Lauren Robbins Main PostCOLLAPSE

The patient is a 46-year-old female who presents with hot flashes, nights sweats and genitourinary symptoms. According to Rosenthal & Burchum, (2021) many women between the ages of 45 and 55 years old may experiences signs and symptoms of menopause. Menopause is a normal process that happens with women who are aging. The process develops as the number of ovarian quickly diminish, resulting in a decrease of estrogen production and menstruation. During this process there is change in the vagina also. The patient presents with genitourinary symptoms.

The vagina consists of several epithelial layers including the mucosa, muscularis, and adventitia. During menopause, the most superficial layer, the mucosa begins to atrophy because of lack of estrogen (Pérez-Herrezuelo, Aibar-Almazán, Martínez-Amat, Fábrega-Cuadros, Díaz-Mohedo, Wangensteen, & Hita-Contreras, 2020). This causes the cell layer to become dry and thin. In addition, blood pressure may be elevated from arterial vasoconstriction. Hormone therapy may be used in this case to treat vasomotor symptoms and prevent vaginal atrophy (Kotenko, Barashkov, Salamadina, & Borisevich, 2020). Assessment of the effectiveness of physiotherapeutic methods for management of early menopause disorders. Gynecology, Obstetrics & Perinatology / Voprosy Ginekologii, Akusherstva i Perinatologii, 19(4), 58–62. https://doi-org.ezp.waldenulibrary.org/10.20953/1726-1678-2020-4-58-62. Medication such as conjugated estrogens (Cenestin, Estrace, Estratab, Femtrace, Ogen, and Premarin) or estrogens-bazedoxifene (Duavee) may be prescribed for the [atients symptoms. For example, Cenestin 0.45mg PO daily may be prescribed. In addition, other forms such as a patch or vaginal creams may also works.

References

Kotenko, N. V., Barashkov, G. N., Salamadina, G. E., & Borisevich, O. O. (2020). Assessment of the effectiveness of physiotherapeutic methods for management of early menopause disorders. Gynecology, Obstetrics & Perinatology / Voprosy Ginekologii, Akusherstva i Perinatologii, 19(4), 58–62. https://doi-org.ezp.waldenulibrary.org/10.20953/1726-1678-2020-4-58-62

Pérez-Herrezuelo, I., Aibar-Almazán, A., Martínez-Amat, A., Fábrega-Cuadros, R., Díaz-Mohedo, E., Wangensteen, R., & Hita-Contreras, F. (2020). Female Sexual Function and Its Association with the Severity of Menopause-Related Symptoms. International Journal of Environmental Research and Public Health, 17(19). https://doi-org.ezp.waldenulibrary.org/10.3390/ijerph17197235

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.

Nick Daneri week9 discussion board initial postCOLLAPSE

Based on patient’s on going poorly managed hypertensions and presenting symptom related new onset of menopause, possibly a UTI, as well as poor absorption or clearance of htn meds. To confirm this the following labs would be ordered to confirm diagnosis: CBC, BMP, Thyroid, estrogen, testosterone. Additionally, ask how recently last pap was done, if not with in relate recommended timeline, order a pap-smear. The onset on menopause will usually occur between the ages of 40 to 60 years old, a hormonal process that that can trigger or exacerbate changes in the uterus, breast, cardiac, skeletal, and urinary track systems (Rosenthal & Burchum, 2017). The cardiac involvement compounded by a history of HTN increases the risk of a CVA (Rosenthal & Burchum, 2017). Additionally, the hormonal involvement in menopause increases the risk of cancer triggering patients with a familial history of breast cancer (Rosenthal & Burchum, 2017).

            A change in BP med is recommended to the beta-blocker Metoprolol to reduce the risk of CVA, with education to check the heart rate and BP prior to administration because this med can contribute to brady cardia and hypotension (Manson, et. al., 2015). To address the early menopause, a hormone replacement medication such as Escitalopram (an SSRI) or Venlafaxine (an SNRI) if menopause symptoms worsen, as recommended by The North American Menopause Society (NAMS) (Di Angelantonio, et. al., 2016). Because of her genitourinary systems, she should be evaluated for UTI and another pap-smear for cancer development related to her ASCUS. If positive for UTI she should be treat with a broad-spectrum antibiotic such ceftriaxone; and if found to have cancerous uterine cells an oncology appointment should be made (Manson, et., al., 2015)

References

Di Angelantonio, E., Bhupathiraju, S. N., Wormser, D., Gao, P., Kaptoge, S., De Gonzalez, A. B., … & Hu, F. B. (2016). Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents. The Lancet, 388(10046), 776-786.

Manson, J. E., Ames, J. M., Shapiro, M., Gass, M. L., Shifren, J. L., Stuenkel, C. A., … & Utian, W. H. (2015). Algorithm and mobile app for menopausal symptom management and hormonal/non-hormonal therapy decision making: a clinical decision-support tool from The North American Menopause Society. Menopause, 22(3), 247-253. https://doi-org.ezp.waldenulibrary.org/10.1177/1010539515586457

Rosenthal, L., & Burchum, J. (2017). Lehne’s Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants-E-Book. Elsevier Health Sciences. https://books.google.com/books?hl=en&lr=&id=IPm9DwAAQBAJ&oi=fnd&pg=PP1&dq=Lehne%E2%80%99s+Pharmacotherapeutics+for+Advanced+Practice+Nurses+and+Physician+Assistants-E-Book&ots=rPV3leJySQ&sig=iYWkRJfqwwAFfSpBWKxJ7QVFCmU#v=onepage&q=Lehne%E2%80%99s%20Pharmacotherapeutics%20for%20Advanced%20Practice%20Nurses%20and%20Physician%20Assistants-E-Book&f=false

3 sources for each discussion, thanks.

Instructions

Evaluate: Mass Media Impact

Evaluation Title: Pop Culture and Race, Ethnicity, Sexual Morality, and Gender

Bell hooks (nee Gloria Jean Watkins) is a professor and social activist who has written about feminism and popular culture.  For this assignment, you will watch bell hooks’ views on Cultural Criticism and Transformation in the video and read the accompanying extended transcript (Links to an external site.). (Note: there are several very difficult subjects discussed, and visual examples from movies are used to support these examples; more examples are used to further explore each of these themes throughout the remainder of this video.)

Your essay should include some discussion of the following questions:

1. Do you agree or disagree with hooks’ views?  Support your position.
2. Does mass media promote images of equality by leveling racial, ethnic, and gender differences, or do they promote inequality through exclusion and exaggeration of difference?
3. Does mass media reinforce the viewpoints of white, male, corporate culture, or does mass allow for the authentic expression of racial, ethnic, and sexual identity?  Give examples to support your position.

Specifications: 

Submit an 800-1000 word essay addressing the questions above. 

In your essay:

• Be sure to structure your essay with an introduction paragraph that includes a thesis statement, well-organized supporting paragraphs, and a conclusion that reiterates the main points of your argument. 
• Your argument should be supported by reputable research cited in APA format both in the body of the paper and in your references section.

Helpful Resources:

• Herzing University’s Tutoring and Writing Center 
• Grammar checker and writing help: https://www.grammarly.com/ (Links to an external site.)
• Use the Herzing Library to search for scholarly research sources.

1. GI
   • Make a comprehensive list of relevant information to gather when assessing abdominal pain.
   • How do you assess for masses in the abdomen and how you would document such findings?
   • Describe your findings on a previous patient that you have encountered where you have palpated a mass in the abdomen.
2. Musculoskeletal
   • Define, Compare, and Contrast the following conditions:
     • Osteoarthritis
     • Rheumatoid Arthritis

Submission Instructions:

• Your initial post should be at least 500 words, formatted and cited in proper current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.

Describe your experience with locating and reading weekly research articles. Share an example of an article that has been useful and applicable to your practice. Share an example of an article (or information) that was not helpful. Provide rationale.

Submission Instructions:

• Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.