285 Nursing Care of the Postmenopausal Woman, 3rd Edition
pharmacotherapy for smoking cessation. ● Electrocardiogram : There is currently no recommendation for annual screening by electrocardiogram for asymptomatic patients. As a woman ages, her risk for CVD increases, and it is up to the healthcare provider and the woman to decide if a regular electrocardiogram should be considered (AHA, 2019). Iron deficiency screening Testing hemoglobin and hematocrit is not usually recommended for an asymp- tomatic woman. However, if the woman has been having menorrhagia during her perimenopausal years or is age 65 or older, blood for hemoglobin and he- matocrit levels should be drawn. Anemia is common in older adults. After age 50, the incidence of anemia increases. This occurs primarily due to chronic disease, iron deficiency, vitamin B12 deficiency, folate deficiency, and/or gastrointestinal bleeding (Katsumi et al., 2021; National Library of Medicine [NLM], 2022b). This screening may be recommended for a woman who has symptoms such as weak- ness, dizziness, pale skin, cold hands and feet, a family history of an inherited blood disorder, a diet low in iron or minerals, or blood loss after injury or surgery (National Heart, Lung, and Blood Institute [NHLBI] 2022; NLM, 2022b). Blood chemistry panel The blood chemistry panel (also called the complete metabolic profile ) evaluates blood sugar as a preliminary screen for di- abetes. The test also checks kidney func- tion and liver enzymes, as well as elec- trolytes and acid–base balance. It can be used to monitor known conditions such as hypertension, use of certain medica- tions, and kidney or liver illness. Some of
the tests require fasting beforehand. The patient must be informed of the necessity of fasting and how long she should fast (AACC Lab Tests Online, 2022). Diabetes screening A woman who presents with any of the signs and symptoms of diabetes—poly- dipsia, polyphagia, or polyuria—should be tested. However, there are no clear symptoms of prediabetes, so a woman may have it and not know it. But a wom- an who is overweight or has hypertension (or both) should be screened using the glycosylated A1c test. This test measures the average amount of blood glucose over the past two to three months. If the A1c is normal, it should be repeated at least every three years. If abnormal, the healthcare provider and the woman will determine the need for further testing (AHA, 2019). A result of 6.5% or higher is diagnostic for diabetes. A result between 5.7% and 6.4% is diagnostic for predia- betes, and a result of less than 5.7% is normal. A woman who is diagnosed with prediabetes will not necessarily develop type 2 diabetes. She can lower her risk by losing weight, exercising moderately, and eating a healthy diet. If a woman already has diabetes, she may need other screen- ing tests such as albumin to creatinine ra- tio, ankle–brachial index, blood pressure, bone mineral density, body mass index, cholesterol and triglycerides, dilated eye exam, and estimated glomerular filtra - tion rate (American Diabetes Association, 2022).
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