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12 Cards in this Set
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A 55 year old woman has not had menstrual periods for 5 years and tells the NP that she is having increasingly frequent vasomotor symptoms. She has no family history or risk factors for coronary artery disease or breast cancer but is concerned about the side effects of hormone therapy. The NP should |
Tell her that starting hormone therapy now may reduce her risk for breast cancer. The current Gap hypothesis regarding breast cancer supports initiating hormone therapy 5 years or more after menopause. To decrease risk for CHD, hormone therapy should begin at the time of menopause. Hormone therapy will relieve vasomotor symptoms at all stages of menopause. Herbal supplements have estrogen sizing affects and carry the same risks as estrogen therapy |
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The NP sees a woman who has been taking hormone therapy for menopausal symptoms for 3 years. The NP decreases the dosage, and several weeks later, the woman calls to report having several hot flashes each day. The NP should |
Increase the hormone therapy dose. The Women's Health Initiative results indicate that hormone therapy used for 3 to 5 years is safe and recommend slow weaning after women review hormone therapy with their providers at annual visits. If symptoms reoccur the dose should be increased until symptoms improve |
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A 52 year old woman reports having hot flashes and intense mood swings. After a year of having irregular menstrual periods, she has not had a period For 6 months. The NP should diagnose |
Perimenopause. Usually occurs between ages 42 and 55 and is characterized by erratic ovulation and irregular periods, hot flashes, and intensified PMS symptoms. Menopause begins when periods have been absent for 12 months. Post-menopause describes the 5-year period After menopause. Dysmenorrea is painful periods |
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A woman with a family history of breast cancer had her last menstrual period 12 months ago and is experiencing hot flashes. She has not had hysterectomy. The NP should recommend |
Limiting alcohol and caffeine intake. Hot flashes can be triggered by environmental conditions such as stress, excitement, anxiety and alcohol and caffeine consumption. Black cohosh carries the same risks as estrogen. Estrogen-only therapy is not recommended for women with an intact uterus. Progesterone therapy is not |
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A 50 year old woman with a family history of CHD is experiencing occasional hot flashes and is having periods every three to four months. She asks the primary NP about hormone therapy to relieve her symptoms. The NP should |
Plan to use estrogen progesterone therapy when menopause Begins. The timing hypothesis suggests that initiating HT at or very near to the time of menopause, which begins when a woman has not had a period For 12 months, reduces CHD and post-menopausal woman. Estrogen-only therapy is indicated only for women who do not have a uterus. Oral contraceptive pills increase the risk of CHD. Bioidentical HT is not indicated |
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A thin 52 year old woman who has recently had a hysterectomy tells the NP she's having frequent hot flashes and vaginal dryness. A recent bone density show early osteopenia. The woman's mother had CHD. She has no family history of breast cancer. The NP should prescribe |
Estrogen-only HT now. HT relieve symptoms of menopause and prevents osteoporosis. When started soon after menopause, HT can reduce CHD risk. Breast cancer may be decreased if HT is begun 5 years after onset of menopause. This woman has a higher risk of CHD and osteoporosis, so initiating therapy now is a good option. Because she has had a hysterectomy, and estrogen-only therapy is indicated |
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Osteopenia is diagnosed in a 55 year old woman who has not had a period In 15 months. She has a positive family history of breast cancer. The NP should recommend |
Non-hormonal drugs for osteoporosis. Although estrogen slows the progression of osteoporosis, it also increases the risk of breast cancer when initiated early in menopause this woman should receive all non-hormonal treatment for osteoporosis and may receive HT in five years if menopausal symptoms persist. Testosterone therapy, estrogen-only therapy, and estrogen progesterone therapy are not indicated |
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A 50 year old woman reports severe, frequent hot flashes and vaginal dryness. She is having irregular periods. She has no history of CHD or breast cancer and no personal risk factors. The NP should recommend |
Low-dose oral contraceptive therapy. Oral contraceptive pills are not approved by the FDA for management of perimenopausal symptoms except to treat irregular menstrual bleeding. This patient has a low risk for CHD and breast cancer, so oral contraceptive pills are relatively safe. She is also at risk for pregnancy, so oral contraceptive pills can help to prevent that |
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A perimenopausal woman tells the NP that she is having hot flashes and increasingly severe mood swings. The woman has had a hysterectomy. The NP should prescribe |
Estrogen-only HT. Estrogen-only regiments are used in women without a uterus and may be initiated to treat perimenopause symptoms if needed. Low dose contraceptive pills are used to treat irregular menstrual bleeding in perimenopausal woman |
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A male patient tells the NP he's experiencing decreased libido, lack of energy, and poor concentration. The NP performs an examination and notes increase body fat and gynecomastia. A serum testosterone level is 225. The NP next action should be to |
Obtain a morning serum testosterone level. To diagnose hypogonadism, two serum testosterone levels must be drawn, serum collected in the morning. LH, FSH, and prolactin levels may be drawn as well. Testosterone replacement should not be prescribed until diagnosis is definitive |
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A man who has secondary hypogonadism associated with pituitary dysfunction will begin exogenous testosterone therapy. The patient asks the np about future chances of fathering children. The NP should tell him that |
Fertility May improve with testosterone therapy. Men with secondary hypogonadism may become fertile with exogenous testosterone |
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A patient who has diabetes and congestive heart failure takes insulin and Warfarin. The patient will begin taking exogenous testosterone to treat secondary hypogonadism. The NP should recommend |
More frequent blood glucose monitoring. Patients with diabetes may require a decrease in insulin dose because of the metabolic effects of androgens. More frequent blood glucose monitoring should be performed. Warfarin doses may need to be decreased because androgens increase sensitivity to anticoagulants |
