A 46-year-old, 230lb woman with a family history of breast cancer. She is up to date on yearly mammograms. She has a history of HTN. She complains of hot flushing, night sweats, and genitourinary symptoms. She had felt well until 1 month ago and she presented to her gynecologist for her annual gyn examination and to discuss her symptoms. She has a history of ASCUS about 5 years ago on her pap, other than that, Pap smears have been normal. Home medications are Norvasc 10mg qd and HCTZ 25mg qd. Her BP today is 150/90. She has regular monthly menstrual cycles. Her LMP was 1 month ago.
An efficient treatment strategy will be developed using the patient’s family history of breast cancer, obesity, and atypical squamous cells of unknown significance (ASCUS). A woman’s risk of having breast cancer is increased if she has close relatives who have the disease. Compared to women who maintain a healthy weight, overweight and obese women are more likely to get breast cancer. The most frequent abnormal pap test result is ASCUS, but the evidence is not definitive that this increases the risk of invasive cancer diseases. As a result, women with ASCUS who receive regular care are at low risk of developing invasive cancer (Tai et al., 2018).
A diagnosis of perimenopause is reasonable given the patient’s age and complaints of hot flashes, nocturnal sweats, and genitourinary symptoms. According to Santoro (2016), perimenopause is a transitory period marked by significant hormonal and reproductive changes that surround the final years of reproductive life. Since the patient is still having regular periods but exhibiting vasomotor symptoms (VSM) like hot flashes and night sweats along with genitourinary symptoms, it is likely that she is in the early stages of menopause. Beginning in the mid-40s, the transition can extend for up to 5-8 years before menstrual cycles finally stop (Roberts & Hickey, 2016).
Treatment Option
Hormone therapy is frequently used to treat vasomotor symptoms brought on by menopause (HT). According to Roberts and Hickey, hormone therapy ought to be avoided in this patient because she has a family history of breast cancer (2016). There are options available for treating menopause symptoms. The antidepressants Pristiq and Lexapro can significantly lessen the frequency and intensity of hot flashes, according to Rosenthal and Burchum (2021).
Additionally, the patient’s high blood pressure needs to be treated. I would initially encourage her to lose weight to treat her hypertension. It has been demonstrated that cutting back on carbohydrates and exercising more frequently can assist women in perimenopause lose weight (Santoro, 2016). If It would also be reasonable to increase her hydrochlorothiazide dosage to 50 mg at this time in order to aid in shedding extra water weight and bringing her blood pressure down.
Recommended Education Strategy
The diagnosis of perimenopause, dietary modifications, drugs, and blood pressure control would all be covered in the lessons. The patient would require explanations of the menstrual cycle, menopause, and, the reasons why HT cannot be used to treat her genitourinary symptoms and VSM because of her family history of breast cancer. By showing the patient how to count carbohydrates and choose healthier foods, you can help them lose weight and eventually get improved blood pressure readings. Teaching her how to take her blood pressure at home and when to call for potential dose modifications is also crucial.
References
Roberts, H., & Hickey, M. (2016). Managing the menopause: An update. Maturitas, 86(2016), 53-58.
https://doi.org/10.1016/j.maturitas.2016.01.007
Rosenthal, L. D., & Burchum, J. R. (2021). Lehnes pharmacotherapeutics for advanced practice
nurses and physician assistants (2nd ed.). Elsevier.
Santoro, N. (2016). Perimenopause: From research to practice. Journal of Womens Health, 25(4), 332-339.
https://doi.org/10.1089/jwh.2015.5556
Tai, Y. J., Chen, Y. Y., Hsu, H. C., Chiang, C. J., You, S. L., Chen, C. A., Cheng, W. F., & Taiwan Cervical Cancer Control Task Force (2018). Risks of cervical intraepithelial neoplasia grade 3 or invasive cancers in ASCUS women with different management: a population-based cohort study. Journal of gynecologic oncology, 29(4), e55.
https://doi.org/10.3802/jgo.2018.29.e55

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discussion 9

Cyberattacks
Prior to beginning work on this discussion, please read all of the required resources for this week. Review the instructions below and research a minimum of three additional scholarly sources in the UAGC Library that were published within the last 10 years to help support your statements. Be sure to include a reference list for your articles at the end of your post in APA format as outlined by the UAGC Writing Center.
Cyberattacks are a dangerous innovation in warfare and have become one of the greatest threats to national security since the turn of the 21st century. From a professional, evidence-based perspective, address the following.

Evaluate at least one key ethical and one key legal challenge pertaining to the United States government engaging in cyberattacks against other nations and entities.
Explain at least one technique that the United States currently utilizes to protect valuable data from potential cyberattacks from other nations and entities.

Analyze whether the technique you explained has any legal, ethical, or moral ambiguities.

Required Resources
Articles
Brust, R. (2012).Cyberattacks: Computer warfare looms as the next big conflict in international lawLinks to an external site.. American Bar Association Journal, 98(5), 40-45.

The full-text version of this article can be accessed through the Academic OneFile database in the UAGC Library. This article explores some of the realities and hidden dangers related to cyberattacks from an international law perspective.

Healey, J. (2011). The spectrum of national responsibility for cyberattacksLinks to an external site.. Brown Journal of World Affairs, 18(1), 57-70.

The full-text version of this article can be accessed through the EBSCOhost database in the UAGC Library. This article examines who is responsible for cyberattacks on a national level.

Ristuccia, H. & Baich, R. (2012). Preparing for corporate cyberattacksLinks to an external site.. Corporate Board, 33(196), 11-15.

The full-text version of this article can be accessed through the General OneFile database in the UAGC Library. This article explores the increasing external threats that companies may face from outside cyberattacks.

Robb, D. (2014). Could HR Be the Next Target?Links to an external site.. HR Magazine, 59(7), 50-53.

The full-text version of this article can be accessed through the General OneFile database in the UAGC Library. This article explores whether HR departments and professionals are vulnerable to cyberattacks, and includes suggestions for prevention.

Woldt, J. (2016). Prepare now for a cyberattackLinks to an external site.. Credit Union Magazine, 82(1), 24-28.

The full-text version of this article can be accessed through the EBSCOhost database in the UAGC Library. This article discusses how credit unions can prepare for a cyberattack.

Recommended Resource
Website
MSCJ Professional SourcesLinks to an external site.. (http://ashford-mscj.weebly.com/)

This resource site will provide assistance in researching additional sources for the assessments within this course.