The patient, for this discussion will be named MJ. MJ is a 46-year-old, 230-pound woman with a family history of breast cancer and hypertension. MJ is up to date on yearly mammograms and presents with complaints of hot flashes, night sweats, and genitourinary symptoms. MJ has a history of ASCUS from about five years prior, but recent pap smears appear normal. Her current medications include Norvasc 10mg and HCTV 23 mg QD. MJ blood pressure is 150/90 at the time of the interview, states regular menstrual cycles with her LMP a month ago. Diagnosis: Menopause Due to MJs age, weight, and complaints of hot flashes, night sweats, and genitourinary symptoms, a diagnosis of menopause was given. Menopause can be best described as the last menstrual period indicating the end of menstruation and characterized as the decline or loss of estrogen (Roberts & Hickey, 2016). Estrogen production occurs in both males in females but more profoundly in females. In females, estrogen promotes female maturation and help regulate the activity of female reproductive systems (Rosenthal & Burchum, 2018). The typical onset of menopause is around 51-52 years, although 95% of women will enter menopause between the ages of 45-55 years (Rosenthal & Burchum, 2018). Symptoms of menopause include vasomotor symptoms, genitourinary symptoms, mental changes, bone loss, altered lipid metabolism. MJ stated she was having hot flashes and night sweats, which are vasomotor symptoms. The patient weight can also be a risk factor for her vasomotor symptoms. Previous studies indicated obesity to be protective against vasomotor symptoms but that ideology has changed (Thurston & Joffe, 2012). Genitourinary symptoms include vaginal dryness, vaginal burning, vaginal discharge, and genital itching (mayoclinic.org, n.d.). Since the urethra and the vagina have the highest concentrations of estrogen receptors, a decline in estrogen levels can lead to vaginal atrophy of the epithelium causing vaginal dryness as well as pain with intercourse (Rosenthal & Burchum, 2018). Due to clear and up to date mammograms, breast cancer was ruled out. Regarding MJs previous history of ASCUS but with normal pap smears, cervical cancer was ruled out. ASCUS or atypical squamous cells of undetermined significance are abnormal cells in the tissue that lines the outer part of the cervix and are the most common abnormal finding in a pap test, according to cancer.gov (n.d.). Furthermore, they may be a cyst or polyp that is benign in menopausal women with low hormone levels. Treatment Regimen A treatment regimen of hormonal therapy (HT) is suggested. HT consists of low doses of estrogen (with or without progestin) and is given to counteract the loss of estrogen during menopause (Rosenthal & Burchum, 2018). Progestin is sometimes added with estrogen to counterbalance estrogen-mediated stimulation of the endometrium. In the case of Lucy, estrogen- only can suffice for her HT. HT, when used in low doses, is the most effective treatment for vasomotor symptoms, aid vaginal dryness associated with menopause, and increase mood and libido (Mayoclinic.org, n.d.).The typical short treatment periods are three to four years at low doses are presumably safe, although reassessment at consistent intervals is well recommended. Due to Lucys family history of breast cancer, a complete and personalized risk profile will be needed as well as educating Lucy on the benefits and the harm of starting HT. If Lucy is found to be an acceptable candidate for HT, transdermal therapy is preferred by way of Estradiol (generic name) formulated transdermal patch. The strength of Estradiol is 14 mcg absorbed/day and used once weekly. MJ will be given direction to apply the patch upon her trunk area of her body (excluding breast and waist) changing application sites as ordered (Rosenthal & Burchum, 2018). Should she feel her family history of breast cancer leaves her susceptible to higher risks with HT, there are antidepressant therapies that can be used. They are not as effective but do have fair results treating vasomotor symptoms. The two antidepressants are escitalopram [Lexapro] & desvenlafaxine [Pristiq]. Lexapro is a selective serotonin reuptake inhibitor (SSRI), while Pristiq is a serotonin-norepinephrine reuptake inhibitor (SNRI). As with the start of any therapy, the patients needs and expected outcomes will need to be taken into consideration. Patient education on the benefits, added risks, side effects, therapy time line of medication use, additionally available therapies as well as timely feedback is critical for safe treatment plans and positive patient care outcomes I NEED A RESPONSE FOR THIS CASE STUDY 3 REFERENCES NO MORE THAN FIVE YEARS
Why Choose Us
High Quality, 100% Original and Well-Researched Papers
HireProWriter always ensure that our writers follow all your instructions precisely. You can pick your academic level: high school, college/university or professional, and we will assign a writer who much your field or discipline.
Professional and Experienced Academic Writers
Our Company has a team of professional writers with experience in business articles and academic papers. The majority are native speakers and capable to tackle any task for which you need assistance.
Free Unlimited Revisions
Do you think we missed something on your paper? No worries, send your order for a free revision. We give you up to 10 days to submit the order for review after you have received the final document. You can do this yourself after logging in to your account or get help from our support.
Prompt Delivery and 100% Money-Back-Guarantee
All papers are always delivered on time. In case we need an extension to master your paper, we will contact you on time regarding the deadline extension. In case you cannot provide us with more time, a 100% refund is guaranteed.
Original & Confidential
100% Plagiarism free work! We use premium writing tools to check plagiarism. Our professional editors carefully review all quotations in the text. Besides, we guarantee maximum confidentiality in all of our services.
Customer Support 24/7
Our support team is available 24/7. We are dedicated to giving the best customer experience. Feel free to get in touch any time for assistance.
Try it now!
How it works?
Follow these simple steps to get your paper done
Place your order
Fill in the order form and provide all details of your assignment.
Proceed with the payment
Choose the payment system that suits you most.
Receive the final file
Once your paper is ready, we will email it to you.
Why work on your paper all night? While you can sleep tight, as we cover you back. HireProWriter offer all kinds of writing services.
No matter what kind of academic assistance you need and how urgent you need it, you are welcome to choose your academic level and the type of your paper at a reasonable cost. HireProWriter take care of all your academic paper needs with a 24/7 customer care support system.
Admission and Business Papers
An admission essay is an essay or other written statement by a candidate, often a potential student enrolling in a college, university, or graduate school. You don't have to worry about writing a presentable College admission essay, You can be rest assurred that through our services we will write the best admission essay for you.
Editing and Proofreading
Our Team (academic writers and editors) make the necessary adjustments to your essay/paper so that it is polished. Besides, we format your document by correctly quoting the sources and creating reference lists in the formats APA, Harvard, MLA, Chicago / Turabian.
We value our clients feedback, our system is designed to ensure that we deliver quality work through collaboration of our team and clients. In case you need an improvement in your paper, you are free to request for revision. For such case, your paper will be checked by the writer or assigned to an editor. Your Satisfaction is our Concern!