Question

CASE STUDY - OSTEOPOROSIS Millie Brown is a 55 y/o woman presenting to the clinic with complaints of episodes of feeling hot and sweaty during the day and waking up at night soaked with perspiration. Because her sleep is so disrupted, she is tired all day and having trouble concentrating at work. She states that the episodes are becoming unbearable and is now seeking treatment for them. You suspect that Ms. Brown is premenopausal. You obtain her prior medical and surgical history and her current medication regime 1. List 5 questions that would be important to ask the patient in exploring the possibility of menopause being related to her symptoms. You are concerned with the possible development of osteoporosis in Ms. Bowles. 2. List at least 8 questions you would ask to determine her risk of developing osteoporosis 3. State the rationale for adding Vitamin D to persons taking calcium for osteoporosis. Mrs. Brown is not currently taking estrogen replacement therapy 4. List three factors that would have to be identified to determine whether there are contraindications or precautions to this therapy for her. Mrs. Brown states that she has frequent backaches. Spinal films are ordered. Later you see the report stating that the films appear normal with no significant findings 5. Prepare a list of appropriate supportive measures for Ms. Bowles to relieve the non- injury-related low back pain in the absence of fracture. In your discussions with the patient she tells you that she does not like milk or milk products and rarely includes them in her diet 6. Explain how you would encourage the patient to increase her dietary calcium intake The physician tells Ms. Brown that her blood calcium was normal. The patient questions, "If I have enough calcium in my blood, I cannot have osteoporosis, could 1?" 1. Explain how you would answer this question to the patient. Ms. Bowels explains that she rarely exercises 7. Discuss the advice that should be given to this patient as it relates to exercise.

CASE STUDY - OSTEOPOROSIS Millie Brown is a 55 y/o woman presenting to the clinic with complaints of episodes of feeling hot and sweaty during the day and waking up at night soaked with perspiration. Because her sleep is so disrupted, she is tired all day and having trouble concentrating at work. She states that the episodes are becoming unbearable and is now seeking treatment for them. You suspect that Ms. Brown is premenopausal. You obtain her prior medical and surgical history and her current medication regime 1. List 5 questions that would be important to ask the patient in exploring the possibility of menopause being related to her symptoms. You are concerned with the possible development of osteoporosis in Ms. Bowles. 2. List at least 8 questions you would ask to determine her risk of developing osteoporosis 3. State the rationale for adding Vitamin D to persons taking calcium for osteoporosis. Mrs. Brown is not currently taking estrogen replacement therapy 4. List three factors that would have to be identified to determine whether there are contraindications or precautions to this therapy for her. Mrs. Brown states that she has frequent backaches. Spinal films are ordered. Later you see the report stating that the films appear normal with no significant findings 5. Prepare a list of appropriate supportive measures for Ms. Bowles to relieve the non- injury-related low back pain in the absence of fracture. In your discussions with the patient she tells you that she does not like milk or milk products and rarely includes them in her diet 6. Explain how you would encourage the patient to increase her dietary calcium intake The physician tells Ms. Brown that her blood calcium was normal. The patient questions, "If I have enough calcium in my blood, I cannot have osteoporosis, could 1?" 1. Explain how you would answer this question to the patient. Ms. Bowels explains that she rarely exercises 7. Discuss the advice that should be given to this patient as it relates to exercise.

Answer 1

Q. No. 6. Answer :

Encourage the client to take increased calcium levels, like

* every day morning and evening taking egg and one glass of milk.

* encourage to take calcium supplementations like calcium tablets.

* and educate to exposure to the morning and evening sunlight, it may increases the calcium obsorption.

If the patient is having blood calcium levels are normal also there is a chance of developing osteoporosis in women's, because the women's are having less bone capacity than men's, estrogen hormone is protects the bones of female, during menopause time the estrogen levels was reduces, so the protection to the bones decreases and develops osteoporosis.

Like this I will educate the patient.

Q. No. 7. Answer :

* even though the client is having sufficient vit D and calcium supplementations, the regular exercises can reduce the rate of the bone loss, by improving muscle strength and by reducing falls which are cause for fractures.

* so along with the diet, regular exercises can improve the muscle strength and improves the balance.

Q. No. 9. Answer :

Common side effects of this premarin :

* stomach upset or cramps,

* nausea and vomitings,

* bloating,

* breast tenderness or swelling,

* head ache,

* appetite changes,

* tired feeling,

* dizziness,

* increased hair growth ect.

Q. No. 10. Answer :

Dangerous adverse side effects of premarin :

* mood and memory changes like depression, memory loss,

* breast lump,

* unusual vaginal bleeding,

* yellowish eyes and skin,

* dark urine,

* increased thirst,

* urination,

* severe stomach or abdominal pain,

* swelling hands and ankles and feet ect.