case study SP is a 53-year-old white female, G1, P1, from…

case study SP is a 53-year-old white female, G1, P1, from… case study SP is a 53-year-old white female, G1, P1, from Washington state. She is sexually active and presents with a 8-month history of vasomotor symptoms. she averages 6 or more hot flashes per day and is frequently awakened by night sweats. SP feels that her symptoms make it difficult for her to concentrate and cause her to be irritable, affecting her ability to do her job and negatively impacting the quality of her relationships. She is experiencing a decrease of libido and is thinking about getting a divorce.SP has an intact uterus but has had no menstrual periods for 1 year. She is 5’7″ in height and weighs 126 lbs, for a body mass index (BMI) of 19.8. She does not routinely exercise and has smoked 1 pack of cigarettes per day for 20 years. Although she takes a multivitamin/mineral tablet each day, SP is uncertain about the doses of calcium and vitamin D provided by this supplement. Her mother and a maternal aunt had osteoporosis, and her mother has sustained a hip fracture. SP has no family or personal history of breast cancer and has not had a breast biopsy.SP is uncertain about HT because of the negative press coverage following publication of the results from the WHI hormone trials. She is concerned about the possibility of developing breast cancer even though she has no personal or family history of this disease. SP is also concerned about the possible risk of developing Alzheimer’s disease (AD). She does not voice any concern about bone health. Please answer the following s based upon the above scenario.1. Based on the ACOG committee opinion, what evaluation and counseling would you conduct for this patient?2.  Should postmenopausal vaginal bleeding be evaluated? 3.  How would you diagnose the patient with vaginal atrophy? 4.  What treatment options for a patient with valvovaginal symptoms without a history of breast cancer?5.  What are non-hormonal treatment options for a patient with vaginal atrophy? 6.  Discuss Bio-identical hormones.  Would you prescribe them for this patient? 7.  What guideline would you use to develop your treatment plan? 8.   2 EBP resources within the 5 years.Health Science Science Nursing NUR 734

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