Question

. 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 five 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. Describe the direction that your assessment might take in this situation.

2. 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.

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

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

Answer 1

1) The age- related macular degeneration is a disease condition that can lead to permanent loss of vision. Here, it is metnioned that the patient is legally blind. Therefore, the assessment should be like how to assess a blind person who really need help for her daily activities and medication administration. Besides this, she is an older woman. Thus, it is necessary to assess for memory problems and mental status. In this case, patient has the difficulty to follow the commands and understanding the questions. So, it is important to assess for other age related problems.

2) The factors that pause threat to the health of the patient is her blindness and her inability to understand the commands. Due to these reasons, it is difficult for her to adhere with her current treatment regimen.

3)

Provide adequate help for the patient to do her daily activities

Administer medications under the supervision of a nurse and teach her how to take medicines on time and which medicines to take

Encourage the patient to seek early medical help for the vision problems

Encourage the patient to verbalize her problems and ask for help if necessary

Provide adequate lighting in the room and keep necessary items near by the patient for her convenience.

4) Infrom the patient's current status and limitations to the consulting doctor and follow the doctor's order.

Inform the concerning helathcare members in the treating team regarding her limitations for ensuring adequate care.

Opthalmology consultation is also required to assist her to improve her vision.

Occupational therapy is also a good option for assisting the rehabilitation process.