Question

Case Study: Acid-Base Imbalance from Aspirin Overdose Millie is an 83-year-old female that lives with her cat, Sam, in a senior apartment. She suffers from rheumatoid and osteoarthritis, cataracts, and adrenal insufficiency, (Addison’s disease). She no longer drives but takes the bus to the market three times a week for groceries. Her church is at the end of the block, and she never misses a Sunday service. The home care nurse comes to see Millie once a week since she came home from the skilled care rehabilitation facility three weeks ago after fracturing her hip. Her physical therapist also comes to her home twice a week. Her rehabilitation is going well, and she is independent with the use of a walker when she is outside the house. Millie’s daughter and son live out of the state but stayed with her the first week after she returned home. During the visit the nurse reviews Millie’s medication bottles: Prednisone 5 mg tablets Furosemide 20 mg tablets ASA/Hydrocodone Aspirin Extra Strength . Reflect on the information the nurse colleted and answer the following questions: a. What are the top three highest needs for Millie right now? b. What interventions or assessment can be implemented immediately? c. Identify a risk to safety for Millie? d. Further assessment is needed to determine if there is a bigger issue? True or False

Answer 1

MILLIE AN 83 YEARS OLD LADY IS STAYING ALONE IN A SENIOR APARTMENT.

AFTER GOING THROUGH YOUR QUESTION I WOULD LIKE TO ANSWER ALL YOUR QUESTIONS.

a) TOP THREE NEEDS OF MILLIE I FEEL ARE 1.A SUPPORTIVE PERSON AT HOME

2.CHANGES IN THE HOME INFRASTRUCTURE

3.MEDICAL NEEDS LIKE REHABILITATIVE SERVICES,PHYSIOTHERAPY,MEDICATIONS

B) as her children are away from home, she needs a person to help her in her daily household activities

this also makes her happy because it reduces her loneliness

as she already had hip injury it is difficult for her to go out thrice a week so hiring a helper would reduce this tension

as she is aged and because of the medicines she uses,she might have a risk because all these medicines have a commonest side effect i.e blurred vision....so s supportive person at home is definitely needed.

HOME INFRASTRUCTURE:

slight changes are needed in the home environment because of risk of fall

--flooring should be non slippery

--sufficient lighting in the day and in the night

--grab bars in toilet

--avoiding steps if possible

--carpets if any should be fixed properly or removed

keeping all her medicines and other daily essentials separate

--MEDICAL NEEDS:

making sure that the rehabilitative nurse and physiotherapist visit her as planned

making sure she doesnt miss any of her follow up visits

using of medications properly

C) RISK TO MILLIE:

there are many risk factors in her case

1.her underlying disease conditions

2.rheumatoid arthritis may lead to osteoporosis especially because of the drugs

3.cataract-reduced vision because of this may lead to fall

4.her age-she might not cope up with the things very easily because of many factors related to age

5.emotional depression-she is at risk of this because of lack of support system at home

6.risk of fall-might be because of age or hip injury or drug effect etc

7.side effects related to drugs she uses. eg:osteoporosis,blurred vision,weight gain etc

8.anxiety related to the outcome and related to the stage she is passing by.

D) YES...definitely further assessment is needed regarding her underlying diseases,to find out the disease stage

and also she needs a review of the tablets mentioned because she already had a acid base imbalance because of aspirin and now she is again put on aspirin

and also no details provided about her vital signs and i think this aspect should always be reviewed in time.