Family history of breast cancer
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.
• Write a description of the above patient’s health needs.
• Explain the type of treatment regimen you would recommend for treating this 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.
• Discuss alternative therapies such as hypnosis, acupuncture, and mind-body exercises. What are your thoughts regarding complementary therapies and do you feel that you would utilize them in your practice?
Health Needs of a Menopausal Woman
Patient’s Health Needs
The patient is a 46 year old woman, weighing 230lb. Her family history breast cancer places her at risk of going through the same condition due to her genetics. Her history of hypertension also shows that she is a critical patient. The symptoms being experienced started a month ago when she began experiencing hot flushes, night sweats, and genitourinary symptoms. Considering these factors, it is clear that her health needs include health education, diagnosis and treatment. She has no idea what is happening to her body. The symptoms are uncomfortable enough to prompt her to seek medical attention. Given her age and medical history, it is evident that this patient needs to be put on a specific diet to help in maintaining the right blood pressure, and reducing the severity of her symptoms. Additionally, she needs to be educated on what to expect in future, and steps she can take to avoid such unpleasant symptoms.
Considering the patient’s symptoms, it can be concluded that she is entering menopause. In such a case, the condition has no medical treatment. On the contrary, the treatment regimen will focus on relieving the signs and symptoms being experienced, and preventing any possible chronic conditions that may be related to it.
First, hormonal therapy will be considered whereby estrogen will be used to relieve the hot flashes being experienced by the patient. However, since this patient has a history of breast cancer in her family and a history of hypertension, using this therapy for a prolonged period of time will put her at risk (Natarajan & Chakrabarty, 2021). Therefore, the lowest dose will be administered over the shortest time frame needed to help relieve the symptom (Cheng, 2018). As the patient has also reported experiencing genitourinary symptoms, the use of vaginal estrogen will also be considered. This is expected to be safe and effective for this patient since it ensures that only a small amount of estrogen is absorbed into the vaginal tissues. It will help in relieving the dryness and discomfort, along with some other urinary symptoms. Since the patient also has hypertension, it may be effective to also use Clonidine which will help in treating her high blood pressure while offering relief from hot flashes.
Second, lifestyle changes will also be recommended to help the patient in dealing with the current situation. For the hot flashes, it is important that the triggers are identified. For some, it can be hot beverages, caffeine, spicy foods, alcohol, or even stress. The identified triggers should be avoided where necessary (Şener, 2019). To decrease vaginal discomfort, the patient may be advised to consider water-based vaginal lubricants that are available over the counter. The patient also needs to rest well and eat a balanced diet. Engaging in relaxation techniques have been found to also help with relieving some menopausal symptoms.
The two approaches should be used side by side to ensure that the patient gets the best possible outcome. Hormone therapy and lifestyle changes are both important forms of intervention. They will help in dealing the symptoms showcased by the patient.
Patient Education Strategy
To assist this patient with the management of her health needs, an education strategy featuring four steps will be considered. First, the health literacy of the patient must be assessed. Health literacy refers to the degree to which an individual has the capacity to obtain and understand basic health information, thereby enabling the appropriate health decisions (Bartlett et al., 2020). If the patient has low health literacy, it is important to ensure that the problem is addressed by offering them simple training sessions.
Once it can be determined that the patient has high health literacy, then the next step can be adopted. It features the use of a patient teach-pack. Here, the health professional explains specific important concepts and techniques before asking the patient to repeat the lesson in his or her own words. This process enables them to synthesize health information thereby enabling them to properly comprehend it. If the patient is unable to explain the concepts, then a different approach should be used to help them understand.
Next, educational materials should be offered to the patient in a format that she prefers. Many tools are available for use, including digital technologies and paper handouts. Examples include, graphics, brochures, videos, power point presentations and many others (Bartlett et al., 2020). Lastly, it is important to consider the use of health technology. Through information technology, it is easier for patients to obtain educational materials that they need. It makes it easy for them to access specific data that they are looking for, without having to visit the hospital in person.
When trying to deal with the symptoms of menopause, there are alternative therapies such as hypnosis, acupuncture, and even mind-body exercises. Although these are not interventions that are based on medicine, they have proven effective in enhancing the patient outcomes (Avis et al., 2017). Therefore, if they are to be used in addition to the healthcare approaches such as hormone therapy, then there would be no problem utilizing them in practice.
Menopause is a condition that many women have to live with once they approach their old age. Although it has no cure, there are specific interventions that may be considered to help alleviate the severe symptoms which may cause the women discomfort. That is why measures such as hormone therapies and lifestyle changes have been recommended.
Avis, N., Coeytaux, R., Levine, B., Isom, S., & Morgan, T. (2017). Trajectories of response to acupuncture for menopausal vasomotor symptoms. Menopause, 24(2), 171-179. https://doi.org/10.1097/gme.0000000000000735
Bartlett, S., Lambert, S., McCusker, J., Yaffe, M., de Raad, M., & Belzile, E. et al. (2020). Self-management across chronic diseases: Targeting education and support needs. Patient Education And Counseling, 103(2), 398-404. https://doi.org/10.1016/j.pec.2019.08.038
Cheng, W. (2018). The Roles of Menopausal-specific Quality of Life on Breast Cancer Screening Beliefs in Menopausal and Postmenopausal Women. Journal Of Menopausal Medicine, 24(3), 188. https://doi.org/10.6118/jmm.2018.24.3.188
Natarajan, V., & Chakrabarty, A. (2021). A Concise Viewpoint on Menopause, Hormone-Replacement Therapy and Breast Cancer Risk. Archives Of Breast Cancer, 14-15. https://doi.org/10.32768/abc.20218114-15
Şener, N. (2019). Qualıty of Lıfe Among Menopausal Women and Nursıng. Research And Reviews On Healthcare: Open Access Journal, 3(4). https://doi.org/10.32474/rrhoaj.2019.03.000167