Week 7 – Assignment 1
Select one of the two questions from the discussion
questions listed below. By Week 7, Day 3, respond to the selected discussion
question and submit your response to this Discussion Area.
Be sure to respond to the question using the lessons and
vocabulary found in the reading. Justify your answers using examples and
reasoning. Support your answers with examples and research and cite your
research using APA format.
Start reviewing and responding to the postings of your
classmates as early in the week as possible. Respond to at least two of your
classmatesâ€™ posts. Participate in the discussion by asking a question,
providing a statement of clarification, providing a point of view with a
rationale, challenging an aspect of the discussion, or indicating a
relationship between two or more lines of reasoning in the discussion.
Discussion Question 1
EP is a fifty-year-old woman who reports experiencing two to
three hot flashes per day, occasionally associated with insomnia. She also
states she is awakened from sleep about two to three times per week, needing to
change her bedclothes and linens due to sweating. Her symptoms began about
three months ago, and over that time, her symptoms have worsened to the point
where they have become very bothersome. She is concerned about starting any
hormonal treatment because she has read news stories that the medication is not
safe. She has been successfully treated for depression and is currently doing
well on paroxetine. Her current medications include omeprazole 20 mg daily,
paroxetine 20 mg, Synthroid 0.075 mg daily, and hydrochlorothiazide 25 mg
daily. Her physical exam is normal; her blood pressure is 128/86, her pulse is
78, and her body mass index (BMI) is 30.5. Answer the following questions:
Is there any additional information you would want to
What are the variables you would take into account before
deciding how to help her?
What treatment will you recommend?
What nonpharmacological treatment would you suggest?
For medications, include dosages and schedules. Include
highlights of patient teaching and/or lifestyle alterations. Support your
decisions with at least one reference to a published clinical guideline and one
Discussion Question 2
VG is a thirty-one-year-old female who comes in for a
routine follow-up. She reports that she has been feeling excessive fatigue over
the last month. She also notes that she is having some problems at work, not
only because of her fatigue but also because of difficulty concentrating. She
also notes that she has gained 10 pounds over the last month, and she is unable
to identify the cause of the weight gain. She also notes that her periods are a
little heavier and more irregular. She is currently taking daily ferrous
sulfate and over-the-counter calcium. According to her medical record, she had
a TSH level of 4.2 mIL/L about a year ago. Although this is slightly elevated,
no further follow-up was deemed necessary at the time. Repeat blood work today
reveals a TSH level of 9.8 mIL/L and a free T4 of 0.72 ng/dL. Answer the
What additional findings on the physical exam would you look
What implication does the previous TSH level have?
What therapy would you institute?
If VG becomes pregnant, what adjustment, if any, would be
needed in her thyroid medication?