Explain how the factor (i.e. genetics, gender, ethnicity, age or behavior) you selected might influence the pharmacokinetic and pharmacodynamicprocesses in the patient from the case study you were assigned.
· 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. Would you discontinue any medications, change the dosage, and/or add medications to the patient’s regimen? DISCUSS EACH MEDICATION.
Case study assigned
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:
Metformin 500mg, 1 BID
Glyburide 5mg, 1 BID
ALLERGIES: NKA
BUN 42, Cr 1.6, UA Clear
eGFR: 45 ml/min
PE:
HEENT: Normocephalic, no evidence of trauma, PERRLA, EOMI
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
The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The College of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at
https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632Links to an external site.
). All papers submitted must use this formatting.
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Formatting
Title Page
Citation
Outline
