Question

Case Scenario # 4

You are making a nursing visit to an older woman in her retirement facility. She was recently discharged from the hospital after treatment for a gastric ulcer that resulted from pain medications she was taking for arthritis. During your initial conversation, as you inquire about her health, you notice that the patient appears distracted and seems to have difficulty following questions and giving answers. When you ask about her current medications, her responses indicate that she is unsure about what they are for and how to take them. When you ask her to show you her medications, she produces a large brown paper bag with about 10 bottles: two bottles of a diuretic labeled “Take two tablets twice a day,” three bottles of potassium chloride labeled “Take fi ve tablets a day in divided doses,” one bottle of a histamine blocker labeled “Take one capsule daily,” one bottle of analgesic containing oxycodone to take “as needed arthritis pain,” one bottle of extra-strength acetaminophen, one bottle of stool softener capsules to take “as needed,” and one bottle of another analgesic containing codeine to take “every 4 hours as needed.” As you continue inquiring about which medications she takes and when she takes them, you learn that she has age-related macular degeneration and is legally blind.

   

   1.   From the information the woman shared with you, identify possible factors that may make it difficult for the patient to adhere to her medication regimen, possibly threatening her health.

   2.   Propose a course of timely and appropriate nursing actions.

   3.   What other individuals or healthcare professionals might you want to collaborate with concerning this situation?  

Answer 1

1) The possible factors that may make it difficult for the patient to adhere to her medication regimen are :-

- Age related memory loss

- Age related sensory loss ( she is legally blind )

- No support system

- Confusion

- Gets distracted easily

2) Appropriate Nursing actions :-

- Making arrangements for her support system to take care of her.

- Explanation of the actions of the medications in verbal and also writting it on the bottles in simple terms .

- Explaining how to take the doses of drug .

- Distribution of the different bottles in different boxes and mentioning the action of the drug and it's doses

- Explaining the importance of compliance to medications

- Teaching the importance of regular follow up

- Providing knowledge about the warning signs and when to reach a physician .

3) The other individuals or healthcare professionals i want to collaborate with are :-

- Rehabilitation team

- Counsellor

- Medical social worker