The case is about a 46-year-old with hot flushes, night sweats, and genitourinary symptoms that began one month ago. She has a family history of breast cancer, history of HTN, and ASCUS. Her current BP is 150/90, and her weight is 230 lbs. The patient’s health needs include genitourinary and vasomotor, weight management, blood pressure management, and decreasing the risk of cervical and breast cancer. The vasomotor symptoms include night sweats and hot flushes, which can be linked to perimenopause (Pinkerton et al., 2019). The family history of breast cancer and history of ASCUS on Pap smear increases her risk of breast and cervical cancer. Besides, obesity and HTN increase her risk of heart disease, stroke, and obesity.
The recommended therapy is hormonal replacement therapy (HRT), with combined estrogen and progesterone. I would recommend a transdermal formulation like Estradiol 25 mcg patch for estrogen replacement. Estrogen is the primary active constituent of hormonal therapy and is considered the gold standard for managing perimenopausal vasomotor symptoms (Palacios et al., 2019). However, unopposed estrogen increases the risk of endometrial hyperplasia. Thus, I will recommend intravaginal progesterone 100 mg to restore progesterone.
The teach-back technique evaluates patients’ understanding by asking them to explain in their words what they have understood on ways to improve their health. A nurse can use this approach to verify that they have explained things in a way that the patient understands. Therefore, I would recommend the teach-back strategy to educate this client on measures to reduce the severity of hot flushes, like wearing light clothing and using fans to control room temperature (Ward & Deneris, 2018). The strategy will also be applied to educate the patient on lifestyle modification interventions to promote weight loss and lower BP, like increasing physical exercises and reducing caloric dietary intake.
References
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
Pinkerton, J. V., Conner, E. A., & Kaunitz, A. M. (2019). Management of menopause and the role For hormone therapy. Clinical Obstetrics and Gynecology, 62(4), 677-686. https://doi.org/10.1097/GRF.0000000000000487
Order this paper