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.

As an advanced practice nurse, you will likely experience patient encounters with complex comorbidities. For example, consider a female patient who is pregnant who also presents with hypertension, diabetes, and has a recent tuberculosis infection. How might the underlying pathophysiology of these conditions affect the pharmacotherapeutics you might recommend to help address your patient’s health needs? What education strategies might you recommend for ensuring positive patient health outcomes?

For this Discussion, you will be assigned a patient case study(Above) and will consider how to address the patient’s current drug therapy plans. You will then suggest recommendations on how to revise these drug therapy plans to ensure effective, safe, and quality patient care for positive patient health outcomes.

Photo Credit: Getty Images

To Prepare

· Review the Resources for this module and reflect on the different health needs and body systems presented.

· Your Instructor will assign you a complex case study to focus on for this Discussion ( Above)

· 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.

Post a brief description of your patient’s health needs from the patient case study you assigned. Be specific. Then, explain the type of treatment regimen you would recommend for treating your 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.

Resources for reference( Need 3-4 References)

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advacned practice providers. St. Louis, MO: Elsevier.

  • Chapter 44, “Anticoagulant      and Antiplatelet Drugs” (pp. 451–472)
  • Chapter 45, “Drugs for      Deficiency Anemias” (pp. 473–483)
  • Chapter 48, “Estrogens and      Progestins: Basic Pharmacology and Noncontraceptive Applications” (pp.      521–533)
  • Chapter 49, “Birth Control”      (pp. 535–547)
  • Chapter 50, “Androgens” (pp.      549–556)
  • Chapter 51, “Drugs for      Erectile Dysfunction and Benign Prostatic Hyperplasia” (pp. 557–569)
  • Chapter 68, “Basic      Principles of Antimicrobial Therapy” (pp. 769–781)
  • Chapter 69, “Drugs That      Weaken the Bacterial Cell Wall I: Penicillins” (pp. 783–790)
  • Chapter 73, “Sulfonamides      and Trimethoprim” (pp. 619–826)
  • Chapter 74, “Drug Therapy of      Urinary Tract Infections” (pp. 827–831)
  • Chapter 75,      “Antimycobacterial Agents” (pp. 833–847)
  • Chapter 76, “Miscellaneous      Antibacterial Drugs” (pp. 849–853)
  • Chapter 77, “Antifungal      Agents” (pp. 855–866)
  • Chapter 78, “Antiviral      Agents I: Drugs for Non-HIV Viral Infections” (pp. 867–886)
  • Chapter 80, “Drug Therapy of Sexually      Transmitted Diseases” (pp. 905–911)

Lunenfeld, B., Mskhalaya, G., Zitzmann, M., Arver, S., Kalinchenko, S., Tishova, Y., & Morgentaler, A. (2015). Recommendations on the diagnosis, treatment and monitoring of hypogonadism in men. Aging Male, 18(1), 5–15. doi:10.3109/13685538.2015.1004049

This article presents recommendations on the diagnosis, treatment, and monitoring of hypogonadism in men. Reflect on the concepts presented and consider how this might impact your role as an advanced practice nurse in treating men’s health disorders.

Montaner, J. S. G., Lima, V. D., Harrigan, P. R., Lourenço, L., Yip, B., Nosyk, B., … Kendall, P. (2014). Expansion of HAART coverage is associated with sustained decreases in HIV/AIDS morbidity, mortality and HIV transmission: The “HIV Treatment as Prevention” experience in a Canadian setting. PLoS ONE, 9(2)e87872. Retrieved from https://doi.org/10.1371/journal.pone.0087872

This study examines HAART therapy and its sustainability and profound population-level decrease in morbidity, mortality, and HIV transmission.

Roberts, H., & Hickey, M. (2016). Managing the menopause: An update. Maturitas, 86(2016), 53–58. .https://doi.org/10.1016/j.maturitas.2016.01.007

This article provides an update on treatments on Vasomotor symptoms (VMS), genito-urinary syndrome of menopause (GSM), sleep disturbance, sexual dysfunction, and mood disturbance that are common during the menopause transition.

Agency for Healthcare Research and Quality. (2014). Guide to clinical preventive services, 2014: Section 2. Recommendations for adults. Retrieved from http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/guide/section2.html

This website lists various preventive services available for men and women and provides information about available screenings, tests, preventive medication, and counseling.

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