nurs 6521 week 2 assignment:

Write a 2- to 3-page paper that addresses the following:

 Explain how the factor you selected might influence the pharmacokinetic and

pharmacodynamic processes in the patient from the case study you were

assigned. Factors can include behavior, age, gender, ethnicity, etc.

 Describe how changes in the processes might impact the patient’s

recommended drug therapy. Be specific and provide examples.

 Explain how you might improve the patient’s drug therapy plan and explain why

you would make these recommended improvements.

 

LM is an 89-year-old female resident of a long-term care facility who has been

experiencing multiple falls, some resulting in injuries such as bruising and skin tears. Over

the last 6 months, her ambulation status has declined from independent to wheelchair

level. She complains of pain in her legs when walking more than short distances across the

nursing unit.

PMH:

 HTN

 Alzheimer’s disease

 Hypothyroidism

 Osteoarthritis

 Diabetes

MEDICATIONS:

 Amlodipine 10 mg QD

 Donepezil 10 mg QHS

 Levothyroxine 0.88 mg QAM

 Celecoxib 200 mg QD

 Furosemide 40 mg QAM

 Metformin 500mg, 1 BID

 Glyburide 5mg, 1 BID

ALLERGIES: NKA

SOCIAL HISTORY:

Widowed with 2 adult children living in town, retired photographer and owner of an art

supply store

 

VITALS: LABS:

Weight: 129 lbs TSH 2.45        Free T4 0.98

Height: 64 inches

 

Na 135, K+ 3.8, Cl 99, CO2 25,

 

BP: Supine = 177/82

 

Glucose 101, SCr 0.9, BUN 42

 

HR: 78 bpm

 

WBC 7.0, RBC 4.5, Hgb 11.9, Hct 34.1

 

Plt 255

Cr: 1.6 UA: Clear

eGFR: 45 ml/min

PE:

 HEENT: Normocephalic, no evidence of trauma, PERRLA, EOMI, Dry mucous

membranes

 CV: RRR

 Respiratory: Clear to auscultation bilaterally

 Abdomen: Soft, non-tender, no masses or guarding

 G/U: Skin intact, assisted with toileting and personal hygiene by staff

 Extremities: Bilateral 2+ edema to lower extremities; skin dry, dark bruising and

skin tear to right elbow and forearm

 Neuro: Alert and oriented to person only. MMSE 18/30, stable over last 12

months.

PAIN ASSESSMENT:

Faces pain scale: No pain occurs at rest, upon walking, pain is moderate to severe