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NR568 Final Exam Study Guide Week 5 to 8

Detailed nursing notes on hormone replacement therapy (HRT), including indications, estrogen vs. progestin use, local vs. systemic options, and prevention of osteoporosis in menopausal women.

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NR568 Final Exam Study GuideWeek 5Prevention of osteoporosis with hormone replacement therapy-HT reducespostmenopausal bone loss and thereby decreases the risk for osteoporosis and relatedfractures.Unfortunately, when HT is stopped, bone mass rapidly decreases by approximately12%. ****Hence to maintain bone health, HT must continue lifelong.***HT should be considered only for women with significant risk for osteoporosis, and onlywhen that risk outweighs the risks of HT.A person on HT and pts, in general, should practice primary prevention of bone loss byensuring adequate calcium and vitamin D intake, regular weight-bearing exercise, andavoiding smoking and excessive alcohol use.When and when not to use progestin for hormone replacement therapy and why-combined estrogen-progestin therapy for women with an intact uterus. Estrogen-onlyHRT can be given to someone with a hysterectomy. Progestin isrequiredto preventestrogen-associated endometrial hyperplasiaLocal vs. systemic estrogen options and whyone would be chosen over the other-intravaginal preparations are most helpful in treating symptoms associated with localestrogen deficiency, such as vaginal and vulvar atrophy; these preparations areassociated with a lower risk of systemic effectsprogesterone is contraindicated in women who have undergone a hysterectomy butrequired in women with an intact uterus who have undergone hormone replacementtherapyIV administration is generally limited to acute, emergency control of heavy uterinebleeding.One of the two available vaginal rings (Estring) are used only for local effects, primarilytreatment of vulval and vaginal atrophy associated with menopause.The other vaginal ring (Femring) is used for systemic effects (e.g., control of hot flashesand night sweats) as well as local effects (e.g., treatment of vulval and vaginal atrophy).oPeri-menopausal estrogen therapy (ET) -remains the most effective treatmentoption for relieving perimenopausal and menopausal hot flashes and nightsweats.taken to compensate for the loss of estrogen that occurs during menopause.There are two basic regimens for HT: estrogen alone (ET) and estrogen plus aprogestin (estrogen/progestin therapy [EPT]).The purpose of estrogen in both regimens is to control menopausal symptoms byreplacing estrogen that was lost owing to menopauseTransdermal estrogen therapy has fewer adverse effects.-The total dose of estrogen isgreatly reduced (because the liver is bypassed).There is less nausea and vomiting.Blood levels of estrogen fluctuate less.There is a lower risk for DVT, pulmonary embolism, and stroke.1

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