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- Patient is a 55 year old female with a diagnosis of diabetes. She was diagnosed when she was 50 aftershe changed jobs and became more sedentary and which also resulted in a poor diet. She currentlyoverweight with a BMI of 32.Allergies NKDACurrent MedicationsMetformin 1000 mg BIDLisinopril 10 mg once dailyPMH Propranolol 10 mg TIDDMHTNList the long term complications of DMOrdered; Nozinan 1'/2ounces subcut daily divided Into do ses for delirium lagitation• 3. Av ailable: NOzinan 2mg /ml Admiristered datly dose is Administered darly dose isA 76-year-old patient states, “I have been experiencing com-plications of diabetes.” The nurse needs to direct the patient to gain more information. What is the most appropriate com-ment or question to elicit additional information? a. “Do you take two injections of insulin to decrease thecomplications?” b. “Most physicians recommend diet and exercise to regulateblood sugar.”c. “Most complications of diabetes are related to neuropathy.”d. “What specific complications have you experienced?”
- Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia1. Discuss possible reasons this patient fell.2. List common side effects of Levodopa/Carbidopa3. He states that he doesn’t think his antidepressant is working. How will you address his concern?4. Which of his medications might be causing the insomnia? How could this be addressed?5. List some general education points regarding sleep hygiene.6. Do you have…Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomniaWhich of his medications might be causing the insomnia? How could this be addressed?Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia 1. His wife tells you that he has started having hallucinations. Which medication might be causing this?Discuss why this happens.
- Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia 5. List some general education points regarding sleep hygienePatient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia Do you have any concerns about his pain medication?Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week. Hx COPD, cor pulmonale It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindings Pulse – Regular,…
- Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week. Hx COPD, cor pulmonale It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindings Pulse – Regular,…Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week. Hx COPD, cor pulmonale It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindings Pulse – Regular,…Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week. Hx COPD, cor pulmonale It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindings Pulse – Regular,…
