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 1. Determine the specifics for each of Millie’s medications. For each shade ox in the table select the correct answer. Medication Dose/Route/Frequency Drug Class Patient Teaching Prednisone 5 mg po daily 1. Mineralocorticoid 2. Glucocorticoid 3. Loop Diuretic 4. Osmotic Diuretic Increase during times of stress Furosemide 20 mg po daily Diuretic Select all that apply: 1. Report signs of infection 2. Monitor potassium level 3. Weigh self-daily 4. Increase fluid intake ASA and Oxycodone 1-2 tablets every 4-6 hours for pain as needed Select all that apply: 1. Nonsteroidal anti-inflammatory 2. Narcotic 3. Analgesic 4. Antiplatelet Surgical site pain Aspirin Extra-Strength 1. 325mg po 2 tabs every 4 hours prn 2. 500 mg po 2 tabs every 6 hours prn 3. 650 mg 2 tabs every 4 hours prn 4. 1000 mg 2 tabs every 6 hours prn Analgesic, antipyretic, anti-inflammatory, and platelet aggregation inhibitors Arthritis pain 2. As the nurse reviews the medications, what is concerning?
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| Dose | Route | Frequency | Drug class | Patent education | |
| Prednisone | 5 to 60 mg | Oral | OD | Glucocorticoid |
|
| Furosemide | 20mg | oral | OD | Loop diuretics |
|
| ASA/Hydrocodone Aspirin extra strength | 325 mg | oral | whenever needed | narcotic analgesic |
|
When administration of furosemide the following side effects has to be observed and measures to be dine
OSA Hydrocodone is an analgesic and non steroidal anti inflammatory drug
The usually dosage for rheumatoid arthritis should not exceed 3 g /day
325 mg 2 tab every 4 hourly can be given
The things which can concern a nurse are
Case Study: Acid-Base Imbalance from Aspirin Overdose Millie is an 83-year-old female that lives with her...
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...
Nursing Report: Mrs. Millie Larson is an 84 year old female who lives alone in a two story house and is usually very independent, was admitted from the emergency department 45 minutes ago. The patient’s only daughter, Dina Olsen, accompanied her mother to the hospital. According to the daughter, she had last seen her mother three days ago at which time Millie was alert and oriented x 3 but didn’t seem her usual talkative self. When Dina called yesterday, her...
Millie Larsen is an 84-year old Caucasion female who lives alone in a small home. Her husband, Harold passed away a year ago and she has a cat, Snuggles, who is very important to her. Millie has one daughter, Diana Olsen, who is 50, that lives nearby, and Millie's major support system. Her current medical problems include: hyperyension, glaucoma, osteoarthritis of the knee, stress incontinence, osteoporosis and hypercholesterolemia. Millie is at the clinic for routine examination follow up. She is...
Millie Larsen is an 84-year-old Caucasian female who lives alone in a small home. Her husband, Harold, passed away a year ago and she has a cat, Snuggles, who is very important to her. Millie has one daughter, Dina Olsen, who is 50, that lives nearby, and is Millie's major support system. Her current medical problems include: hypertension, glaucoma, osteoarthritis of the knee, stress incontinence, osteoporosis, and hypercholesterolemia. Millie is at the clinic for routine examination and medication follow up....
Case Study - Grandmother Seventy-five-year-old Esther, an active grandmother who fractured her hip while hiking with her senior outing group, is a new patient on the 10th floor orthopedic unit of University Hospital at the OSU Wexner Medical Center. A nurse practitioner has examined Esther and prepared her admission orders (prescriptions and care instructions). The nurse practitioner entered the orders into the electronic medical record, which includes a Computerized Physician Order Entry system (CPOE). The prescription orders have just been...
SIM CASE SCENARIO: History and information Patient name: Sarah Grace 78 year old female admitted from emergency room at 1000 this morning with rib fractures from fall sustained while getting up to bathroom during night. Patient lives at home with her sister who is her primary caregiver. Admitted for PT and OT. Patient reports having generalized arthritis that she is taking ibuprofen on a regular basis. She has severe constipation and is taking multiple medications with minimal relief. Patient also...
Carol Petros (C. P.) is a 77-year-old female admitted to the hospital 4 hours earlier after a fall at home caused by dizziness and weakness. She was initially brought to the emergency department by her daughter, who checked on her after not reaching her by phone. Her medical history includes hypertension, osteoarthritis, and a hysterectomy at age 50. She states that she has an allergy to penicillin, and she is full-code status. The patient has lived alone since the death...
Patient name: Sarah Grace 78 year old female admitted from emergency room at 1000 this morning with rib fractures from fall sustained while getting up to bathroom during night. Patient lives at home with her sister who is her primary caregiver. Admitted for PT and OT. Patient reports having generalized arthritis that she is taking ibuprofen on a regular basis. She has severe constipation and is taking multiple medications with minimal relief. Patient also reports history of hypertension and cardiac...
Geriatric and Anticoagulants Case Study A 77-year-old female was brought to the emergency room after falling twice at her daughter’s home. The first fall was in the bathtub, where she slipped while rising from the shower chair. She fell a second time when leaving her daughter’s home to visit friends 2 hours later. Her daughter, who is present, states that her mother hit her head on the side of the house, and there is presently a large hematoma on the...
#1. Case Study Millie Larson is an 80 year old widow being seen in the Emergency Room. She complains that she hasn’t been feeling well the past few days. Your RN assessment is as follows: Chief complaint—“decreased appetite, not sleeping well, fatigue, abdominal pain off and on, constipation.” Past medical History: Hypertension, Atrial Fibrillation (A-fib), osteoporosis, anemia, Past Surgical History: Appendectomy, C-section x 2 Home Medications: Aspirin 81 mg daily, Metoprolol 100 mg daily, Oxycodone 5 mg q 4 hrs...