Integrated Nursing Practice

Table of Contents

Introduction.

Discussion.

Discussion of the pathophysiology of PCOS.

Discussion of diagnostic assessments used to diagnose PCOS.

Discussion of pharmacological management of PCOS.

Conclusion.

Reference list

Introduction to Integrated Nursing Practice

Polycystic ovary syndrome (PCOS) is measured as hormonal disease prevailing mostly among the women close to the age of reproduction. It mainly results in the enlargement of the ovaries within the women bodies with a formation of the small cysts within the outer edge of the outer edges. In this respect, the present study will be dealing with the discussion of pathophysiology, diagnostic assessment, and therapy alongside pharmacological management of PCOS (Polak et al. 2017).

Discussion on Integrated Nursing Practice

Discussion of the Pathophysiology of PCOS

The abnormality related to the endocrinology of PCOS begins after menarche. The two most common endocrine aberrations that are being experiment in the disease of PCOS include insulin confrontation and luteinising hormone (LH). In addition to this, it can also be noted that high LH alongside hyperinsulinemia work synergistically mainly relates to the growth of the ovarian cysts and androgen production. The disease of PCOS (McCartney & Marshall, 2016) primarily targets 50% to 60% of the people suffering from obesity. It increases the resistance of the insulin alongside the hyperinsulinemia. Aa observed in the case study, Sharon is having the issue of excess weight gain. She gained 20 kg in the past 5 years. The resistance of insulin is further classified through the aspects of impaired action in the metabolism and uptake of the glucose. However, as argued by Azzizet al. (2016), an elevated level of insulin results from impaired actions in terms of insulin.

It further causes a decrease in the insulin-like growth factor binding protein (IGFBP-I) and sex hormone-binding globulin (SHBG). From the obtainable case study, it can be further detected that Sharon is also suffering from increased hirsuitism, acene and suffered from cessation of menses few years ago. However, the trade of the mentioned aspects seems to be appearing in the subgroup of the patients suffering from PCOS. Acanthosis Nigerians is considered a marker of the insulin generally found at the nape of the neck. However, it is usually found within 30% of the women suffering from the above-mentioned disease (Dokraset al. 2018). Other symptoms related to the current condition include pelvic pain, excess hair growth in the different parts of the body, acne, deeper voice, loss of hair from the head and many others most of which is seen within Sarah, a 26 years old Caucasian female. Hence, proper pathophysiology detection of PCOS can be useful in formulating a suitable solution. 

Discussion of Diagnostic Assessments Used to Diagnose PCOS

Proper diagnostic assessment assists in the diagnosis of the PCOS, further implementing proper cure for the disease. However, no adequate test is used for the determination of PCOS within the human body. Nonetheless, as argued by Polak et al. (2017), Laboratory test is the most viable way of diagnosing PCOS. This includes blood tests such as Testosterone for testing excess androgens, SHBG as it is considered to be reduced in terms of PCOS and Anti-Müllerian hormone (AMH) as the level of the mentioned aspect is considered to be increasing in terms of PCOS (Delitalaet al. 2017). In addition to this, there are specific secondary test executed with respect to the current disease.

It includes Thyroid-stimulating hormone (TSH), Cortisol, Prolactin, 17-hydroxyprogesterone, HCG, IGF-1 and many others. Other than that, checking the glucose level cholesterol, lipid panel and many others are also used for the diagnosis of the current disease (Polak et al. 2017). Besides, there is also a specific non-laboratory test, including pelvic ultrasound for the evaluation of the ovaries, looking for cysts and many others. As the ovaries become 1.5 to 3 times larger than the reasonable condition of the ovaries, therefore, it can be checked without any types of laboratory equipment. However, the test of Sarah reflects that her heart rate is 72bpm, while her temperature reflects 35.50C. Other than that, her respiration rate has been tested as 16/minute and her blood pressure is 128/76m. Based on the heights of Sarah that is 172 cm, her BMI reflects 32 giving her a weight of 96 kg. However, her heart and lung sounds are normal giving her proper access to breathing and strong blood flow. Hence, the test conducted of Sarah provides a close confirmation of PCOS.

Discussion of Pharmacological Management of PCOS

Based on the tests mentioned above, proper treatment is analysed for the disease of PCOS. However, as reflected from the thoughts of Bellveret al.(2018), there is no such specific care or treatment of PCOS, and it is observed to be getting cursed on its own. The treatment of PCOS is reflected from the severity of the symptoms and the available options. Best options, however, are likely to be described by the physicians based on the severity of the condition. Apart from that, there are specific general treatments adopted for PCOS. Following proper duet prescribed by the fitness expert can be useful for Sarah for treating the 20 kg of weight gain alongside adequate exercise. As obesity is the leading cause of PCOS in the case of Sarah and in general, therefore, reduction of body weight can be helpful in curing PCOS.

Metformin drug is also prescribed by the doctors in this situation for treating diabetes and insulin resistance. Besides, for treating acne, antibiotics can be prescribed to Sarah alongside the prescription of oral contraceptives for the treating of menstrual periods that will be effective in treating the infertility and cessation of menses. Nonetheless, the doctors for stabilising the condition of hormones also mandate other medicines; induce ovulation, risk of cancer and others (Franiket al. 2018). This will also help Sarah in fighting the miscarriages faced her in the past years. Moreover, treatment such as laser treatment, waxing, depilatory, shaving and others are also used for the reduction of excess fat from the body and make the skim presentable one. Hence, as there is no such particular treatment of OCOS, different types of treatment are applied for the various symptoms raised within the body.

Conclusion on Integrated Nursing Practice

From the above-presented discussion, it can be observed that PCOS is a high threat and is mainly prevailing within the teenage girls or women. In the current case, it can be seen Sarah is suffering from obesity and also suffer from PCOS. The symptoms mainly present the enlargement of the ovaries, formation of cysts, excess fat, scene, hair fall, excess hair in different operates of the bidet and many others. In the current scenario, a laboratory test is used to detect several symptoms of PCOS through a blood test and others. However, through observing the enlargement of the ovaries and cysts, PCOS is also identified without any help from the laboratory. Henceforth, proper dieting and other treatment related to the symptoms raised within the body PCOS can be cured.

Reference List for Integrated Nursing Practice

Azziz, R., Carmina, E., Chen, Z., Dunaif, A., Laven, J. S., Legro, R. S., ... &Yildiz, B. O. (2016). Polycystic ovary syndrome. Nature reviews Disease primers, 2(1), 1-18. Retrieved on 25 July 2020, from: http://www.medfer.cl/uploads/2/3/1/4/23144434/azziz2016.pdf

Bellver, J., Rodríguez-Tabernero, L., Robles, A., Muñoz, E., Martínez, F., Landeras, J., ... & Acevedo, B. (2018). Polycystic ovary syndrome throughout a woman’s life. Journal of assisted reproduction and genetics, 35(1), 25-39. Retrieved on 25 July 2020, from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5758469/

Delitala, A. P., Capobianco, G., Delitala, G., Cherchi, P. L., &Dessole, S. (2017). Polycystic ovary syndrome, adipose tissue and metabolic syndrome. Archives of gynecology and obstetrics, 296(3), 405-419. Retrieved on 25 July 2020, from: https://www.researchgate.net/profile/Giampiero_Capobianco/publication/317849544_Polycystic_ovary_syndrome_adipose_tissue_and_metabolic_syndrome/links/5a2ffff9aca27271ec89e2a8/Polycystic-ovary-syndrome-adipose-tissue-and-metabolic-syndrome.pdf

Dokras, A., Stener-Victorin, E., Yildiz, B. O., Li, R., Ottey, S., Shah, D., ... &Teede, H. (2018). Androgen Excess-Polycystic Ovary Syndrome Society: position statement on depression, anxiety, quality of life, and eating disorders in polycystic ovary syndrome. Fertility and sterility, 109(5), 888-899. Retrieved on 25 July 2020, from: https://www.fertstert.org/article/S0015-0282(18)30064-5/fulltext

Franik, S., Eltrop, S. M., Kremer, J. A., Kiesel, L., & Farquhar, C. (2018). Aromatase inhibitors (letrozole) for subfertile women with polycystic ovary syndrome. Cochrane Database of Systematic Reviews, (5). Retrieved on 25 July 2020, from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010287.pub3/full

McCartney, C. R., & Marshall, J. C. (2016). Polycystic ovary syndrome. New England Journal of Medicine, 375(1), 54-64. Retrieved on 25 July 2020, from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5301909/

Polak, K., Czyzyk, A., Simoncini, T., &Meczekalski, B. (2017). New markers of insulin resistance in polycystic ovary syndrome. Journal of endocrinological investigation, 40(1), 1-8. Retrieved on 25 July 2020, from: https://link.springer.com/content/pdf/10.1007/s40618-016-0523-8.pdf

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