Posted: September 27th, 2022

NUR 39700: Week 2 Discussion: Medication in the Elderly

NUR 39700: Week 2 Discussion: Medication in the Elderly

You are assigned a new admission. The client’s diagnoses include:

1) Dementia

2) Parkinson’s disease

3) CVA with residual L-sided weakness

4) Osteoporosis

5) Urinary incontinence

6) Recurrent UTIs

7) Hypertension

8) CAD; stent 2 years ago

9) CHF (EF 30%)

10) Atrial fibrillation

11) Hyperlipidemia

12) Osteoarthritis, especially hips and knees

13) Macular degeneration

14) Type 2 DM

15) Peripheral neuropathy

16) Chronic renal insufficiency

17) Anemia

18) Hypothyroidism

19) COPD on oxygen

20) Diverticulosis

The client’s medication list includes:

1) donepezil (Aricept) 5 mg PO daily

2) Sinemet 10/100 PO TID

3) aspirin 325 mg PO daily

4) warfarin (Coumadin) 5 mg PO qHS

5) tolterodine (Detrol) 2 mg PO BID

6) atorvastatin (Lipitor) 40 mg PO qHS

7) insulin (long-acting and sliding scale)

8) gabapentin (Neurontin) 300 mg PO TID

9) iron sulfate 325 mg PO TID

10) trazodone 50 mg PO qHS

11) levothyroxine 50 mcg PO daily

12) furosemide (Lasix) 60 mg PO BID

13) potassium chloride 20 mEq PO daily

14) metoprolol 100 mg PO BID

15) lisinopril 20 mg PO daily

16) amlodipine 10 mg PO daily

17) acetaminophen 1,000 mg PO TID

18) docusate sodium 100 mg PO BID

19) polyethylene glycol powder (Miralax) 17 g PO daily

20) tiotropium (Spiriva) 18 mcg inhaled daily

21) montelukast (Singulair) 10 mg PO daily

22) fluticasone/salmeterol (Advair) 100/50 inhaled BID

23) Albuterol/Atrovent nebulizers PRN for wheezing

24) multivitamin one PO daily

25) vitamin E 400 IU PO daily

26) calcium carbonate 500 mg PO TID

27) vitamin D 800 units PO daily

28) kava root 100 mg PO QID

29) nitrofurantoin (Macrobid) 100 mg PO qHS

Based on your review of the three references found in the library guide under readings and the information in the case study:

1) List three medications you would have concerns in administering to an elderly client and explain why.

2) Discuss what alternatives you might recommend to either the client or provider.

3) Describe the teaching and/or information you would need to provide to ensure the client understands the medication regimen prior to discharge.
====
Writing Guide:
Three medications that may raise concerns in administering to an elderly client include:
a) Warfarin (Coumadin): Warfarin is an anticoagulant that may increase the risk of bleeding in elderly patients. Elderly patients may also have difficulty managing the medication regimen, leading to potential complications. Additionally, warfarin has many drug interactions, including interactions with many of the other medications listed in the client’s medication list, which could increase the risk of bleeding or other adverse effects.

b) Gabapentin (Neurontin): Gabapentin is an anticonvulsant medication that is often used to treat neuropathic pain. However, it can cause sedation, confusion, and dizziness, which could lead to falls and other complications in elderly patients. Additionally, gabapentin can interact with other medications, such as opioids, which could increase the risk of adverse effects.

c) Kava root: Kava root is a natural supplement that is sometimes used to treat anxiety and insomnia. However, it can interact with many medications, including those used to treat Parkinson’s disease and depression, potentially leading to adverse effects. Additionally, the safety of kava root is unclear, and it may be associated with liver toxicity.

Alternatives to consider:
a) Warfarin (Coumadin): Alternatives to warfarin may include newer anticoagulant medications, such as apixaban or dabigatran, which may be easier to manage and have fewer drug interactions.

b) Gabapentin (Neurontin): Alternatives to gabapentin may include non-pharmacologic treatments, such as physical therapy, massage therapy, or acupuncture, as well as other medications, such as pregabalin or duloxetine, which may have fewer adverse effects.

c) Kava root: Given the potential risks associated with kava root, it may be best to avoid this supplement and consider other non-pharmacologic treatments or alternative medications, as appropriate.

Teaching and information to provide:
a) Ensure the client understands the name, dose, frequency, and route of administration for each medication.

b) Review potential adverse effects and drug interactions for each medication.

c) Discuss strategies for managing medication regimens, such as using pillboxes or setting reminders.

d) Emphasize the importance of taking medications as prescribed and not altering doses without consulting a healthcare provider.

e) Provide information on how to refill prescriptions and obtain new medications, as needed.

f) Encourage the client to ask questions and seek clarification as needed to ensure full understanding of the medication regimen.
g) Provide information on how to monitor for potential adverse effects or drug interactions, and when to seek medical attention if concerns arise.

h) Discuss the importance of regular follow-up appointments with healthcare providers to monitor the effectiveness and safety of the medication regimen.

i) Provide information on lifestyle modifications, such as diet and exercise, that can support medication management and overall health.

j) Review any special instructions for administration, such as taking medications with food or avoiding certain activities after taking specific medications.

k) Provide clear and concise written instructions for the medication regimen, along with contact information for healthcare providers and pharmacies.

l) Encourage the client to involve a family member or caregiver in medication management and to communicate any concerns or difficulties with medication administration to healthcare providers

Order | Check Discount

Tags: best dissertation writing services, best research paper writing services, college paper writing service, dissertation writing services cost, dissertation writing services near me, dissertation writing services reviews