Reference no: EM133485112
Case Study: Mrs. P. is an 80-year-old woman recently discharged from a 24-hour observation stay at the hospital after being diagnosed with acute bronchitis. She has a history of heart failure, hypertension, osteoarthritis, GERD, and hyperlipidemia. She has no history of smoking. While in the hospital she was prescribed doxycycline, prednisone 15 mg to taper, and a tiotropium inhaler. Her current list of daily medications prior to hospitalization includes metoprolol succinate 12.5 mg, pantoprazole 40 mg, atorvastatin 10 mg, lisinopril 10 mg, furosemide 40 mg, potassium chloride 20 meq bid, acetaminophen 650 mg bid for pain and tramadol 25 mg as needed. She lives alone but will reside temporarily with her daughter while she recovers. Her discharge report indicated resolving bronchitis, no exacerbation of heart failure, and stable arthritic pain. Today she reports 1 week after discharge with her daughter for a primary care appointment, and they both were concerned about the number of medications she was prescribed and wanted her medications reviewed. In further review, she was found to have lost weight over the past 6 months of 5 lbs and her current BMI is 25. She states that the weight loss may be due to a change to a healthier diet and reducing sodium as instructed. She also reports no symptoms of GERD for the past 6 months and minimal arthritic pain because of regular use of acetaminophen and daily walking in the halls of her independent living facility. Upon examination her lungs are clear to auscultation and no evidence of lower extremity edema.
Discuss the following:
Question 1) In reviewing her medication list and current symptoms and clinical signs, which medication could the nurse practitioner consider de-prescribing.
Question 2) Once the patient has completed the prednisone taper, which medication could the nurse practitioner begin to reduce given the patient's reported symptoms.
Question 3) Given the absence of an exacerbation of heart failure and compliance with a reduced sodium diet, what other medication(s) adjustments could the nurse practitioner consider at this time.
What are some of the alternatives to regional integration
: What are some of the alternatives to regional integration, and how do they compare to the benefits and drawbacks of trade blocs?
|
Should individual be held accountable for making unhealthy
: Should individual be held accountable for making unhealthy lifestyle choices? If your view is that they should held accountable how would they held accountable?
|
How should a company respond to a product harm crisis
: How should a company respond to a product harm crisis? The role of corporate reputation and consumer-based cues. Business Horizons, 49(5), 379-385.
|
How large is organization and what positions do people hold
: Who do they serve? Who benefits from their services? How large is the organization and what positions, in general, do people hold in the organization?
|
List and current symptoms and clinical signs
: list and current symptoms and clinical signs, which medication could the nurse practitioner consider de-prescribing. which medication could the nurse
|
Operation and control of doubly-fed induction generator
: MMH624492 Smart Grid and Sustainable Energy System, Glasgow Caledonian University - Operation and control of Doubly-Fed Induction Generator Wind Turbine
|
Describe the assessment of a patient, detailing the signs
: Describe your clinical experience for the final week as a student nurse practitioner at a family health clinic caring for older adult patients.
|
Describe your healthcare organization, including its culture
: describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous
|
Briefly explain the use of Phase Locked Loop
: Calculate the impedance of line AB in Ohms and Calculate Loads B active and reactive powers in MW and MVAR, respectively.
|