Pearl Homan has just been admitted to Baycrest Long Term Care… Pearl Homan has just been

Pearl Homan has just been admitted to Baycrest Long Term Care… Pearl Homan has just been admitted to Baycrest Long Term Care facility for rehabilitation services following pin placement for a patellar fracture two week ago. Before she was injured, she used a pickup walker and did not normally climb stairs. She was active in weekly church-sponsored outings, but otherwise lived a sedentary lifestyle due to her mild mobility problems. All she wants to do is regain her former independence.  Medications:1. Potassium Chloride 20 mEq by mouth daily.2. Colace 100 mg by mouth once daily.3. Losartan 100mg 1 tab PO daily4. Coumadin 2.5mg one tab PO dailiy5. Spironolactone 25 mg by mouth daily.6. Metformin 1000mg 1 tab PO once a day sustained release tablet 1. Review the medication order for metoprolol and write the medication research. Generic name and popular Trade name(s) for this drugDrug classificationWhat is this drug typically used for?Describe the pharmacokinetics of the drug:Onset (O)Peak (P)Duration (D)Half-life (1/2)Metabolized where (M)Excreted (E) Questions 2. Identify the age-related factors that alter the pharmacokinetics response and increase the risk of medication related problems. 3. What are the factors that have contributed to the polypharmacy for Pearl? 4. Diuretic: Name the diuretic medication Pearl is taking.a. What is the indication for the diuretic for Pearl? b. What are the risk factors and contraindications for taking this medication? c. What nursing assessment would be needed when caring for Pearl? d.  What blood values should the nurse assess prior to giving the diuretic?  Pearl was diagnosed with type 2 diabetes 10yrs ago and manages her blood sugar well on her oral medication.  After surgery Pearl’s glucose was very high 18mmol/L and required IV insulin. After 24hrs Pearl was switched to Regular insulin SC.   a. Explain why Pearl required Regular Insulin to control her blood glucose post-surgery. b.What are the sympathetic nervous system and central nervous system responses to altered blood glucose (BG) level? Explain the rationale for the responses. During your morning assessment Pearl presents lethargic, confused and slurring her words. Her glucose reading was 2.8mmol/L.  c. What action will you take to respond to Pearl’s blood glucose level? d. What nursing implementations are required for the administration for Regular Insulin SC?  Pearl has restarted on her Metformin a few days before her transfer to the long-term care hospital.  Her husband is concerned about the change and unsure if she should start back on her oral medications. e. Explain the mechanism of action for Metformin. f. What are the adverse reactions and contraindications for the medication Metformin? What is Pearl at risk for? g. The physician has ordered bloodwork and contrast radiology testing to be completed before Pearl is transferred. Which lab values and assessment findings are important to report to physician? During Pearl’s hospital stay she received LMW heparin SC. Before her discharge to the long-term hospital this medication was switched over to Coumadin. 7. Anticoagulation medication: Name the medications Pearl is taking. a. Explain the why patients are temporarily started on two anticoagulants before transitioning to an oral formulation. b. What is the potential risk during this transition time?c.  Explain why Pearl was prescribed Coumadin.  What are the nursing implications for this medication—state clearly what you will monitor. Identify the adverse effects of Coumadin and the risk for Pearl.    8. Antihypertensive:  Name the medication Pearl is taking.a. Explain the mechanism of action and nursing implications for Pearl for this medication. (4marks) You start afternoon assessment of your patients and find Pearl crying in her bed. You explore why she is upset. Pearl explains she is in pain after her physiotherapy and would like her pain medication. You advise Pearl you can give oxycodone 5mg pain medication to help her feel more comfortable.  Pearl explains I feel ‘full and nauseated’… “I think my pain medication is making me constipated.”  9. Laxative: Name the medication Pearl is takinga. What nursing physical assessments should be completed? What questions and further data would you ask and collect from Pearl? b. Explain the mechanism of action and possible adverse effects Pearl may experience from the laxative prescribed. c. What health teaching and patient education would you provide Pearl to help her prevent constipation.    Health Science Science Nursing PNM 300 Share QuestionEmailCopy link Comments (0)

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