Melodee7
Read the case study to answer the question below What type of…
Read the case study to answer the question below
What type of medication is this and why should elderly patients refrain from taking this medication?
Case Study J.L.
You are a home health nurse following a client for the past two months. J. L. is a 65-year-old-male with a 12-year history of poorly managed hypertension. Two months ago, J. L. had a left transmural myocardial infarction (full thickness of the left ventricular myocardium). He still complains of significant shortness of breath; on a follow-up chest x-ray performed by his cardiologist, he has mild pulmonary edema in both lung bases. Recent echocardiogram shows an ejection fraction of 35%. He was diagnosed with diabetes mellitus Type 2 when admitted to hospital for his heart attack.
J. L.’ s height is 5’11” and weight is 265 lbs. with a BMI of 37. He worked as an employee in a warehouse and was required to do heavy lifting and continuous movement. In his free time before his MI, when not doing outdoor activities with his family, he was out with his friends fishing and hunting. He has developed significant exercise intolerance since the MI. As he is not able to do his previous work duties, his employer offered him a desk job at a reduced salary. While J. L. is eligible for social security, he did not want to retire for several more years and is struggling with the reduction in pay and not being around his co-workers. Since he is still short of breath on exertion, he does not feel he can do the extracurricular activities with his family like he use to. He is afraid of having another heart attack, so he does not want to go out with his friends to even go fishing as it is too far away from a hospital. His wife has pulled you aside and let you know of her concerns as he is always angry and lashing out at her. He hides inside the house watching TV or on the computer and does not want to see his old co-workers or friends.
Current medications for J. L. include:
Amlodipine 5 mg oral route AM
EC ASA 325 mg oral route daily
Terazosin 1 mg oral route at bedtime
Somatostatin 20 mg oral route daily
Glyburide 10 mg oral route AM
When talking to J. L., he tells you that he is not sleeping and taking Tylenol® PM nightly. He occasionally feels very anxious about his current health condition so occasionally take one of his wife’s Oxazepam to help with anxiety. He complains of lower back pain, especially when he has been sitting for a while and takes over the counter (OTC) NSAIDs 2 to 3 pills four times per day. J. L. is spending a lot of time on the computer researching supplements that he can take to make “my heart stronger.” He asks for your opinion on adding Red Yeast Rice and L-arginine into his medication regimen. J. L.’s wife is also concerned about his mood and wants you to advocate for an anti-depressant to be prescribed for her husband.
Evaluate the type of grief experienced by J. L., identify two nursing diagnoses, and a nursing intervention for each diagnosis that are going to help J. L. address his losses. Using the Beer’s Criteria Download Beer’s Criteria, evaluate the prescribed and OTC medications used or desired by J. L. Discuss the education you would provide to the client and his wife, and what advocacy would you do to the provider regarding prescribed medications to manage polypharmacy and/or inappropriate medications in older adults.
