Exercise Content

1. Use APA 6 or 7th Edition Format and support your work with at least 3 peer-reviewed references within 5 years of publication. Remember that you need a cover page and a reference page. All paragraphs need to be cited properly. Please use headers.  All responses must be in a narrative format and each paragraph must have at least 4 sentences. Lastly, you must have at least 2 pages of content, no greater than 4 pages, excluding cover page and reference page.

   Week 12 Case Study: Osteoporosis

   J.S., a 72-year-old woman of Asian descent, has just transferred to your practice. She had a hysterectomy 8 years ago and has not been on hormone replacement therapy. She is 5 ft 2 inches tall and weighs 102 lb. She has had a sedentary lifestyle (she was a secretary and retired 2 years ago). She drinks four glasses of wine a day. Her mother died at age 62 from complications of a hip fracture. J.S.’s sister was just diagnosed with metastatic breast cancer. You prescribe a DEXA scan, and the T-score is −2.6 SD.

   Diagnosis: Osteoporosis

   1. List specific goals of therapy for J.S.
   2. What drug therapy would you prescribe? Why?
   3. What are the parameters for monitoring the success of the therapy?
   4. Discuss specific patient education based on the prescribed therapy.
   5. List one or two adverse reactions for the selected agent that would cause you to change therapy.
   6. What OTC or alternative medicines might be appropriate for this patient?
   7. What dietary and lifestyle changes might you recommend?
   8. Describe one or two drug–drug or drug–food interactions for the selected agent.

To support your work, use your course and text readings as well as the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format. Patient or lay person medical information portals such as webMD, Medscape, Mayo Clinic, or any disease foundations, such as the arthritis foundation or the diabetic foundation, are not acceptable resources for your scholarly work.

Discussion Prompt

Case Study
Anna Sanchez, a 21-year-old nursing student, comes to her nurse practitioner in December with a 5-week history of itchy eyes and nasal congestion with watery nasal discharge. She also complains of a “tickling” cough, especially at night, and she has had episodes of repetitive sneezing. She gets frequent “colds” every spring and fall.

Physical Examination

• Vital Signs: Afebrile; respiratory rate, pulse, and blood pressure all normal
• Skin: Flaking erythematous rash on the flexor surfaces of both arms
• Head, Eyes, Ears, Nose, and Throat: Tender over maxillary sinuses; sclera red and slightly swollen with frequent tearing; outer nares with red irritated skin; internal nares with red, boggy, moist mucosa and one medium-sized polyp on each side; pharynx slightly erythematous with clear postnasal drainage (NOTE: Nasal polyps are common in allergic rhinitis. They are edematous protrusions of the mucosa that are infiltrated with neutrophils, eosinophils, and plasma cells.)
• Lungs: Clear to auscultation and percussion

Initial Post: Answer the following questions about Anna Sanchez and her condition.

1. What evidence suggests that Anna does not have an acute severe infection?
2. If Anna has allergic rhinitis, what type of hypersensitivity reaction is involved?
3. A skin test indicates that Anna is allergic to cat dander. Two months ago, Anna’s roommate brought home a cat. Why didn’t Anna’s symptoms start when the cat entered the household, rather than 3 weeks later?
4. What class of antibodies bind to the mast cells?
5. What physiological mechanisms caused the redness of Anna’s nasal mucosa?
6. What mechanisms caused Anna’s clear postnasal drainage?

Go back into your own initial post.

• Identify what diagnostic testing or additional information you might need to establish a diagnosis.
• Identify what you believe is the correct diagnosis for the patient in the case study with the rationale for your response.
• Identify why the differential diagnoses left by your peers are or are not the correct diagnosis and support this with evidence from research and from the case posted by your peers.