NURS 6521 Week 9 Discussion: Women and Men Health, Infectious Disease, and Hematologic Disorders

NURS 6521 Week 9 Discussion: Women and Men Health, Infectious Disease, and Hematologic Disorders

NURS 6521 Week 9 Discussion: Women and Men Health, Infectious Disease, and Hematologic Disorders

The case concerns a 46-year-old, 230lb female client with a family history of breast cancer and HTN. She presents with complaints of hot flushes, night sweats, and genitourinary symptoms for one month. She had a history of ASCUS five years ago, but other Pap smears and the menstrual cycle have been normal. The health needs of this client include being overweight, high BP (150/90), and perimenopausal vasomotor symptoms. The patient’s overweight and high BP increase her risk of developing chronic illnesses like type 2 diabetes and heart disease. Besides, the client’s history of ASCUS and positive family history of breast cancer puts her at risk of developing cervical and breast cancer.

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           I would recommend Hormone replacement therapy (HRT) with combined systemic estrogen and progesterone for this patient. HRT remains the most effective treatment for VMS. Estrogen therapy is regarded as the most effective therapy for managing hot flashes. Recommendation state that the lowest effective dose should be used for the shortest duration possible (Pan et al., 2022). Besides, the transdermal route is preferred to avoid the hepatic first-pass effect and lower the risk of venous thromboembolism. A combination of estrogen with progestin is recommended for endometrial protection if the uterus is intact to prevent carcinoma and endometrial hyperplasia (Palacios et al., 2019).

           Patient education will focus on lifestyle modification to promote weight loss, lower BP, and reduce the risk of developing comorbid chronic illnesses. Overweight/obesity is linked with reduced secretion of LH, FSH, estradiol, and progesterone and worsens hot flashes. Thus, the client will be educated on measures to promote weight loss, such as taking healthy diets and increasing physical exercise (Delamater & Santoro, 2018). This will not only reduce body weight but will also improve cardiovascular function and lower BP. In addition, the client will be educated on environmental control to reduce hot flashes, like wearing light clothing, minimizing indoor temperature, and using fans.

References

Delamater, L., & Santoro, N. (2018). Management of the Perimenopause. Clinical obstetrics and gynecology, 61(3), 419–432. https://doi.org/10.1097/GRF.0000000000000389

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 (London, England), 15, 1745506519864009. https://doi.org/10.1177/1745506519864009

Pan, M., Pan, X., Zhou, J., Wang, J., Qi, Q., & Wang, L. (2022). Update on hormone therapy for the management of postmenopausal women. Bioscience trends, 16(1), 46–57. https://doi.org/10.5582/bst.2021.01418

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Week 9: Women’s and Men’s Health/Infections and Hematologic Systems, Part I
As an advanced practice nurse, you will likely encounter many disorders associated with women’s and men’s health, such as hormone deficiencies, cancers, and other functional and structural abnormalities. Disorders such as these not only result in physiological consequences but also psychological consequences, such as embarrassment, guilt, or profound disappointment for patients. For these reasons, the provider-patient relationship must be carefully managed. During evaluations, patients must feel comfortable answering questions so that you, as a key health-care provider, will be able to diagnose and recommend appropriate treatment options. Advanced practice nurses must be able to educate patients on these disorders and help relieve associated stigmas and concerns.
This week, you examine women’s and men’s health concerns as well as the types of drugs used to treat disorders that affect women’s and men’s health. You also explore how to treat aspects of these disorders on other health systems.
Learning Objectives
Students will:
• Evaluate patients for treatment of complex health issues
• Evaluate patients for treatment of infections
• Evaluate patients for treatment of hematologic disorders
• Analyze patient education strategies for the management and treatment of complex comorbidities

Learning Resources

Required Readings (click to expand/reduce)

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
• Chapter 46, “Anticoagulant and Antiplatelet Drugs” (pp. 364–371)
• Chapter 47, “Drugs for Deficiency Anemias” (pp. 389–396)
• Chapter 50, “Estrogens and Progestins: Basic Pharmacology and Noncontraceptive Applications” (pp. 425–436)
• Chapter 51, “Birth Control” (pp. 437–446)
• Chapter 52, “Androgens” (pp. 447–453)
• Chapter 53, “Male Sexual Dysfunction and Benign Prostatic Hyperplasia” (pp. 454–466)
• Chapter 70, “Basic Principles of Antimicrobial Therapy” (pp. 651–661)
• Chapter 71, “Drugs That Weaken the Bacterial Cell Wall I: Penicillins” (pp. 662–668)
• Chapter 75, “Sulfonamides Antibiotics and Trimethoprim” (pp. 688–694)
• Chapter 76, “Drug Therapy of Urinary Tract Infections” (pp. 695–699)
• Chapter 78, “Miscellaneous Antibacterial Drugs” (pp. 711–714)
• Chapter 79, “Antifungal Agents” (pp. 715–722)
• Chapter 80, “Antiviral Agents I: Drugs for Non-HIV Viral Infections” (pp. 723–743)
• Chapter 82, “Drug Therapy of Sexually Transmitted Diseases” (pp. 763–770)

Lunenfeld, B., Mskhalaya, G., Zitzmann, M., Arver, S., Kalinchenko, S., Tishova, Y., & Morgentaler, A. (2015). Recommendations on the diagnosis, treatment and monitoring of hypogonadism in men. Aging Male, 18(1), 5–15. doi:10.3109/13685538.2015.1004049

This article presents recommendations on the diagnosis, treatment, and monitoring of hypogonadism in men. Reflect on the concepts presented and consider how this might impact your role as an advanced practice nurse in treating men’s health disorders.

Montaner, J. S. G., Lima, V. D., Harrigan, P. R., Lourenço, L., Yip, B., Nosyk, B., … Kendall, P. (2014). Expansion of HAART coverage is associated with sustained decreases in HIV/AIDS morbidity, mortality and HIV transmission: The “HIV Treatment as Prevention” experience in a Canadian setting. PLoS ONE, 9(2), e87872. Retrieved from https://doi.org/10.1371/journal.pone.0087872

This study examines HAART therapy and its sustainability and profound population-level decrease in morbidity, mortality, and HIV transmission.

Roberts, H., & Hickey, M. (2016). Managing the menopause: An update. Maturitas, 86(2016), 53–58. .https://doi.org/10.1016/j.maturitas.2016.01.007

This article provides an update on treatments on Vasomotor symptoms (VMS), genito-urinary syndrome of menopause (GSM), sleep disturbance, sexual dysfunction, and mood disturbance that are common during the menopause transition.

Agency for Healthcare Research and Quality. (2014). Guide to clinical preventive services, 2014: Section 2. Recommendations for adults. Retrieved from http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/guide/section2.html

This website lists various preventive services available for men and women and provides information about available screenings, tests, preventive medication, and counseling.

Discussion: Women’s and Men’s Health, Infectious Disease, and Hematologic Disorders
As an advanced practice nurse, you will likely experience patient encounters with complex comorbidities. For example, consider a female patient who is pregnant who also presents with hypertension, diabetes, and has a recent tuberculosis infection. How might the underlying pathophysiology of these conditions affect the pharmacotherapeutics you might recommend to help address your patient’s health needs? What education strategies might you recommend for ensuring positive patient health outcomes?
For this Discussion, you will be assigned a patient case study and will consider how to address the patient’s current drug therapy plans. You will then suggest recommendations on how to revise these drug therapy plans to ensure effective, safe, and quality patient care for positive patient health outcomes.

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.

Please use the case study above for this discussion paper
To Prepare
• Review the Resources for this module and reflect on the different health needs and body systems presented.
• Your Instructor will assign you a complex case study to focus on for this Discussion.
• 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.

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.