissues, causing pain and swelling along with other symptoms like fatigue or joint stiffness.

• Osteoporosis is another condition affecting women more so than men; this condition occurs when there isn’t enough calcium in a person’s bones due to low levels of estrogen and other hormones called sex hormones.*

Conclusion

If you have any of these conditions, it is important to talk with your doctor about the impact it can have on your health and well-being.