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.
-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.
You will respond to your colleagues’ posts in Week 10.
Main Post
In this case study, a 46-year-old woman presents with hot flushing, night sweats, and
genitourinary symptoms. Given her age and sex, and the fact that 95 percent of women enter
menopause between 45 and 55 years old, her symptoms appear to be menopausal (Rosenthal
& Burchum, 2018). The hot flashes and night sweats symptoms appear to be vasomotor
symptoms of menopause. Vasomotor symptoms are typical during the transition into
menopause and affects nearly 80 percent of women. The patient also presents with
genitourinary symptoms which are typically vaginal dryness and urinary symptoms (Roberts &
Hickey, 2016). As estrogen levels decrease, the urethra and vaginal epithelium undergo
degenerative changes causing urge incontinence, urinary frequency, dryness, urinary tract
infections, and vaginal infections (Rosenthal & Burchum, 2018).
The patient would like relief from these symptoms. These symptoms interfere with
one’s daily life activities and women commonly seek hormone therapy (HT) once these
symptoms arise (Rosenthal & Burchum, 2018). Women who take HT often report an improved
quality of life with relief of their vasomotor and genitourinary symptoms, as well as other
benefits. There are also risks associated with taking hormone replacement therapy. Estrogen
replacement therapy is contraindicated in persons with a history of breast cancer, heart disease,
DVT, PE or MI, and also in persons with a history of vaginal bleeding with no known cause
(Rosenthal & Burchum, 2018). The patient has a family history of breast cancer (although no
personal history of breast cancer), a history of ASCUS (although recent pap smears have been
normal, currently has hypertension and possible CHD.
Given that the patient is considered high risk for HT, I would consider alternative options.
In high risk patients, certain antidepressants such as SSRIs or SNRIs have been shown to relieve
vasomotor symptoms of menopause, although not as effectively (Rosenthal & Burchum, 2018).
I would treat the patient with escitalopram for vasomotor symptoms, along with a topical
This study source was downloaded by 100000829216747 from CourseHero.com on 04-28-2022 23:33:27 GMT -05:00
https://www.coursehero.com/file/52652021/Wk-9-Discussiondocx/
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.
-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.
You will respond to your colleagues’ posts in Week 10.
Main Post
In this case study, a 46-year-old woman presents with hot flushing, night sweats, and
genitourinary symptoms. Given her age and sex, and the fact that 95 percent of women enter
menopause between 45 and 55 years old, her symptoms appear to be menopausal (Rosenthal
& Burchum, 2018). The hot flashes and night sweats symptoms appear to be vasomotor
symptoms of menopause. Vasomotor symptoms are typical during the transition into
menopause and affects nearly 80 percent of women. The patient also presents with
genitourinary symptoms which are typically vaginal dryness and urinary symptoms (Roberts &
Hickey, 2016). As estrogen levels decrease, the urethra and vaginal epithelium undergo
degenerative changes causing urge incontinence, urinary frequency, dryness, urinary tract
infections, and vaginal infections (Rosenthal & Burchum, 2018).
The patient would like relief from these symptoms. These symptoms interfere with
one’s daily life activities and women commonly seek hormone therapy (HT) once these
symptoms arise (Rosenthal & Burchum, 2018). Women who take HT often report an improved
quality of life with relief of their vasomotor and genitourinary symptoms, as well as other
benefits. There are also risks associated with taking hormone replacement therapy. Estrogen
replacement therapy is contraindicated in persons with a history of breast cancer, heart disease,
DVT, PE or MI, and also in persons with a history of vaginal bleeding with no known cause
(Rosenthal & Burchum, 2018). The patient has a family history of breast cancer (although no
personal history of breast cancer), a history of ASCUS (although recent pap smears have been
normal, currently has hypertension and possible CHD.
Given that the patient is considered high risk for HT, I would consider alternative options.
In high risk patients, certain antidepressants such as SSRIs or SNRIs have been shown to relieve
vasomotor symptoms of menopause, although not as effectively (Rosenthal & Burchum, 2018).
I would treat the patient with escitalopram for vasomotor symptoms, along with a topical
This study source was downloaded by 100000829216747 from CourseHero.com on 04-28-2022 23:33:27 GMT -05:00
https://www.coursehero.com/file/52652021/Wk-9-Discussiondocx/
