A patient who has several risk factors for osteoporosis has a ...

[kfurse]

A patient who has several risk factors for osteoporosis has a bone density test that indicates osteopenia. The primary care NP plans to prescribe a bisphosphonate. Before initiating treatment, the NP should:
 
  a. order an upper GI x-ray.
  b. initiate PPI therapy.
  c. order serum calcium and vitamin D levels.
  d. prescribe a calcium and vitamin D supplement.

Question 2

A postpartum woman will begin taking the minipill while she is nursing her infant. The primary care NP should instruct the patient:
 
  a. to use backup contraception while taking the minipill.
  b. to continue using the minipill for 6 months after she stops nursing.
  c. that irregular periods while taking the minipill may indicate she is pregnant.
  d. that this method does not increase her risk of thromboembolic events.

[wfdfwc23]

Answer to Question 1

C
Patients must have adequate nutrition, calcium, and vitamin D. Hypocalcemia and vitamin D deficiency must be corrected before therapy is initiated. An upper GI x-ray is indicated only if the patient is symptomatic. Patients at risk for fracture should not take PPIs. Calcium and vitamin D supplements should be given with bisphosphonate therapy; however, the first action is to evaluate current serum levels.

Answer to Question 2

D
Minipills are used primarily in breastfeeding women. There is no increased risk for thromboembolic events for women taking these pills. It is not necessary to use a backup method of contraception. Women should be advised to contact the provider when they stop nursing so that a COCP can be prescribed. The more disrupted the bleeding pattern, the more likely it is that ovulation is inhibited.

[kfurse]

TYSM

[kjohnson]

Thanks for the timely response, appreciate it