Medication in The Elderly Discussion Essay

NUR 39700: General Discussion Guidelines

This course makes extensive use of online discussions. Due dates and times for initial posts and replies are given in the Course Schedule. Points possible for each discussion are given in the Syllabus.

I will post instructions in each forum, including the purpose of the discussion and the questions/topics to be covered, but others may be generated over the course of the discussion. Listed below are some guidelines and requirements for these online discussions:

1. Your “initial post” is an original idea posted in response to the faculty question(s) and assigned topic(s). Be sure to make your initial post prior to the due date/time. Late initial posts are NOT accepted for grading. Medication in The Elderly Discussion Essay
   

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*Note: For the EBP discussions, failure to attach the complete guideline as instructed will result in loss of points for the initial post.

2. Log in to the course site, checking the forum frequently.
3. Make a minimum of 2 posts as replies to your peers prior to the due date/time. Late reply posts are NOT accepted for grading. Reply with substantive comments. “Substantive” is not “Yes, I agree” or “No, I don’t see that” or “I like what you said,” and so on. These types of comments alone do not add to or advance the conversation. Offer comments that are reflective and demonstrate critical thought. What can you say that would move the conversation forward? Agreeing or disagreeing is fine, but say why. Offer examples. When necessary and appropriate, use scholarly references from the literature to support your thinking and rationales. There are no “right” or “wrong” answers. Consider asking questions of your classmates. You are surrounded by people with varied backgrounds, professionally and personally, as well as varied individual strengths and challenges. Draw on others’ knowledge and expertise; this is your opportunity to learn and grow from each other!
4. I do not require a minimum or maximum number of words per post or per reply. Treat the online discussion forum as you would if you were face-to-face in class; address the question/topic while being succinct and articulate. However, one or two sentences is rarely enough to add to the discussion in a substantive manner.
5. I expect to see citations and references in your posts, demonstrating your ability to draw on scholarly material to support your ideas. Unless directed otherwise in a specific discussion forum, I do not generally require that you use and include a minimum number of references in your posts and replies. While opinions are ok to include, they should be supported by scholarly references when possible. You must be able to properly cite and reference others’ work. Additionally, it is important to understand what a “scholarly” reference/resource is. In general, these are articles written by people who are considered experts in a particular field and published in peer-reviewed sources (i.e., journal articles).
6. Use scholarly and professional presentation (i.e., writing or speaking) at all times. When referencing and citing materials in written form, use correct APA formatting. Write and/or speak in complete sentences with correct grammar. Texting/shorthand-type posts are not considered professional or scholarly. Medication in The Elderly Discussion Essay

Points will be assigned according to a rubric. In general, points are earned based on quality of responses, adherence to discussion guidelines, and according to the required number of postings as specified in individual forum instructions. As in other online activities, remember to treat one another on the discussion board as you would in person; be respectful and considerate at all times. Please follow the rules of netiquette. Your peers, Academic Coach, and Course Faculty will be viewing the posts. Posts considered disruptive will not be allowed (e.g., off-topic, offensive to individual or group of people, foul/abusive/threatening language, etc.).

In sum, please keep three words in mind: professional, meaningful, and decent. Since this is a baccalaureate-level nursing course, students are expected to write and/or speak in a professional manner, similar to what you would do in any professional setting. When participating in class discussions, it is important to make contributions meaningful. Try to avoid making “I agree” comments or offering up generic platitudes that do not add value to the discussion at hand. Discussions are moved forward by asking intelligent questions and bringing facts, logic, and course material to the table. As always, please keep in mind that there is a real live person on the other end of the conversation. Treat everyone with whom you interact with decency.

NUR 39700: Week 2 Discussion: Medication in the Elderly

You are assigned a new admission. The client’s diagnoses include:

1) Dementia

2) Parkinson’s disease

3) CVA with residual L-sided weakness

4) Osteoporosis

5) Urinary incontinence

6) Recurrent UTIs

7) Hypertension

8) CAD; stent 2 years ago

9) CHF (EF 30%)

10) Atrial fibrillation

11) Hyperlipidemia

12) Osteoarthritis, especially hips and knees

13) Macular degeneration

14) Type 2 DM

15) Peripheral neuropathy

16) Chronic renal insufficiency

17) Anemia

18) Hypothyroidism

19) COPD on oxygen

20) Diverticulosis Medication in The Elderly Discussion Essay

The client’s medication list includes:

1) donepezil (Aricept) 5 mg PO daily

2) Sinemet 10/100 PO TID

3) aspirin 325 mg PO daily

4) warfarin (Coumadin) 5 mg PO qHS

5) tolterodine (Detrol) 2 mg PO BID

6) atorvastatin (Lipitor) 40 mg PO qHS

7) insulin (long-acting and sliding scale)

8) gabapentin (Neurontin) 300 mg PO TID

9) iron sulfate 325 mg PO TID

10) trazodone 50 mg PO qHS

11) levothyroxine 50 mcg PO daily

12) furosemide (Lasix) 60 mg PO BID

13) potassium chloride 20 mEq PO daily

14) metoprolol 100 mg PO BID

15) lisinopril 20 mg PO daily

16) amlodipine 10 mg PO daily

17) acetaminophen 1,000 mg PO TID

18) docusate sodium 100 mg PO BID

19) polyethylene glycol powder (Miralax) 17 g PO daily

20) tiotropium (Spiriva) 18 mcg inhaled daily

21) montelukast (Singulair) 10 mg PO daily

22) fluticasone/salmeterol (Advair) 100/50 inhaled BID

23) Albuterol/Atrovent nebulizers PRN for wheezing

24) multivitamin one PO daily

25) vitamin E 400 IU PO daily

26) calcium carbonate 500 mg PO TID

27) vitamin D 800 units PO daily

28) kava root 100 mg PO QID

29) nitrofurantoin (Macrobid) 100 mg PO qHS

Based on your review of the three references found in the library guide under readings and the information in the case study:

1) List three medications you would have concerns in administering to an elderly client and explain why.

2) Discuss what alternatives you might recommend to either the client or provider.

3) Describe the teaching and/or information you would need to provide to ensure the client understands the medication regimen prior to disch

Medication in the Elderly

One of the medications that should be administered to the elderly adult sparingly includes Aspirin 325 mg PO daily. That is because aspirin use in adults tends to irritate the stomach lining, and in other cases, it may trigger gastrointestinal upsets, bleeding, and ulcers, making it riskier for individuals with bleeding problems. Hence, if the healthcare provider has to administer the medicine, it should be the low-dose aspirin from 75mg to 100mg. Also, Furosemide (Lasix) 60 mg PO BID must be avoided since the patient has a urinary incontinence issue. According to Kumpf and Parrish (2022), healthcare providers should evaluate if the patient has bladder emptying issues, liver diseases, systematic lupus erythematosus, or diabetes. Levothyroxine 50 mcg PO daily must also be avoided since it has high mortality rates for the elderly. Hence, since the patient has hypothyroidism, there will be a need to use the drug carefully or look for an alternative drug.

The most effective alternative medication to Aspirin 325 mg PO daily is Ibuprofen, two 200mg capsules or tablets thrice per day. That is because it is an effective painkiller for headaches, arthritis, and other types of pain since it is a nonsteroidal anti-inflammatory drug (Balamurugan & Lakshmanan, 2021). For Furosemide (Lasix) 60 mg PO BID, Metolazone 5mg daily helps potentiate the furosemide diuretic effects making it easier to treat fluid retention. Consequently, Levothyroxine 50 mcg PO daily needs to be replaced with WP Thyroid 32.5 mg/day since it is more effective in treating hypothyroidism (Burgos et al., 2021). Medication in The Elderly Discussion Essay

Patient education is essential to the patient since it helps improve the overall patient outcome. Therefore, the first step will be engaging the teach-back strategy to ensure that the patient clearly understands how they need to take the medication. However, it will also be essential

Medication in the Elderly
Weekly Objectives 1 and 2 are addressed in this discussion.

Needed document: Medication Worksheet

Review the medication and diagnosis list (link above) along with the items from the library guide (link within the medication assignment document) to critically analyze this client. Answer the following questions.

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Explain which of the medications you would have concerns in administering to an elderly client and why. (Minimum of three)

Discuss what alternatives you would recommend to either the client or provider (as appropriate).
Describe the teaching you would provide and/or information you would need to ensure that the client understands related to the medication regimen prior to discharge.
Your response posts should be to students that identified medications other than those you discussed in your initial post. Medication in The Elderly Discussion Essay