NUR 39700: Medication In The Elderly Discussion
NUR 39700: Medication In The Elderly Discussion
One of the medications that should be administered to the elderly adult sparingly includes Aspirin 325 mg PO daily. That is because aspirin use in adults tends to irritate the stomach lining, and in other cases, it may trigger gastrointestinal upsets, bleeding, and ulcers, making it riskier for individuals with bleeding problems. Hence, if the healthcare provider has to administer the medicine, it should be the low-dose aspirin from 75mg to 100mg. Also, Furosemide (Lasix) 60 mg PO BID must be avoided since the patient has a urinary incontinence issue. According to Kumpf and Parrish (2022)NUR 39700: Medication In The Elderly Discussion, healthcare providers should evaluate if the patient has bladder emptying issues, liver diseases, systematic lupus erythematosus, or diabetes. Levothyroxine 50 mcg PO daily must also be avoided since it has high mortality rates for the elderly. Hence, since the patient has hypothyroidism, there will be a need to use the drug carefully or look for an alternative drug.
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The most effective alternative medication to Aspirin 325 mg PO daily is Ibuprofen, two 200mg capsules or tablets thrice per day. That is because it is an effective painkiller for headaches, arthritis, and other types of pain since it is a nonsteroidal anti-inflammatory drug (Balamurugan & Lakshmanan, 2021). For Furosemide (Lasix) 60 mg PO BID, Metolazone 5mg daily helps potentiate the furosemide diuretic effects making it easier to treat fluid retention. Consequently, Levothyroxine 50 mcg PO daily needs to be replaced with WP Thyroid 32.5 mg/day since it is more effective in treating hypothyroidism (Burgos et al., 2021)NUR 39700: Medication In The Elderly Discussion.
Patient education is essential to the patient since it helps improve the overall patient outcome. Therefore, the first step will be engaging the teach-back strategy to ensure that the patient clearly understands how they need to take the medication. However, it will also be essential to inform the patient that once they notice any adverse side effects from the medications, they should seek medical help to prevent the medicine from triggering other health issues.
References
Balamurugan, J., & Lakshmanan, M. (2021). Nonsteroidal anti-inflammatory medicines. Introduction to Basics of Pharmacology and Toxicology, 335-352. DOI: 10.1007/978-981-33-6009-9_19
Burgos, N., Toloza, F. J., Singh Ospina, N. M., Brito, J. P., Salloum, R. G., Hassett, L. C., & Maraka, S. (2021). Clinical outcomes after discontinuation of thyroid hormone replacement: a systematic review and meta-analysis. Thyroid, 31(5), 740-751. https://doi.org/10.1089/thy.2020.0679
Kumpf, V. J., & Parrish, C. R. (2022). The Clinician’s Toolkit for the Adult Short Bowel Patient Part II: Pharmacologic Interventions. PRACTICAL GASTROENTEROLOGY, 13. https://med.virginia.edu/ginutrition/wp-content/uploads/sites/199/2022/08/July-2022-Pharmacologic-Interventions-for-SBS.pdf NUR 39700: Medication In The Elderly Discussion
Medication in the Elderly
Weekly Objectives 1 and 2 are addressed in this discussion.
Needed document: Medication Worksheet
Review the medication and diagnosis list (link above) along with the items from the library guide (link within the medication assignment document) to critically analyze this client. Answer the following questions.
Explain which of the medications you would have concerns in administering to an elderly client and why. (Minimum of three)
Discuss what alternatives you would recommend to either the client or provider (as appropriate).
Describe the teaching you would provide and/or information you would need to ensure that the client understands related to the medication regimen prior to discharge.
Your response posts should be to students that identified medications other than those you discussed in your initial post.
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
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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. NUR 39700: Medication In The Elderly Discussion