Elder Interview: Medication Use and Nutrition - Essay Example

ELDER INTERVIEW Elder Interview Word Count: 1000 (4 pages) Log Entry #3 – Medication Use and Nutrition (25 points) 

 Ask your client toshow you all of his/her medications, including other-the-counter drugs and herbs. Record all meds. Ask the following questions: (7 points) 
 PART I. 1. Reason for taking med? When is it taken? (248) Temazepam was prescribed for short-term management of insomnia and for anxiety or sleep problems; it’s taken orally at bedtime. Omeprazole is an anti-ulcer agent; it’s taken once or twice per day. Digoxin helps the heart to beat more effectively; ½ tab is taken daily. Lasix is taken orally 3 times daily as a diuretic which resolves water retention due to CHF. Singulair is a bronchodilator taken orally once daily. Warfarin is an anti-coagulant (a blood thinner) for reducing risk of cardiac events; the patient takes 2 tabs orally every evening. Diltiazem is an anti-arrythmic taken orally, twice a day in caplet form. Albuterol is a bronchodilator; the patient must take 2 puffs every four to six hours. Advair, an anti-asthmatic, is inhaled in one puff twice a day. Mesalamine is to treat inflammatory bowel disease; the patient takes 2 tabs orally twice a day. The patient also takes Pravastatin, which is a pipid-lowering agent for heart disease; the patient takes two tabs daily. Fluticasone is an anti-asthmatic; the patient should take 1 to 2 sprays in each nostril daily. Potassium chloride is taken by the patient as an electrolyte replacement; she takes this orally twice daily. Vitamin D is for prevention of vitamin deficiency; it is taken once or twice monthly. Hydrocodone is an opioid analgesic taken for pain management; 2 tabs are taken orally by the patient every 8 hours for pain. Nortryptiline is a tricyclic anti-depressant; 4 caplets are taken at bedtime, not to exceed 5 caps total. 2. What reminders does he/she use to remember to take the med? (14) The patient sets an alarm so she will know when to take her medications. 2a. Are these reminders effective? (10) These reminders appear to be very effective for the patient. 3. Any noted side effects experienced? (12) The side effects the patient experiences are some fatigue and occasional dizziness. 4. Is his/her physician aware of OTC or herbs that are taken? (15) The patient’s physician is aware of any over-the-counter or herbal medicines that are taken. 
 5. Any hospital admissions due to an adverse reaction, mishandling, or overdose? (14) There were no hospital admissions due to an adverse reaction, mishandling, or overdose. 
 6. From whom or where does your client receive information regarding meds? (9) My client receives information regarding medications from her doctor.

 After the interview, refer to a drug reference text and answer the following questions: 
(10 points) PART II. 
 1. Does your client understand the reasons for taking the meds? (59) Yes, the patient notices right away when she doesn’t take her diuretic, because her hands and feet get swollen. She knows when it’s time for her pain medication, the Hydrocodone—and she knows because she begins to have pain. She knows that, if she doesn’t take her Advair and Singulair, she’s not going to be able to breathe right. 2. Does your client understand the “common” side effects, including the OTCs and herbs? Give examples. (39) The patient understands many of the common side effects that go along with the over-the-counter medications as well as her prescribed medications. For example, she tries to plan taking most of her sedative medications before she goes to bed. 3. Is your client at risk for an adverse reaction? Why? (19) This particular client is at risk for adverse reactions because she is allergic to shellfish, as well as aspirin. 4. How does the number of meds taken by your client compare to the number of meds taken by your hospitalized clients? Does your hospitalized client have a better understanding of his/her meds as compared to your community dwelling client? (85) The number of medications taken by my patient is a lot compared to the number of medications taken by hospitalized clients. Hospitalized clients generally do not have better understandings of their medications than this particular patient—who knows why each medication is being used. Also, usually the amounts of medication that are taken by the patient in the hospital are not as many because the patient is being monitored by the hospital. Overall, my interview client understands each of the meds she takes and why. 5. What conclusions can you draw regarding medication use in the older adult? (58) This patient sees her medication management as a way of life; she knows that she depends on these medications for her well-being and is faithful in taking her necessary medications. It is a good idea to make sure that, according to Deglin and Vallerand (2011), that she understands the seriousness of having to take her medications (pp. 5). Ask your client the following questions related to nutrition: (8 points) 
 PART III. 1. What foods does your client typically eat within a 24-hour period? (40) Usually my patient has a breakfast of yogurt and toast, or cereal and coffee. She eats simply, but only eats if she feels hungry. Right now she might be considered a failure to thrive, since she is a taller individual. 2. Is your client following a specific, restricted diet? Describe food allergies. (40) There is no particular restriction for the client’s diet, except that she must follow a low-sodium, low-fat, low-calorie, low-sugar diet. The client is allergic to shellfish and aspirin, but other than that she doesn’t have any severe restrictions per se. 3. Does your client experience difficulty shopping for groceries? (20) The client does experience difficulties when her fibromyalgia or Crohn’s disease flares up. She must stick to her medication schedule. 3a. Who does the shopping and meal preparation? (20) The client’s daughter does the shopping, or, alternatively, she orders her groceries from Safeway.com online. She prepares her own meals. 4. Does your client skip meals due to impaired function, change in appetite, or financial difficulties? (22) Sometimes, when the patient is in great pain, she doesn’t feel like eating and she will skip a meal here and there. 4a. Does culture/religion prohibit any food? (19) This patient has no cultural or religious prohibitions that would inhibit her from eating anything to which she is not allergic. 5. Does your client have chewing or swallowing difficulties or report noticeable changes in taste? (17) The client’s dentures don’t fit properly so she has to eat foods that she can chew easily. 6. Is your client taking sufficient fluids to prevent dehydration? Is your client following a fluid-restricted diet? (16) This patient drinks plenty of water each day. There are no fluid restrictions on this patient. 7. Record and analyze a 24-hour meal plan followed by your client. Include the amount and type of fluids, dietary supplements, use of assistive devices, and vitamins. (248) 
 The client’s typical day consists of the following. Usually, every day, the client has yogurt and cereal, and coffee with cream. For a snack, she usually eats a piece of cheese or fruit with cottage cheese, and has a glass of water. For lunch, she eats a sandwich made with her favorite deli meat, or has a cup or bowl of soup, usually with water or a diet soda. She tries to have a light meal in the middle of the day so she’s not too full. Usually for dinner, the client has baked chicken breast. She also makes brown rice and broccoli, and usually has a glass of water every evening with dinner. The patient’s snack is a diet ice cream bar that is low in sugar and low-calorie. The patient drinks 2 to 3 glasses of water between meals, in addition. The patient does not use “assistive devices” of any kind. She happens to take a multivitamin with breakfast. Obviously, this is not necessarily the best diet that she could have. According to Larson and Larson (2009), one should have “healthful, complete balanced meals for breakfast and brunch, everyday dinners…” (pp. 14). Balanced meals are healthy choices. Seniors, especially, like the client in question, should definitely make sure to take their vitamins, because people like the client are at risk for bone density loss if she doesn’t take extra calcium. She only drinks water and diet soda. This should be highly recommended to her attending physician. 
 REFERENCES Deglin, J.H., & Vallerand, A.H. (2011). Daviss drug guide for nurses, 12th edition. Philadelphia: F.A. Davis Company. Larson, I., & Larson, A. (2009). Whole foods diet cookbook: 200 recipes for optimal health. US: Gibbs Smith. Read More