Melissa is a 31-year-old, recently married female who presents to your office for an annual visit. She has three children ages 2, 5, and 8. Her new husband wants to wait at least a year before they try to have a child of their own. She has used combined oral contraceptives (COCs) for more than 10 years. Since the birth of her last child, she has been using COCs intermittently. She finds it too difficult to remember to take the pills regularly and wants an easier method.
Menses are regular, although her periods seem heavier than usual, and she gets more irritable when she is not taking the COCs. She rarely exercises and admits to smoking and drinking occasionally. She is overweight. She has no medical history. What additional information do you need to obtain? Discuss her options and provide evidence for your rationale. Include patient education in your discussion
Emily is a 44-year-old African American woman who presents with a 6-week history of initial insomnia and a 10-pound weight loss. She admits to feeling sad almost every day since she lost her job 6 weeks ago. She has no interest in engaging in previously enjoyable activities. She denies suicidality (ideation or plan).
She has never been treated for depression. Her physical examination is negative, vital signs and blood work including a thyroid profile is all within normal limits, and her body mass index is 22. Her mother has a history of depression and she was treated successfully with Sertraline. What medication should be considered for Emily and why? Does her age and childbearing potential influence your treatment decision? Is medication therapy enough? Please include medication education in your discussion.
Lilly is a 6-year-old girl who presents with a 2-week history of worsening redness, dryness, and rash to the volar aspects of the wrists and dorsum of the hands. The area is moderately pruritic. She has a history of stable asthma. On assessment, you note her rash is consistent with mild eczema. You would like to prescribe a topical corticosteroid.
What potency should be considered for this patient? Include the frequency of application and length of recommended treatment. What can be done about her pruritus? Are there any OTC ointments that should be considered for this patient? Include medication and general patient education in your discussion.
Use at least one scholarly source other than your textbook to connect your response to national guidelines and evidence-based research in support of your ideas.