CASE STUDY:
Lillian Cho, a 65-year-old female client (DOB: 5/22/1959), presents for a follow up visit after having a routine DXA scan to assess for osteoporosis. She has a 3.6% 10-year probability of hip fracture and a 25% 10-year probability of a major osteoporosis-related fracture. The NP has ruled out the causes of secondary osteoporosis. Her physical exam is unremarkable, and her lab results are normal. Based on the DXA scores, Lillian is diagnosed with osteoporosis and the NP considers appropriate pharmacotherapy in addition to calcium and vitamin D.
Past Medical History: High Cholesterol
Allergies: None
Medications: atorvastatin (Lipitor) 40mg PO daily, aspirin 81mg PO daily
Social History: She has never smoked cigarettes and drinks alcohol on special occasions, estimated twice per year.
Physical Exam:
• Height: 5 ft 3 in
• Weight: 15lbs
• Body Mass Index (BMI): 26.6
• Blood Pressure (BP): 115/72
• Heart Rate (HR):  83
• Respiratory Rate (RR): 17 
• Oxygen Saturation (O2 Sat): 97% on RA
• Temperature (TEMP): 98.6 oral
Step 1: Assess the client’s case, the applicable clinical practice guideline (CPG), and the prescription writing activity for that client within the lesson.
Step 2: Answer the discussion prompts below with explanation and detail, providing complete references for all citations. Refer to the lesson for client information.
Answer the following sections:
I. Application of Course Knowledge: Answer all questions/criteria with explanations and detail.
1. Describe your assigned client’s situation. Why are they presenting to the clinic? What medications are they currently taking?
2. Assess the applicable clinical practice guideline (CPG) for the assigned client (it’s attached). What treatment is recommended by the CPG for your client’s situation? Reference where it was found like page number or something.
3. Discuss your personal professional assessment of the client’s situation provided in the scenario. What pharmacological treatment is necessary and why?
4. Reflect on additional questions you have about your assigned client that may influence treatment. What else do you need to know? What follow-up assessments, labs, or conversations are required to ensure optimal health outcomes?