Summary of case summary
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.
Instructions:
Post a brief description of your patient’s health needs from the patient case study you assigned. Be specific. Then, 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. Explain a patient education strategy you might recommend for assisting your patient with the management of their health needs. Be specific and provide examples.
- Consider how you will practice critical decision making for prescribing appropriate drugs and treatment to address the complex patient health needs in the patient case study you selected.
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Solution
Case Study
Considering the patient’s symptoms in the case study, who is a 46-year-old woman, her main health needs include managing menopausal symptoms, controlling blood pressure, and maintaining a healthy weight. The patient weighs 230 lbs., which is quite excess weight considering that the patient has a history of hypertension. The patient’s blood pressure also appears to be a bit high, considering that the current blood pressure measurement is 150/90. Finally, the patient appears to be suffering from menopausal symptoms because she complains of having night sweats, hot flashes, and genitourinary symptoms, which are all menopausal symptoms (Palacios et al., 2019).
In the case study of the 46-year-old woman, critical decision-making will be applied to prescribe the appropriate drugs for the patient’s treatment. Considering the patient’s history of hypertension, hormone replacement therapy that she would receive to manage her menopausal symptoms would need to be safe and not interfere with her blood pressure. The treatment regimen for the patient would include hormone replacement therapy to manage her menopausal symptoms (Palacios et al., 2019). Increasing her hydrochlorothiazide dose from 25 mg to 50 mg daily would also help control her blood pressure (Burnier et al., 2019). Finally, providing dietary and exercise counseling to help the patient lose weight would also assist significantly in controlling blood pressure (Jurik & Stastny, 2019).
Cenestin, an estrogen pill, would be the most suitable drug to help the 46-year old patient manage her menopausal symptoms with little or no effect on her blood pressure (Palacios et al., 2019). On the other hand, the ideal patient education strategy for the 46-year-old woman would be a referral to a trained peer educator. A trained educator would have sufficient time to guide the 46-year-old patient with the ideal physical activity and dietary changes to help her manage her weight (Jurik & Stastny, 2019.
References
Burnier, M., Bakris, G., & Williams, B. (2019). Redefining diuretics use in hypertension. Journal of Hypertension, 37(8), 1574–1586. https://doi.org/10.1097/hjh.0000000000002088
Jurik, & Stastny. (2019). Role of Nutrition and Exercise Programs in Reducing Blood Pressure: A Systematic Review. Journal of Clinical Medicine, 8(9), 1393. https://doi.org/10.3390/jcm8091393
Palacios, S., Stevenson, J. C., Schaudig, K., Lukasiewicz, M., & Graziottin, A. (2019). Hormone therapy for first-line management of menopausal symptoms: Practical recommendations. Women’s Health, 15, 174550651986400. https://doi.org/10.1177/1745506519864009