Diagnosis of Menopausal Symptoms - Essay Example

Menopause ive Data Patient initials: M.T Age: 52 years Sex: Female History of Present Illness: The patient presents with subjective information of experiencing hot flushes, that is associated with nausea for a period of one month. She reports having tried to use some natural remedies to reduce the symptoms, but none was satisfactory. Past medical history: M.T reports a history of hyperlipidemia that has been existence for five years. She has been attempting to control the lipid levels through dietary measures. The patient reports a medical history of gastro esophageal reflux disease that has been in existence for two years and she is managing it with Prilosec 20 mg bid. M.T reports having experienced her last menstrual period 10.5 years ago with the periods having been irregular before they stopped. Social and family history: M.T works as a part-time bank teller. She is married with three children who are all adults and in good health condition. She equally has grandchildren whom she watches during the weekdays after school. M.T denies the use of illicit medications, but she reports a history of cigarette smoking of two and a half packets of cigarette every day from when she was fifteen until she was forty-five years. The patient reports occasional alcohol consumption coupled with ten to twelve diets of cock per day. The patient has attempted to follow a low salt and low cholesterol diet, but she admits this has been a challenge. The patient has increased her calcium-containing foods to three to four servings per day. The patient reported that the father died from presumed heart disease in his fifties while the mother died from complications related to motor vehicle accident at the age of seventy-five. The patient is the eldest of four sisters with the other sisters alive and well. The patient reports no family history of breast cancer. Medications at the time of admission 1. Acetaminophen 325 mg 12 po qid prn for joint pain after exercise 2. Prilosec 20 mg bid The patient reports no known drug allergy Objective data Vital signs: Temp: 98.8°F; BP: 130/85 mmHg; Pulse: 85; RR: 16 bpm; Wt: 130 ibs; Ht 5’8” Physical examination: Genitourinary/rectum: pelvic examination reveals pain in the pelvis and mucosal atrophy Neurological: Findings of the assessment are within normal limits Cardiovascular: Assessment findings are within normal limits Skin: The skin presents with dryness and itching Review of system Genitourinary/rectal: presents with a case of dryness, itching, urinary frequency, and dribbing after voiding. The patient is gravida three para three, menarche at the age of 14. The patient is sexually active but experiences dyspareunia. Mental status: The patient reports cases of insomnia, increased fatigue and feeling of depressed. Significant lab tests Total cholesterol (TC) 240 mg/dl Triglycerides (TRG) 250 mg/dl Pap smear and mammogram normal Negative pregnancy test Dual energy X-ray absorptiometry scan of lumber spine and right femoral neck shows slight osteopenia. Diagnosis of menopausal symptoms According to the medical definition, menopause is a stage in life that occurs after 12 months after a woman’s last menstrual period. Menopause can happen in a woman’s 40’s or 50’s. Menopause is a natural biological process; nevertheless, it presents with physical symptoms as the patient, in this case, (M.T) experiences. The experiences of menopause are equally execrated by lifestyle condition, which may fasten or worsen the symptoms. Management of menopausal symptoms thus in cooperate lifestyle changes and hormonal therapy (Mascitelli & Pezzetta, 2007). Menopause results in a reduction in the amount of estrogen levels thus leading to hot flushes, night sweats, mood swings and vaginal dryness. Excessive experience of menopausal symptoms can be managed through hormonal replacement therapy, nevertheless, in a majority of the situation, lifestyle changes including physical activity and proper diet is sufficient in the management of menopausal symptoms Estrogen and its implications Estrogen is a hormone that is important both in menstruation and in the reproductive cycle. Estrogen is a primary female sex hormone. Estrogen levels in the body reduce after menopause resulting in symptoms like hot flushes, vaginal dryness, and dyspareunia. Estrogen is responsible for accelerating the burning of body fats thus reduction in the level of estrogen predisposes to hyperlipidemia. In the skeletal system, estrogen is responsible for the reduction in bone resorption and increases bone formation thus preventing incidences of osteopenia and osteoporosis. Appropriate levels of estrogen in the body increase the level of high-density lipids and triglycerides while decreasing the level of low-density lipids. Estrogen is equally responsible for improvement in vaginal lubrication thus preventing dryness of the vagina as well as dyspareunia, while increasing the blood supply to the skin as a way of enhancing skin integrity and prevention skin conditions and itching (Al-Safi & Santoro, 2014). Management of menopausal symptoms The management of M.T will in cooperate the approach of lifestyle change and hormonal therapy as a means of eliminating menopausal symptoms. The lifestyle change involves improvement in the diet and modulation of the environment to reduce the effects of menopausal symptoms. The patient would be advised to consume a healthy and nutritious diet as well as maintenance of light physical exercise as a way of improving bone density. In regulation of the cholesterol levels in the body, the patient will be managed with a low salt and low cholesterol diet, as much as the patient reports difficulty in adherence to the diet, appropriate health education and information on the need to adhere to the diet will be significance in improving the level of consumption of the healthy diet. This will be achieved through a collaboration with the counselor and a nutritional therapist. Working with a social worker, the patient will be monitored and advised on the importance of avoiding alcohol intake as a means of reducing post-menopausal symptoms (Hickey, Davis, & Sturdee, 2005). Orders: Medications Estradiol 2mg po Od x4 weeks #28 Oxybutynin 3 mg po Bd x2 weeks #48 Pravachol 40 mg po Qid x2 weeks #56 Continue with Acetaminophen 325 mg 12 po Qid prn for joint pain after exercise Prilosec 20 mg bid Consult/Referral Psychiatric services for evaluation of alcohol use/abuse Dietitian for education regarding proper diet on improving immune system Education Instruct on follow up appointment in 2 weeks.       Instruction on the need to avoid consumption of excessive cock drinks as it relate to exacerbation in GERD.   Estradiol acts by regulating the transcription of a number of genes. The drug diffuses through the cell membrane and distributing itself through the cells thus binding to the nuclear receptors of the estrogen and activating them. The drug is important in the treatment of moderate to severe vasomotor symptoms of as well as vaginal and vulva atrophy. Estradiol is equally effective in the prevention of osteoporosis and correction of osteopenia (McCarthy, 2008). Oxybutynin has a direct antispasmodic effect on the smooth muscles of the urinary tract. Oxybutynin is used in the treatment of urinary frequency and dribbing of urine that M.T presents with. This will help in managing the symptoms of menopause that results in weakening of the muscles of the vagina and the bladder (Baldwin & Keating, 2009). Pravachol is an HMG-CoA reductase inhibitor that reduces the level of low-density lipoproteins and triglycerides while increasing the level of high-density lipoproteins. The medication is used to lower the level of cholesterol in the blood, thus lowering the risk to heart diseases and diabetes. The use of this medication will thus be supplemented by dietary adjustments (Frederiksen et al., 2013). Health education and collaboration In the management of the patient, as a nurse, quality outcome will be achieved through a collaborative approach with the social worker, counselor and the therapist. The patient will thus be informed of the need to stop exercises consumption of the cock as it worsens the symptoms of gastroesophageal reflux disease. Consumption of cock equally increases stomach acidity thus worsening the symptoms of menopause. Additionally, in collaboration with the therapist, the patient will be advised on the importance of avoiding alcohol consumption as a lifestyle change with the aim of eliminating the symptoms of menopause. The itching and dryness of the skin will be managed by encouraging the patient to maintain the moisture content of the skin through using moisturizers and avoidance of being in hot environments. The patient will equally be advised on the importance of dietary modification and elimination of excess salt intake as a way of ensuring skin moisture and integrity (Morris & Rymer, 2007). Conclusion Menopausal symptoms are common to most women thus proper management of the condition is important to ensure the provision of quality living to the patient. Through the application of natural means like dietary modification coupled with drug therapy. Menopausal symptoms can be managed, and the woman achieves a desired quality life. The management process thus calls for a collaborative approach to ensuring the woman is advised accordingly on the significance of lifestyle modification. References Al-Safi, Z. A., & Santoro, N. (2014). Menopausal hormone therapy and menopausal symptoms. Fertility and Sterility. Baldwin, C. M., & Keating, G. M. (2009). Transdermal oxybutynin. Drugs. Frederiksen, S. M., Larsen, M. L., Oxenbøll, I. B., Pindborg, T., & Haghfelt, T. (2013). Treatment of primary hypercholesterolemia with pravastatin. A placebo-controlled trial. Ugeskrift for laeger (Vol. 155, pp. 2794–2799). Hickey, M., Davis, S. R., & Sturdee, D. W. (2005). Treatment of menopausal symptoms: What shall we do now? Lancet. Mascitelli, L., & Pezzetta, F. (2007). Management of Menopausal Symptoms. American Journal of Medicine. McCarthy, M. M. (2008). Estradiol and the developing brain. Physiological Reviews, 88, 91–124. Morris, E. P., & Rymer, J. (2007). Menopausal symptoms. Clin Evid (Online), 2007. Read More