Week 10 Discussion: 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.

Week 10 Discussion: 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.

Week 10 Discussion: 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.

Review your peers case studies from Week 9.
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.
Read a selection of your colleagues’ responses from Week 9 and respond to at least two of your colleagues on two different days who were assigned a different patient case study, and provide recommendations for alternative drug treatments to address the patient’s pathophysiology. Be specific and provide examples.

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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.

Week 10 Discussion: 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 Sample

After giving the case careful consideration, I have come to the conclusion that the client is suffering perimenopausal symptoms. The client has to have her high blood pressure under control, get screened for breast cancer once a year, have their cervical cancer checked once a year with a pap smear, and make changes to her lifestyle in order to keep her weight under control.

In the context of the treatment of high blood pressure, I would suggest that the Norvasc be stopped and that a prescription be obtained for 20 milligrams of lisinopril to be taken each day instead. Flushing symptoms may be effectively controlled with this treatment (Lopez et al., 2022). The next step that I would undertake is to make certain that the client checks their blood pressure at least twice a day for a total of fourteen days. This would make the client’s new drug work better. Hydrochlorothiazide should be discontinued when blood pressure is controlled, and lisinopril should be the sole medication prescribed. This would additionally help shed light on the indications and symptoms connected to the genitourinary system. The use of hormone replacement treatment is yet another treatment option that I believe needs to be considered. Typical management for perimenopause consists of using estrogen replacement therapy (Mehta et a., 2021). Prior to beginning hormone replacement medication, I would strongly recommend having complete laboratory testing performed, which would include a bone scan.

The client should have a mammography every year since she is at increased risk of breast cancer due to her family history of ASCUS. In most cases, persons who are receiving hormone replacement treatment have an increased chance of developing breast cancer (Yoo et al., 2020).

References

Lopez, E. O., Parmar, M., Pendela, V. S., & Terrell, J. M. (2022). Lisinopril. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK482230/

Mehta, J., Kling, J. M., & Manson, J. E. (2021). Risks, benefits, and treatment modalities of menopausal hormone therapy: Current concepts. Frontiers in Endocrinology, 12. https://doi.org/10.3389/fendo.2021.564781

Yoo, T., Han, K. D., Kim, D., Ahn, J., Park, W., & Chae, B. J. (2020). Hormone Replacement Therapy, Breast Cancer Risk Factors, and Breast Cancer Risk: A Nationwide Population Based Cohort. Cancer Epidemiology Biomarkers & Prevention, 29(7), 1341-1347. https://doi.org/10.1158/1055-9965.epi-20-0038