Reference no: EM133776637
Medication Reconciliation and Deprescribing
This assignment requires you examine medication reconciliation and deprescribing of medications in the older adult population. A cased based approach will be used to provide the opportunity to develop a management plan for two older adult patients.
This paper should be a maximum of 5 pages, excluding title and reference pages. An abstract is not required. It should adhere to APA 7th edition. The assignment has 2 parts.
Part One-Examine the principles of reconciliation and deprescribing.
What is medication reconciliation and deprescribing?
What types of tools/methods are available to help make decisions?
Part Two-Provide a management plan for the following patients using the following as a guide.
Identify 2 potential new diagnoses based on the case provided.
For the identified diagnoses, provide a management plan including diagnostic tests, non-pharmacological options, pharmacological options, patient education, follow-up plan, and referral (if needed). Your plan should include deprescribing elements.
Case Number One
Mr. Walter Lutz, a 92-year-old man, who lives in an assisted living facility complains of dizziness and weakness for the past 3 weeks. He has had several episodes where he has almost fallen, and his wife is very concerned. He has no known allergies. His past medical history includes atrial fibrillation, hypertension, osteoarthritis, and benign prostatic hypertension. His surgical history includes cholecystectomy and right knee arthroscopy. His current medications are warfarin 4 mg daily, bisoprolol 5 mg daily, valsartan 40 mg BID, and tamsulosin 0.4 mg daily. He takes Tylenol 325 mg every 4 hours for his arthritis.
On exam, W. L. appears well, slightly pale, his vital signs are P- 58 and irregular, blood pressure sitting 102/66, respiratory rate 18 and oxygen saturation is 94%. The remainder of his physical exam is as follows:
Alert and orientated, PERL @ 3mm, cranial nerves intact,
Head and neck unremarkable
S1S2, no murmurs, no extra heart sounds, no peripheral edema
Air entry equal bilaterally, no adventitious sounds
Abdomen soft, non tender
Slight kyphosis noted
Mildly confused to place and time, orientates easily,
Head and neck unremarkable
S1S2, no murmurs, no extra heart sounds, no peripheral edema
Air entry equal bilaterally, no adventitious sounds
Abdomen soft, non tender
Case Number Two
Mrs. Myrna Woods, an 85-year-old woman, has just been admitted to an assisted living facility. She requires some help with her ADL's due to mild cognitive decline but has no specific concerns. You are completing her admission exam and writing orders to guide her care. She has no known allergies. Her past medical history includes osteoporosis, osteoarthritis, hypertension, and dyslipidemia. Her surgical history includes hysterectomy for menorrhagia in her 40's. Her current medications are alendronate 70 mg weekly, calcium 500 mg BID, Vitamin D 1000 units daily, hydrochlorothiazide 25 mg daily, amlodipine 5 mg daily, crestor 20 mg daily, and zopiclone 7.5 mg at hs. She takes advil prn for her knee pain.