The primary care NP sees a woman who has been taking HT for ...

[bucstennis@aim.com]

The primary care NP sees a woman who has been taking HT for menopausal symptoms for 3 years. The NP decreases the dosage, and several weeks later, the woman calls to report having several hot flashes each day. The NP should:
 
  a. increase the HT dose.
  b. discontinue HT.
  c. recommend black cohosh to alleviate symptoms.
  d. reassure her that these symptoms will diminish over time.

Question 2

A patient comes to the clinic complaining of low back pain unrelieved by NSAIDs. The patient has a history of angle-closure glaucoma and renal disease. The primary care NP should prescribe:
 
  a. tizanidine (Zanaflex).
  b. metaxalone (Skelaxin).
  c. acetaminophen (Tylenol).
  d. cyclobenzaprine (Flexeril).

[lindahyatt42]

Answer to Question 1

A
The Women's Health Initiative results indicate that HT use for 3 to 5 years is safe and recommend slow weaning after women review HT with their providers at annual visits. If symptoms recur, the dose should be increased until symptoms improve.

Answer to Question 2

B
Metaxalone may be taken by patients with angle-closure glaucoma and is metabolized by the liver, so it is safe for this patient. Tizanidine should not be given to patients with renal disease because clearance may be reduced by more than 50. After using NSAIDs with no relief, recommendations are to change to a muscle relaxant. Cyclobenzaprine is not recommended in patients with glaucoma.

[bucstennis@aim.com]

Thank you!

[lindahyatt42]

Always glad to help...