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Ms. James is seen in the clinic today for evaluation of menopause symptoms. She is requesting hormone replacement therapy and reports currently taking a red clover herbal therapy:
A: What are the risks and benefits of hormone replacement therapy (HRT)?
B: Many women use herbal or alternative therapies for treating adverse symptoms of menopause. What teaching will Ms. James need about combining herbal treatments and HRT?
A: The benefits of hormone replacement therapy (HRT) help ease the discomforts and adverse effects of menopause. In early studies, HRT was shown to decrease coronary artery disease, slow down osteoporosis, decrease breast cancer, decrease colon cancer and improve memory. However, HRT should not be used more that 3-5 years because the risks of using HRT for fiver years or longer may increase cardiovascular disease, stroke, increase the chances of blood clots, gallstones and ovarian cancer.
B:: Since Ms. James stated she is currently taking an herbal remedy, called Red Clover, for hormone replacement therapy, she will need to stop taking the herb is she chooses a prescription therapy. This is due to the contraindications of HRT with herbal remedies. These contraindications include increased bleeding effects if she is on Warfarin or haparin and, when combined, can cause increased estrogenic effect.

Mr. Jones is an 80-year old, recently married gentleman who has been screened by his primaryt health care provider and received a prescription for Sildenafil (Viagra). He is requesting directions and information about Viagra. Develop a teaching plan that answers the following questions.
A: How does Viagra treat erectile dysfunction?
B: What are the adverse effects of Viagra?
A: Viagra helps treat erectile dysfunction by actingg to relax the vascular smooth muscle allowing the corpus cavernosum to fill from increased blood flow, thus causing an erection.
B: The adverse effects of Viagra include headache, flushing, stomach upset, diarrhea, dizziness, vision loss or blurred vision, loss of hearing, rash, and urinary tract infections. Erections should not last longer than 4 hours.

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