week 3

Week 3 Discussion: Peri- and Post menopause

A 55-year-old Caucasian woman presents for her annual exam. She lives in Maine with her husband of 30 years and reports being in good health. Her only significant event over the past year was a fall and fracture of her right hip resulting in hip replacement surgery 6 months ago. She has completed her physical therapy. Her past medical history includes postmenopausal status (LMP age 51), dyslipidemia, and hypertension. She had two vaginal births in 1994 and 1996. She has no significant gynecologic history other than childbirth. She is reporting occasional vasomotor symptoms of menopause but reports they do not significantly interfere with her life. Her medications include atorvastatin 20 mg orally daily and hydrochlorothiazide 12.5 mg orally daily. She is a social drinker (approximately two to four drinks per week) and smokes 10 cigarettes daily (1/2 pack per day). Today her vital signs are blood pressure 138/88, pulse 84, respiration rate 20, and BMI 30.

Using the Master of Science in Nursing Clinical Note format

1. What portion of the physical exam is of most concern for the APRN?

2. Provide three differential diagnoses based on the case presented.

3. Please list the plan/intervention for management for this condition.