283 Nursing Care of the Postmenopausal Woman, 3rd Edition
SCREENINGS COVID-19 has changed the way health- care is practiced. We now have virtual vis- its for many types of medical visits. Some patients find that it has become easier to handle minor problems at home or with the help of a virtual visit. In addition, some patients have been unwilling to re- turn to the health clinic, putting off rou- tine screenings and immunizations that are necessary for healthy living (Dickin- son et al., 2020). In this section, we dis- cuss the various tests and screening ex- ams that can detect health problems at an early stage, when intervention is most effective. As with all screening tests, ab- normal results do require further testing and follow-up. U.S. Preventive Services Task Force The U.S. Preventive Services Task Force (USPSTF) consists of experts in disease prevention and evidence-based medicine from around the U.S. The purpose of this task force is to improve people’s health by making ev- idence-based recommendations about clinical preventative services. The individ- uals on this task force are independent of any political affiliation (USPSTF, 2022). The USPSTF studies and reviews the literature regarding a particular recommendation and assigns it a letter grade of A, B, C, D, or I. From the letter grade, the healthcare provider can decide what to encourage the woman to do. The letter classifications mean: A : The USPSTF recommends this service. A substantial benefit is highly certain. B : The USPSTF recommends this service. The certainty of benefit is moderate. C : The USPSTF recommends this service based on individual patient
preference and professional judgement. D : The USPSTF recommends against this service. The service has no benefit, or the harm may outweigh the benefit. I : The evidence is lacking, is of poor quality, or is conflicting, and the balance of whether the service provides benefits or harms cannot be determined. This grading system has been used for many of the screenings discussed below (USPSTF, 2018b). Cardiovascular screening The USPSTF has concluded that there is insufficient evidence to screen adults with average health risks for cardiovascular disease on a regular basis, whether by electrocardiography or laboratory tests (USPSTF, 2018a). The American Heart Association (AHA) encourages providers to monitor certain key screening tests: ● Blood pressure : This is an important screening because high blood pressure generally has no symptoms, so it cannot be detected without monitoring. Blood pressure is one of the vital signs that is checked at every healthcare visit. Elevated blood pressure puts women at increased risk for cardiovascular disease, peripheral vascular disease, stroke, renal disease, and retinopathy (AHA, 2019). The AHA recommends that blood pressure be checked in every adult older than age 20. If the blood pressure is below 120/80 mm Hg, it should be checked at least every two years starting at age 20 (AHA, 2022). Individuals with a systolic blood pressure of 120 to 139 mm Hg or a diastolic blood pressure of 80 to 89 mm Hg should
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